Difference between revisions of "Fetal autopsy"

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(→‎Histology: Becker classification)
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===Adrenal gland===
===Adrenal gland===
*Centre regresses.
*Centre regresses.
====Fat pattern====
*Can be access with ''oil red O'' staining.
The pattern of adrenal fat is informative about intrauterine demise:<ref>{{cite journal |author=Becker MJ, Becker AE |title=Fat distribution in the adrenal cortex as an indication of the mode of intrauterine death |journal=Hum. Pathol. |volume=7 |issue=5 |pages=495–504 |year=1976 |month=September |pmid=964978 |doi= |url=}}</ref>
*Pattern I: scant fat/fat only close to medullary zone; acute onset death/rapid death.
*Pattern II: widespread fat; chronic death/prolonged death.
*Pattern III: massive fat - fetal zone and cortex; "chronic" death/prolonged death.


===Kidney===
===Kidney===
Line 43: Line 51:
===Lung===
===Lung===
*PMNs may be seen in [[chorioamnionitis]].
*PMNs may be seen in [[chorioamnionitis]].
*Meconium-laden macrophages may be seen.


===Thymus===
===Thymus===
*Hassall's corpuscles (thymic corpuscle).
*Hassall's corpuscles (thymic corpuscle).


Image: [http://commons.wikimedia.org/wiki/File:Thymic_corpuscle.jpg Thymic corpuscle (WC)].
Image:  
*[http://commons.wikimedia.org/wiki/File:Thymic_corpuscle.jpg Thymic corpuscle (WC)].


==Amnion rupture sequence==
==Amnion rupture sequence==

Revision as of 16:08, 25 March 2011

The fetal autopsy is done to determine the cause of death in a fetus. An introduction to the autopsy is in the autopsy article.

External exam

Post-mortem changes

Sequences of changes with intrauterine death:[1]

  • Normal ~0-12 hours.
  • Skin blistering - usu. prominent on head ~12-48 hours.
  • Moderate skin separation (sloughing) - usu. hands & feet ~48-72 hours
  • Massive skin separation and loosing of symphysis menti (midline mandible), symphysis pubis ~72+ hours.

Common measures[2]

  • Body mass (weight).
  • Crown-to-heel length.
  • Crown-to-rump length.
  • Occipito-frontal circumference.
  • Chest circumference - at nipples.
  • Abdominal circumference - at umbilicus.

Routinue sections

  1. Rib.
  2. Thymus, skin, diaphragm, psoas muscle.
  3. Rectum, duodenum, ileocecal region, mesentery.
  4. Adrenal gland.
  5. Kidney.
  6. Bladder.
  7. Internal genitalia.
  8. Spleen.
  9. Stomach, GE junction, GD junction, pancreas.
  10. Liver.
  11. Right lung.
  12. Left lung.
  13. Heart.
  14. Upper airway with thyroid.
  15. Pituitary.

Histology

Adrenal gland

  • Centre regresses.

Fat pattern

  • Can be access with oil red O staining.

The pattern of adrenal fat is informative about intrauterine demise:[3]

  • Pattern I: scant fat/fat only close to medullary zone; acute onset death/rapid death.
  • Pattern II: widespread fat; chronic death/prolonged death.
  • Pattern III: massive fat - fetal zone and cortex; "chronic" death/prolonged death.

Kidney

  • Cortex regresses.

Lung

Thymus

  • Hassall's corpuscles (thymic corpuscle).

Image:

Amnion rupture sequence

A term that encompasses:[4]

  • Amniotic band syndrome.
  • Amniotic adhesion sequence.
  • Limb-body wall complex

Etiology

  • Congenital.
    • Karyotypes is normal.

Gross

  • Autoamputation of appendages and body wall defects +/- anomalies of internal organs.

Developmental stuff

  • Chiari malformations (from least severe to most severe):
    • Chiari type I.
    • Chiari type II.
    • Chiari type III.
  • Dandy-Walker syndrome.[5]
    • Complete or partial agenesis of the vermis.
    • Cystic dilatation of the fourth ventricle.
    • Large posterior fossa.

Growth parameters

Main article: Growth charts

See also

References

  1. ↑ Burton, Julian L.; Rutty, Guy N. (2010). The Hospital Autopsy A Manual of Fundamental Autopsy Practice (3rd ed.). Oxford University Press. pp. 191. ISBN 978-0340965146.
  2. ↑ Burton, Julian L.; Rutty, Guy N. (2010). The Hospital Autopsy A Manual of Fundamental Autopsy Practice (3rd ed.). Oxford University Press. pp. 196, 198. ISBN 978-0340965146.
  3. ↑ Becker MJ, Becker AE (September 1976). "Fat distribution in the adrenal cortex as an indication of the mode of intrauterine death". Hum. Pathol. 7 (5): 495–504. PMID 964978.
  4. ↑ URL: http://moon.ouhsc.edu/kfung/jty1/neurotest/Q11-Ans.htm. Accessed on: 26 October 2010.
  5. ↑ URL: http://moon.ouhsc.edu/kfung/jty1/neurotest/Q12-Ans.htm. Accessed on: 26 October 2010.
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