The Pediatric and Perinatal Autopsy Manual with DVD-ROM

Cover
Half-title page
Title page
Copyright page
Contents
Contributors
Foreword
Preface
Acknowledgments
Chapter 1 Perinatal autopsy, techniques, and classifications
	The perinatal autopsy
	Classification of perinatal deaths
	References
Chapter 2 Placental examination
	Introduction
	Placental anatomical and functional structure
	Indications for placental examination
	Examination of the placenta
	Gross examination
	Microscopic examination
	Pathology of the placenta
	Placental abruption or retroplacental hematoma
	Characteristic pathologic findings in specific disorders
	The placenta in the medico-legal arena
	Summary
	Acknowledgment
	References
Chapter 3 The fetus less than 15 weeks gestation
	Background
	Terminology
	Causes of early miscarriage (abortion)
	Autopsy objectives
	Practical issues
	Standard protocol
	External examination
	Internal examination
	Microscopic examination
	Clinical situations requiring additional investigations
	Conclusion
	References
Chapter 4 Stillbirth and intrauterine growth restriction
	Introduction
	Pathology and interpretation
	Intrauterine growth restriction
	The concept of optimal growth
	Small for gestational age vs. growth restriction
	Pattern of growth restriction “symmetrical vs. asymmetrical”
	IUGR as a category in stillbirth classification systems
	Post mortem assessment of growth
	External assessment
	Maceration
	Internal examination
	Histological examination
	Placenta
	Ancillary investigations
	The autopsy summary
	Causes of growth restriction
	The combined macrosomic and growth-restricted fetus
	The future
	Summary approach to the examination of the stillbirth
	References
Chapter 5 Hydrops fetalis
	Introduction
	Principal causes of HF
	Specific causes of HF
	Results of in utero treatment of HF
	The placenta in HF
	Practical tips for autopsy of HF
	Summary
	References
Chapter 6 Pathology of twinning and higher multiple pregnancy
	Introduction
	Pathological examination of the twin and higher multiple placenta
	Complications of twinning
	Conclusion
	References
Chapter 7 Is this a syndrome? Patterns in genetic conditions
	Introduction
	Patterns of inheritance
	Clinical approach
	Examination
	Head
	Face
	Neck
	Hands
	Feet
	Heart
	Lungs
	Gastrointestinal tract
	Kidneys and urinary tract
	Spine
	Central nervous system
	Genitalia
	Skeleton
	Minor congenital anomalies
	Syndromal associations
	Genetic counseling
	Genetic resources
	References
Chapter 8 The metabolic disease autopsy
	Introduction
	Clinical presentation
	Gross autopsy findings
	Microscopic autopsy findings
	General approach
	Disease groups
	Investigations and analysis
	Conclusion
	Appendix: common abbreviations used in this chapter
	References
Chapter 9 The abnormal heart
	Introduction
	Before the incision
	Autopsy technique
	Evidence of cardiac disease
	Examination of the arrangement of the organs (situs)
	Examination of the external features of the heart
	Dissection of veins and arteries
	Dissection of the heart
	Microscopic examination of the fetal and pediatric heart
	Structural abnormalities of the heart and great vessels: congenital heart disease
	Anomalies of position and situs
	Anomalies of the atria
	Anomalies of the atrioventricular connections
	Anomalies of the ventricles
	Anomalies of the ventriculoarterial connections
	Anomalies of the great arteries and coronary arteries
	Anomalies of the pulmonary veins
	Anomalies of the venae cavae
	Complications of congenital heart disease
	Pathology of the normally formed heart
	Conclusion
	References
Chapter 10 Central nervous system
	Introduction
	Autopsy examination and removal of the brain
	The autopsy
	Normal brain development
	Cellular reactions
	White matter damage
	Hemorrhages
	Strokes
	Infections
	Primary perivascular inflammation
	Trauma
	Metabolic diseases
	CNS malformations
	Microcephaly/megalencephaly
	Holoprosencephaly
	Other ventral forebrain malformations
	Corpus callosum anomalies
	Hydrocephalus
	Lissencephaly
	Brainstem and cerebellum malformations
	Abnormalities of meninges, choroid plexus, blood vessels, and phacomatosis
	Neurodegenerative diseases
	Neural tube defects
	References
Chapter 11 Significant congenital abnormalities of the respiratory, digestive, and renal systems
	Introduction
	Respiratory system anomalies
	Digestive system anomalies
	Kidney and urinary tract
	References
Chapter 12 Skeletal dysplasias
	Introduction
	Basic autopsy approach
	Common lethal skeletal dysplasias
	Dysostoses (Table 12.6)
	Limb hypoplasia/reduction defects
	Examples of non-genetic disorders with limb involvement often confused with skeletal dysplasias
	Summary
	References
Chapter 13 Congenital tumors
	Introduction
	Incidence of congenital tumors
	Germ cell tumors
	Neuroblastoma
	Congenital renal tumors
	Soft tissue tumors
	Tumors of skeletal muscle origin
	Neural tumors
	Congenital hepatic tumors
	Congenital cardiac tumors
	Congenital brain tumors
	Congenital hematolymphoid neoplasms
	References
Chapter 14 Complications of prematurity
	Introduction
	General approach to the post mortem examination of the premature infant
	Respiratory system
	Gastrointestinal system
	Liver
	Infection
	Complications of catheterization
	Central nervous system
	References
Chapter 15 Intrapartum and neonatal death
	Introduction
	Intrapartum asphyxia
	Diagnosis
	Intrapartum assessment
	Postpartum assessment
	Pathophysiology of intrapartum asphyxia
	Causes of intrapartum asphyxia
	Post mortem findings
	Late deaths
	Intrapartum trauma
	Type of injuries in intrapartum trauma
	Intrapartum trauma versus intrapartum asphyxia
	Neonatal infections
	The neonatal immune system
	Bacterial infections
	Viral infections
	Investigations
	Aseptic technique
	References
Chapter 16 Sudden unexpected death in infancy
	Definition
	Explained SUDI
	Unexplained SUDI or SIDS
	Risk factors for SIDS
	Triple risk hypothesis
	The home visit
	Role of the autopsy
	Autopsy procedure
	Classification systems
	References
Chapter 17 Infections and malnutrition
	Overview of congenital infections with description of the most frequent conditions
	What to consider depending on location and age
	Timing of the infection
	Infections in different organs and systems
	Interaction between malnutritionand infection [53]
	References
Chapter 18 Role of MRI and radiology in post mortems
	Introduction
	Conventional radiography
	Fetal radiography
	Pediatric radiology
	Forensic radiography in suspected non-accidental injury (NAI): skeletal, visceral, and craniospinal
	Underlying bone disease?
	Anthropomorphic radiography
	Post mortem magnetic resonance imaging
	The fetal and neonatal central nervous system
	Fetal heart
	Genitourinary tract
	Gastrointestinal tract/abdomen
	Organ weight
	Acceptance of imaging
	MRI sequences
	The future
	References
	Recommended further reading
Chapter 19 The forensic post mortem
	Introduction to forensic death investigation
	What is death investigation?
	Challenges to the death investigation
	What hurts and kills children?
	Consultations
	Case timeline
	The investigation
	Case report
	What is a case file?
	Death investigation
	Scene investigation
	Timeline analysis
	Case type
	Analysis
	The pediatric forensic post mortem
	Elements of the pediatric medico-legal autopsy
	Documentation
	The autopsy report: protocol/documentation/interpretation (Tables 19.8–19.9)
	Appendices
	References
Chapter 20 Appendix tables
Index