The Pediatric and Perinatal Autopsy Manual is a clear and practical yet comprehensive guide for pathology trainees and non-pediatric pathologists. With chapters organized by types of autopsy, this manual answers questions such as: what do I do in cases of congenital malformation or suspected metabolic disease? What is important in the diagnosis of intrapartum and neonatal death? What must I consider in a baby with intrauterine growth restriction and stillbirth? How do I perform a post-mortem in a case of sudden death in infancy? Chapters describe the most important conditions to consider when examining the organs, both macroscopically and histologically, as well as descriptions of how to perform the autopsy. The book is richly illustrated throughout with numerous color images. Written and edited by leading experts in the field, this is an essential resource for non-pediatric general and trainee pathologists as well as forensic pathologists.
Author(s): Marta C. Cohen (editor), Irene Scheimberg (editor)
Edition: 1
Publisher: Cambridge University Press
Year: 2014
Language: English
Pages: 444
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
