Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Pathology of the newborn
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Basic definitionsI AbortionI DeliveryI Fetus immaturus non vitalisI Fetus immaturus vitalisI Fetus maturusI Fetus permaturus
I dead born fetus < 1000 gI alive born fetus < 500 g, if survives no longer than
24 hours
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Basic definitionsI AbortionI DeliveryI Fetus immaturus non vitalisI Fetus immaturus vitalisI Fetus maturusI Fetus permaturus
I alive born fetus over 500 gI alive born fetus under 500 g, surviving more than 24
hours
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Basic definitionsI AbortionI DeliveryI Fetus immaturus non vitalisI Fetus immaturus vitalisI Fetus maturusI Fetus permaturus
I weight less than 1000 gI usual length under 38 cmI born before 28 week of gestation
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Basic definitionsI AbortionI DeliveryI Fetus immaturus non vitalisI Fetus immaturus vitalisI Fetus maturusI Fetus permaturus
I weight 1000 – 2500I 29 – 38 week
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Basic definitionsI AbortionI DeliveryI Fetus immaturus non vitalisI Fetus immaturus vitalisI Fetus maturusI Fetus permaturus
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Basic definitionsI AbortionI DeliveryI Fetus immaturus non vitalisI Fetus immaturus vitalisI Fetus maturusI Fetus permaturus
I weight over 4000 gI length over 52 cmI born after 41 week of gestation
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Hypotrophy of the fetusI Small for dateI Multiple pregnancy
I placental insufficiencyI metabolic diseasesI alcoholI . . .
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Hypotrophy of the fetusI Small for dateI Multiple pregnancy
I physiologicalI child is small, but usually quickly catches up
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Apgar scoreI Heart rateI RespirationI Muscular toneI Reaction to nasal catetherI Color
I not present (0 points)I under 100 (1 point)I over 100 (2 points)
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Apgar scoreI Heart rateI RespirationI Muscular toneI Reaction to nasal catetherI Color
I not present (0 points)I slow, irregular (1 point)I good, cry (2 points)
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Apgar scoreI Heart rateI RespirationI Muscular toneI Reaction to nasal catetherI Color
I week (0 points)I extremities flexed (1 point)I active movements (2 points)
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Apgar scoreI Heart rateI RespirationI Muscular toneI Reaction to nasal catetherI Color
I no response (0 points)I grimase (1 point)I cry (2 points)
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Apgar scoreI Heart rateI RespirationI Muscular toneI Reaction to nasal catetherI Color
I general cyanosis (0 points)I body pink, extremities cyanotic (1 point)I whole newborn is pink (2 points)
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Results of Apgar scoreI AS < 2I AS 4 – 6I AS > 7
I mortality 50 %
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Results of Apgar scoreI AS < 2I AS 4 – 6I AS > 7
I mortality 20 %
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Results of Apgar scoreI AS < 2I AS 4 – 6I AS > 7
I almost all newborns survive
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Mors praenatalisI No signs of lifeI Maceration (I. – III. grade)I Intrauterine asphyxia
I no respiration, heart action, movement
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Mors praenatalisI No signs of lifeI Maceration (I. – III. grade)I Intrauterine asphyxia
I I.: skinI II.: organs, brainI III.: softening of ligaments and joints
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Mors praenatalisI No signs of lifeI Maceration (I. – III. grade)I Intrauterine asphyxia
I alteration of the heart rateI petechiae, ecchymosesI release of meconium into the amnial fluidI premature activation of respirationI aspiration of amniotic fluid (lanugo, meconium
bodies)
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Macerace, gr. III.
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Macerace, gr. III.
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Mors neonatalisI Before the 28th dayI Mechanical trauma during the deliveryI Ischemia during the deliveryI Morbus haemorrhagicus neonatorumI Sepsis neonatorumI Congenital malformations, genetic diseasesI Congenital tumors
I early newborns: up to 7th day
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Mors neonatalisI Before the 28th dayI Mechanical trauma during the deliveryI Ischemia during the deliveryI Morbus haemorrhagicus neonatorumI Sepsis neonatorumI Congenital malformations, genetic diseasesI Congenital tumors
I CNS hemorrhageI rupture of the tentoriumI spinal column traumaI bone fracturesI hematomas
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Mors neonatalisI Before the 28th dayI Mechanical trauma during the deliveryI Ischemia during the deliveryI Morbus haemorrhagicus neonatorumI Sepsis neonatorumI Congenital malformations, genetic diseasesI Congenital tumors
I damage and bleeding into the CNS (especially inimmature newborns)
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Mors neonatalisI Before the 28th dayI Mechanical trauma during the deliveryI Ischemia during the deliveryI Morbus haemorrhagicus neonatorumI Sepsis neonatorumI Congenital malformations, genetic diseasesI Congenital tumors
I heemorhagic diathesis (lack of vitamin K)I multiple organ bleedings
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Mors neonatalisI Before the 28th dayI Mechanical trauma during the deliveryI Ischemia during the deliveryI Morbus haemorrhagicus neonatorumI Sepsis neonatorumI Congenital malformations, genetic diseasesI Congenital tumors
I abruption of the placentaI chorioamnionitisI generalized infection of the motherI respirators, catethers (umbilical catethers)
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Mors neonatalisI Before the 28th dayI Mechanical trauma during the deliveryI Ischemia during the deliveryI Morbus haemorrhagicus neonatorumI Sepsis neonatorumI Congenital malformations, genetic diseasesI Congenital tumors
I organ malformations (CNS, the heard and bloodvesels, urogenital tract)
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Mors neonatalisI Before the 28th dayI Mechanical trauma during the deliveryI Ischemia during the deliveryI Morbus haemorrhagicus neonatorumI Sepsis neonatorumI Congenital malformations, genetic diseasesI Congenital tumors
I teratomasI Willms tumorI nephroblastomaI retinoblastomaI hepatoblastoma
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
ImmaturityI LungsI CNSI KidneyI Intestine
I to 24. week: tubuloalveolarI to 28. week: transformation to alveolar lungI to 29. week: the lungs are fully alveolarI further development, pneumocytes of the 1st and
2nd type, surfactant production
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
ImmaturityI LungsI CNSI KidneyI Intestine
I gyrification of the brain: after 6th monthI persistency of the germinative periventricular layer
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
ImmaturityI LungsI CNSI KidneyI Intestine
I immature glomeruli
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
ImmaturityI LungsI CNSI KidneyI Intestine
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Pneumopatology of the newbornI Hyaline membranesI Bronchopulmonary dysplasiaI Interstitial emphysemaI Aspiration of amniotic fluidI Adnate bronchopneumoniaI Atelectasis
I immaturity of pulmonary parenchymaI affects immature newborns
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Pneumopatology of the newbornI Hyaline membranesI Bronchopulmonary dysplasiaI Interstitial emphysemaI Aspiration of amniotic fluidI Adnate bronchopneumoniaI Atelectasis
I affects newborns, who survived the RDS with hyalinemembranes
I corresponds to reparation of pulmonary tissue
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Pneumopatology of the newbornI Hyaline membranesI Bronchopulmonary dysplasiaI Interstitial emphysemaI Aspiration of amniotic fluidI Adnate bronchopneumoniaI Atelectasis
I caused by arteficial ventilation of the newborns withatelectasis
I gas bubbles enter the the interstitiumI may get as far as soft tissues of the mediastinum
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Pneumopatology of the newbornI Hyaline membranesI Bronchopulmonary dysplasiaI Interstitial emphysemaI Aspiration of amniotic fluidI Adnate bronchopneumoniaI Atelectasis
I fetal asphyxiaI premature activation of the respiratory reflex
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Pneumopatology of the newbornI Hyaline membranesI Bronchopulmonary dysplasiaI Interstitial emphysemaI Aspiration of amniotic fluidI Adnate bronchopneumoniaI Atelectasis
I infection of the motherI amniotic fluid infection
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Pneumopatology of the newbornI Hyaline membranesI Bronchopulmonary dysplasiaI Interstitial emphysemaI Aspiration of amniotic fluidI Adnate bronchopneumoniaI Atelectasis
I not enough air within the lungs
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Hyaline membrane syndromeI Affects immature newbornsI RDS, immature lungI Oxygen administration is necessaryI Toxic oxygen damages alveolar lining
I under 2000 g
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Hyaline membrane syndromeI Affects immature newbornsI RDS, immature lungI Oxygen administration is necessaryI Toxic oxygen damages alveolar lining
I no surfactant (pneumocytes of the 2nd type)I the lung collapses during the expiriumI inspiration requires increased effort
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Hyaline membrane syndromeI Affects immature newbornsI RDS, immature lungI Oxygen administration is necessaryI Toxic oxygen damages alveolar lining
I increased concetration of oxygen is inevitable(incubator)
I it is necessary to keep oxygen levels as low aspossible
I lung damageI retinal damage (retrolental fibroplasia)
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Hyaline membrane syndromeI Affects immature newbornsI RDS, immature lungI Oxygen administration is necessaryI Toxic oxygen damages alveolar lining
I necrotic alveolar lining and exsudate forms hyalinemembranes
I especially ventilated alveoli are damagedI the condition improves in surviving patients
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Hyaline membranes
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Bronchopulmonary dysplasiaI Clinical signsI PathogenesisI Histology
I immature newbornsI survived RDS, who were treated with oxygen therapy
and artifitial ventilationI changes develop gradually during monthsI death often within 6 months, surviving have
pulmonary disease
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Bronchopulmonary dysplasiaI Clinical signsI PathogenesisI Histology
I ventilated alveoli damaged by oxygen disappear(fibrosis)
I perialveolar fibrosis develops in partially damagedalveoli
I previously unventilated (atelectatic) alveoli developnormally (or get hyperexpanded)
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Bronchopulmonary dysplasiaI Clinical signsI PathogenesisI Histology
I the surface of the lungs is unevenI fibrosis, irregular dilatation of alveoli (compensatory
emphysema)
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Bronchopulmonary dysplasia
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Aspiration of the amniotic fluidI Problem with blood supply of the fetusI Clinical pictureI HistologyI Prognosis
I insufficiency of the placentaI strangulation of the umbilical cordI large infarcions of the placenta and other placental
pathology
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Aspiration of the amniotic fluidI Problem with blood supply of the fetusI Clinical pictureI HistologyI Prognosis
I alteration of fetal soundsI stress of the fetus leads to meconium releaseI activation of the respiratory reflex
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Aspiration of the amniotic fluidI Problem with blood supply of the fetusI Clinical pictureI HistologyI Prognosis
I tiny keratotic squames, lanugo, meconium bodies,amnial cells are aspired to bronchi and alveoli
I variable extent
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Aspiration of the amniotic fluidI Problem with blood supply of the fetusI Clinical pictureI HistologyI Prognosis
I massive aspiration is lethalI condition may be complicated by bronchopneumonia,
especially in infected amnial fluid
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Aspiration of the amniotic fluid
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Aspiration of the amniotic fluid
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Adnate pneumoniaI Inflammation of the lung before, during and short
after the deliveryI EtiologyI Prognosis
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Adnate pneumoniaI Inflammation of the lung before, during and short
after the deliveryI EtiologyI Prognosis
I disease of mother (virosis. . . )I aspiration of infected amniotic fluidI incubator
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Adnate pneumoniaI Inflammation of the lung before, during and short
after the deliveryI EtiologyI Prognosis
I serious complication of overall condition of the child
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Adnate pneumonia
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
Adnate pneumonia
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
AtelectasisI Areas of unventilated lung in a newbornI Usually alteration with areas ventilad normallyI EtiologyI Prognosis
I firm, dark areas of consolidated tissueI alveoli contain no air (therefore protected against
toxic oxygen)I (collapse: not ventilated pulmonary tissue, which
was ventilated previously)
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
AtelectasisI Areas of unventilated lung in a newbornI Usually alteration with areas ventilad normallyI EtiologyI Prognosis
I surrounding tissue is hyperventilatedI prominent especially in artificially ventilated babies
(emphysema)
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
AtelectasisI Areas of unventilated lung in a newbornI Usually alteration with areas ventilad normallyI EtiologyI Prognosis
I immaturity of pulmonary tissueI aspiration
Pathology of thenewborn
Basic definitions
Apgar score
Mors praenatalis
Mors neonatalis
Pneumopatologyof the newborn
AtelectasisI Areas of unventilated lung in a newbornI Usually alteration with areas ventilad normallyI EtiologyI Prognosis
I tendency to spontaneous healing
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