Neuropathologic Documentation of Prenatal Brain Damage

Ellis, William G.; Goetzman, Boyd W.; Lindenberg, Jeffrey A.

doi:10.1001/archpedi.1988.02150080064025

Cited by 31 publications

(19 citation statements)

References 45 publications

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“…13,31,32 Over one-third of our cohort showed evidence of established hypoxic changes, suggesting damage of at least 1-or 2-day duration. In addition, some of the white matter changes suggested damage of longer duration sustained several days before demise.…”

Section: Neuropathologymentioning

confidence: 87%

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The Scottish Perinatal Neuropathology Study—clinicopathological correlation in stillbirths

Becher

Bell

et al. 2006

BJOG

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Objective To examine the neuropathology of fetuses dying before birth, to determine the timing of any brain damage seen and to ascertain clinical associations of pre-existing brain damage.Design Population-based observational study.Setting All 22 delivery units within Scotland, 1995Scotland, -1998 Sample All stillborn fetuses ‡24 weeks of gestation excluding those with chromosomal abnormality or central nervous system/cardiothoracic malformation.Methods Clinical detail was collected on all stillborn fetuses. Requests for postmortem included separate request for detailed neuropathological examination. Stillborn fetuses were classified as full term antepartum (normal growth/growth restricted), preterm antepartum (normal growth/growth restricted), intrapartum (full term/preterm), multiple births and stillborn fetuses following abruptions. Clinicopathological correlation attempted to define the timing of brain insult. Placentas were examined for each case where available.Main outcome measures Presence of established and/or recent brain damage.Results Clinical details were available for 471 stillborn fetuses, and detailed neuropathology was possible in 191 cases. Of these 191, 13 were multiple births, 9 died following abruption, 12 were intrapartum deaths and 157 were antepartum stillborn fetuses (99 preterm and 58 full term). Recent or established brain damage was seen in 66% of the entire cohort. Thirty-five percent of all cases showed well-established hypoxic damage predating the last evidence of fetal life, and this was more common in preterm fetuses (P = 0.015), those fetuses with evidence of recent damage (P < 0.001), in pregnancies complicated by pregnancy-induced hypertension (P = 0.044) and those in whom the placenta was <10th centile (P = 0.002).Conclusions Brain damage is commonly seen in stillborn infants, and in around one-third of cases, damage predates the period immediately before death. Factors suggesting suboptimal placental function are associated with such damage. Early identification of placental impairment may lead to improved pregnancy outcome.

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Section: Neuropathologymentioning

confidence: 87%

“…23 Experimental studies are not possible in human infants, but classic studies have related the timing of neuropathological changes to major clinical incidents. 31,33 Placental pathology…”

Section: Neuropathologymentioning

confidence: 99%

The Scottish Perinatal Neuropathology Study—clinicopathological correlation in stillbirths

Becher

Bell

et al. 2006

BJOG

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“…The identifi cation of clastic lesions, their anatomical localisation and their extension are crucial factors modifying prognosis from intrauterine death to altered psychomotor development [5] , thus determining the following pregnancy management.…”

Section: Discussionmentioning

confidence: 99%

Role of foetal MRI in the evaluation of ischaemic-haemorrhagic lesions of the foetal brain

Manganaro

Bernardo

Barbera

et al. 2012

Journal of Perinatal Medicine

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“…trying to differentiate prenatal insult from peri/postnatal lesions. An antenatal brain lesion was diagnosed on the first ultrasound and criteria were based on literature data [3,4,5]:…”

Section: Methodsmentioning

confidence: 99%