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https://www.readbyqxmd.com/read/27907231/use-of-autopsy-to-determine-live-or-stillbirth-new-approaches-in-decision-support-systems
#1
Riza Yilmaz, Okan Erkaymaz, Erdogan Kara, Kivanc Ergen
Fetal deaths are important cases for forensic medicine, as well as for criminal and civil law. From a legal perspective, the determination of whether a deceased infant was stillborn is a difficult process. Such a determination is generally made during autopsy; however, no standardized procedures for this determination exist. Therefore, new facilitative approaches are needed. In this study, three new support systems based on 10 autopsy parameters were tested for their ability to correctly determine whether deceased infants were alive or stillborn...
December 1, 2016: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/27900454/intact-imaging-of-human-heart-structure-using-x-ray-phase-contrast-tomography
#2
Yukihiro Kaneko, Gen Shinohara, Masato Hoshino, Hiroyuki Morishita, Kiyozo Morita, Yoshihiro Oshima, Masashi Takahashi, Naoto Yagi, Yutaka Okita, Takuro Tsukube
Structural examination of human heart specimens at the microscopic level is a prerequisite for understanding congenital heart diseases. It is desirable not to destroy or alter the properties of such specimens because of their scarcity. However, many of the currently available imaging techniques either destroy the specimen through sectioning or alter the chemical and mechanical properties of the specimen through staining and contrast agent injection. As a result, subsequent studies may not be possible. X-ray phase-contrast tomography is an imaging modality for biological soft tissues that does not destroy or alter the properties of the specimen...
November 30, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27886392/deregulated-expression-of-ezh2-in-congenital-brainstem-disconnection
#3
P G Barth, E Aronica, S Fox, K Fluiter, M A J Weterman, A Poretti, D C Miller, E Boltshauser, B Harding, M Santi, F Baas
Congenital brainstem disconnection (CBSD) is an enigmatic embryo-fetal defect presenting as (sub)total absence of a segment between mesencephalon and lower brainstem. Rostro-caudal limits of the defect vary while the basal pons is always involved and the cerebellum is globally hypoplastic. A recent update and review[1] lists 14 cases, including 3 brain autopsy studies[1-3]. Necrosis and glial- or inflammatory reactions were absent. Inferior olivary nuclei were small or absent, pontine nuclei depleted, and the cerebellar dentate nuclei dysplastic...
November 25, 2016: Neuropathology and Applied Neurobiology
https://www.readbyqxmd.com/read/27879005/transient-distention-of-right-posterior-located-sigma-a-new-sonographic-sign-for-the-prenatal-diagnosis-of-anal-atresia
#4
Moshe Bronshtein, Ayala Gover, Ron Beloosesky, Zeev Blumenfeld
We describe a new sonographic sign for the detection of anal atresia in the early midtrimester on transvaginal sonography. In six cases of fetal anal atresia, the finding of a transient, distended, and right-sided sigmoid colon was observed at 13-16 weeks' gestation. Three cases have undergone pregnancy termination due to multiple anomalies. In the other three, the colonic distension resolved by 19 weeks' gestation. In two of these, the finding was isolated, and no other anomalies were detected. In all six cases, anal atresia or cloaca was confirmed on postabortal autopsy or after delivery...
November 23, 2016: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/27789047/self-induced-illegal-abortion-with-rivanol-%C3%A2-a-medicolegal-toxicological-case-report
#5
Sarah C Koelzer, Hannelore Held, Stefan W Toennes, Marcel A Verhoff, Cora Wunder
Approximately during the 30th week of pregnancy, a woman gave birth to a still-born child in a hospital. After first citing an extraneous cause for the premature still-birth, the woman later admitted to having self-induced the abortion by injecting the antiseptic Rivanol(®) (active agent: ethacridine lactate) through her abdominal wall into the amniotic cavity. The investigating authorities ordered an autopsy of the fetus along with additional toxicological investigations. To the naked eye, no obvious cause of death was apparent...
August 27, 2016: Forensic Science International
https://www.readbyqxmd.com/read/27788335/pathologist-effort-in-the-performance-of-fetal-perinatal-and-pediatric-autopsies-a-survey-of-practice
#6
M Cristina Pacheco, Robyn C Reed
CONTEXT: -Autopsy is an important tool for quality assurance and improving patient care. Fetal, perinatal, and pediatric autopsies have the additional benefit of identifying conditions that may have increased risk of recurrence. In contrast to adult autopsies, special collections and testing are frequently used. Pathologist effort in fetal, perinatal, and pediatric autopsy has not been well documented. OBJECTIVE: -To prospectively quantify pathologist time required to complete fetal, perinatal, and pediatric autopsies, and to gather information on special studies and whether or not a cause of death was identified...
October 27, 2016: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/27788041/fetal-dysmorphology-still-an-essential-art-analysis-of-the-limitations-of-microarray-in-a-fetal-population-and-a-look-toward-the-genome-sequencing-era
#7
Elaine Fletcher, Mary Porteous, Eddy Maher, Kathryn J McKenzie, Margaret J Evans
Cytogenomic microarray allows assessment of the genome at higher resolutions than traditional karyotyping. The objective of this study is to evaluate the utility of microarray in a routine fetal autopsy setting before the advent of routine fetal exome / genome sequencing and the issues these technologies may generate. A systematic review of fetal post mortems performed between Jan 2011 - Dec 2014 was undertaken. Cases where there was no consent for audit, research or genetic testing were excluded as were cases referred to the Procurator Fiscal, stillbirths and neonatal deaths...
October 27, 2016: Pediatric and Developmental Pathology
https://www.readbyqxmd.com/read/27781326/organ-weights-and-ratios-for-postmortem-identification-of-fetal-growth-restriction-utility-and-confounding-factors
#8
J Man, J C Hutchinson, M Ashworth, I Jeffrey, A E Heazell, N J Sebire
OBJECTIVES: The postmortem fetal brain:liver weight ratio is commonly used as a marker of nutrition for diagnosis of fetal growth restriction (FGR). However, there are limited data regarding the effects of intrauterine retention, fetal maceration and postmortem interval on organ weights and their ratios at autopsy. Our aims were to examine the relationships between gestational-age-adjusted and sex-adjusted fetal organ weights at autopsy, cause of intrauterine death and effects of intrauterine retention, and to determine whether the brain:liver weight ratio is a reliable marker of FGR in intrauterine death...
October 25, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27781322/stillbirth-and-intrauterine-fetal-death-contemporary-demographic-features-of-1000-cases-from-an-urban-population
#9
J Man, J C Hutchinson, M Ashworth, A E Heazell, I Jeffrey, N J Sebire
OBJECTIVES: Of 780 000 births annually in the UK, around 3300 are stillborn, a rate of approximately 4 per 1000 births. Traditional epidemiological associations are based on historic data. The aim of this study was to document contemporary demographic findings in a large series of > 1000 deaths in utero in London and compare these with national datasets. METHODS: From a dedicated database, including > 400 data fields per case, of fetal, infant and pediatric autopsies performed at Great Ormond Street Hospital and St George's Hospital, London, we extracted information on all intrauterine deaths, excluding terminations of pregnancy, from 2005 to 2013, inclusive...
October 25, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27781321/effects-of-intrauterine-retention-and-postmortem-interval-on-body-weight-following-intrauterine-death-implications-for-assessment-of-fetal-growth-restriction-at-autopsy
#10
J Man, J C Hutchinson, M Ashworth, A E Heazell, S Levine, N J Sebire
OBJECTIVE: According to the classification system used, 15-60% of stillbirths remain unexplained, despite undergoing recommended autopsy examination, with variable attribution of fetal growth restriction (FGR) as a cause of death. Distinguishing small-for-gestational age (SGA) from pathological FGR is a challenge at postmortem examination. This study uses data from a large, well-characterized series of intrauterine death autopsies to investigate the effects of secondary changes such as fetal maceration, intrauterine retention and postmortem interval on body weight...
October 25, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27781319/stillbirth-and-intrauterine-fetal-death-role-of-routine-histopathological-placental-findings-to-determine-cause-of-death
#11
J Man, J C Hutchinson, A E Heazell, M Ashworth, I Jeffrey, N J Sebire
OBJECTIVES: Placental abnormalities are a common cause of death in stillbirth, ranking second only to unexplained deaths, though there is wide variation in the proportion attributed to placental disease. In clinical practice, interpretation of the significance of placental findings is difficult, since many placental features in stillbirths overlap with those in live births. Our aim was to examine objectively classified placental findings from a series of > 1000 autopsies following intrauterine death in order to evaluate the role of placental histological examination in determining the cause of death...
October 25, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27781317/stillbirth-and-intrauterine-fetal-death-factors-affecting-determination-of-cause-of-death-at-autopsy
#12
J Man, J C Hutchinson, A E Heazell, M Ashworth, S Levine, N J Sebire
OBJECTIVES: There have been several attempts to classify cause of death (CoD) in stillbirth; however, all such systems are subjective, allowing for observer bias and making comparisons between systems challenging. This study aimed to examine factors relating to determination of CoD using a large dataset from two specialist centers in which observer bias had been reduced by classifying findings objectively and assigning CoD based on predetermined criteria. METHODS: Detailed autopsy reports from intrauterine deaths in the second and third trimesters during 2005-2013 were reviewed and findings entered into a specially designed database, in which CoD was assigned using predefined objective criteria...
October 25, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27781316/stillbirth-and-intrauterine-fetal-death-role-of-routine-histological-organ-sampling-to-determine-cause-of-death
#13
J Man, J C Hutchinson, M Ashworth, L Judge-Kronis, S Levine, N J Sebire
OBJECTIVES: Guidelines for the investigation of intrauterine death and sudden unexpected death in infancy (SUDI) recommend, based on expert opinion, autopsy procedures and tissue sampling strategies for histological analysis. Although stillbirth is much more common than SUDI, there have been no large-scale studies published which evaluate the usefulness of histological evaluation of specific organs in stillbirth for determining cause of death. Our aim was to evaluate the use of macroscopic and microscopic assessment of internal organs to determine cause of intrauterine death...
October 25, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27761192/chaos-prenatal-imaging-findings-with-post-mortem-contrast-radiographic-correlation
#14
Kanika Gupta, Bhuvaneswari Venkatesan, Kiruba Shankar Manoharan, Vaithianathan Rajalakshmi, Maya Menon
Congenital high airway obstruction syndrome is a rare fetal anomaly with characteristic constellation of prenatal findings on ultrasound and MRI. The typical triad of imaging features are enlarged and echogenic lungs, flattening or inversion of diaphragm and fetal hydrops. Early prenatal recognition of congenital high airway obstruction syndrome by ultrasound and/or MRI is mandatory for the appropriate perinatal management. We report a case of a male fetus with typical imaging findings of congenital high airway obstruction syndrome on ultrasound and MRI at 19 weeks of gestation...
August 2016: Journal of Radiology Case Reports
https://www.readbyqxmd.com/read/27726416/zika-virus-associated-micrencephaly-a-thorough-description-of-neuropathologic-findings-in-the-fetal-central-nervous-system
#15
Peter Štrafela, Alenka Vizjak, Jerica Mraz, Jernej Mlakar, Jože Pižem, Nataša Tul, Tatjana Avšič Županc, Mara Popović
CONTEXT: -The 2015 outbreak of Zika virus in Brazil resulted in a 20-times increased prevalence of congenital microcephaly in stillborns and neonates and was instrumental in raising the suspicion of a causal association between Zika virus and microcephaly. OBJECTIVE: -To provide a comprehensive description of the neuropathologic features of congenital Zika virus infection. DESIGN: -Autopsy evaluation of the brain from a fetus of 32 weeks and 6 days of gestation, with a prenatal diagnosis of microcephaly associated with polymerase chain reaction-confirmed, fetal, Zika virus infection...
October 11, 2016: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/27709109/defining-sudden-infant-death-and-sudden-intrauterine-unexpected-death-syndromes-with-regard-to-anatomo-pathological-examination
#16
Giulia Ottaviani
Crib death, or sudden infant death syndrome (SIDS), is the most frequent form of death in the first year of life, striking one baby in every 1,700-2,000. Yet, despite advances in maternal-infant care, sudden intrauterine unexplained/unexpected death syndrome (SIUDS) has a sixfold to eightfold greater incidence than that of SIDS. Frequent congenital abnormalities, likely morphological substrates for SIDS-SIUDS, were detected, mainly represented by alterations of the cardiac conduction system, such as accessory pathways and abnormal resorptive degeneration, and hypoplasia/agenesis of the vital brainstem structures...
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/27668203/an-extremely-rare-case-of-prenatally-diagnosed-absent-both-aortic-and-pulmonary-valves
#17
Hyeon Kyeong Yeon, Mi-Young Lee, Sun-Young Yoon, Hee Jung Jung, Ji Eun Park, Jae-Yoon Shim, Hye-Sung Won, Pil-Ryang Lee, Ahm Kim
We describe a case of absent aortic and pulmonary valves, diagnosed at 16.4 weeks of gestation. Fetal echocardiography showed cardiomegaly with dilated both ventricles. No valve leaflets were observed in the aorta and pulmonary artery, and a typical to-and-fro flow pattern was noted in both great arteries on color Doppler imaging. Fetal hydrops was also detected. Follow-up ultrasonographic evaluation at 19 weeks demonstrated intrauterine fetal death. Postmortem autopsy revealed the absence of both aortic and pulmonary valve leaflets...
September 2016: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/27666886/-prenatal-ultrasound-diagnosis-prognosis-and-chromosome-analysis-of-fetal-bowel-dilatation
#18
R Q Yang, Z Y Liu, J L Zhang, Y Nan, L M Fan
Objective: To investigate the relationship among the prenatal ultrasound, prognosis and chromosome results of fetal bowel dilatation. And in order to further improve the positive rate of prenatal chromosome examination operation, and reduce the risk of missed diagnosis. Methods: Ninety fetuses who were diagnosed as fetal bowel dilatation by prenatal ultrasound from June 2013 to December 2015 in the Second hospital of Jilin University were enrolled. Chromosomes were examined by amniotic cavity puncture or umbilical cord blood puncture...
September 6, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27648257/burden-timing-and-causes-of-maternal-and-neonatal-deaths-and-stillbirths-in-sub-saharan-africa-and-south-asia-protocol-for-a-prospective-cohort-study
#19
(no author information available yet)
OBJECTIVES: The AMANHI mortality study aims to use harmonized methods, across eleven sites in eight countries in South Asia and sub-Saharan Africa, to estimate the burden, timing and causes of maternal, fetal and neonatal deaths. It will generate data to help advance the science of cause of death (COD) assignment in developing country settings. METHODS: This population-based, cohort study is being conducted in the eleven sites where approximately 2 million women of reproductive age are under surveillance to identify and follow-up pregnancies through to six weeks postpartum...
December 2016: Journal of Global Health
https://www.readbyqxmd.com/read/27647195/available-evidence-of-association-between-zika-virus-and-microcephaly
#20
REVIEW
Jing Wu, Da-Yong Huang, Jun-Tao Ma, Ying-Hua Ma, Yi-Fei Hu
OBJECTIVE: To clarify the possible association between the Zika virus (ZIKV) and microcephaly and understand where we are in terms of research and the debate on the causation between mild maternal clinical features and severe fetal microcephaly. DATA SOURCES: We did a comprehensive literature review with the keywords "zika" and/or "microcephaly" from inception to May 27, 2016, with PubMed. STUDY SELECTION: Studies were included and analyzed if they met all of the following criteria: "probable or confirmed infant microcephaly" and "probable or confirmed ZIKV infection among mothers or infants"...
2016: Chinese Medical Journal
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