We report a total of 9 fetuses (3 females and 6 males, ranging in age from 34 to 41 gestational weeks) that died suddenly and unexpectedly, and presented brainstem and cardiac conduction system lesions together with abnormalities of the fetal adnexa. A complete autopsy was performed in each case. Histological examination of the fetal adnexa disclosed the presence of chorioamnionitis (7 cases), an abnormally short umbilical cord (1 case), and placental infection by parvovirus (1 case). These lesions were associated with brainstem lesions, i.e., hypoplasia of the arcuate nucleus, inflammatory infiltrates in the brainstem, hypoplasia of the raphe obscurus nucleus, hypoplasia of the parabrachial Kölliker-Fuse complex, hypoplasia of the pre-Bötzinger complex, agenesis of the facial/parafacial complex, as well as conduction system lesions, i.e., dispersion or septation of the atrio-ventricular junction (9 cases), islands of the conduction system inside the central fibrous body (5 cases) resorptive degeneration (4 cases), cartilaginous meta-hyperplasia (2 cases), Mahaim fibers (1 case). The SIUD «gray zone» are hereby described as those cases in which the lesions of the fetal adnexa alone might not have accounted for the sudden deaths, had it not been for the concomitant presence of brainstem and cardiac conduction lesions. Our cases are consistent with the triple-risk model, a hypothesis introduced for SIDS postulating an underlying biological vulnerability to exogenous stressors or triggering factors in a critical developmental period.
Sudden Intrauterine Unexplained Death (SIUD) «Gray Zone» or borderline / L. Matturri, G. Ottaviani, R. Mingrone, A.M. Lavezzi, E. Fulcheri. - In: JOURNAL OF PERINATAL MEDICINE. - ISSN 0300-5577. - 35:suppl. 2(2007 Sep), pp. S210-S210. ((Intervento presentato al 8. convegno World Congress of Perinatal Medicine tenutosi a Firenze nel 2007.
Sudden Intrauterine Unexplained Death (SIUD) «Gray Zone» or borderline
L. MatturriPrimo
;G. OttavianiSecondo
;R. Mingrone;A.M. LavezziPenultimo
;
2007
Abstract
We report a total of 9 fetuses (3 females and 6 males, ranging in age from 34 to 41 gestational weeks) that died suddenly and unexpectedly, and presented brainstem and cardiac conduction system lesions together with abnormalities of the fetal adnexa. A complete autopsy was performed in each case. Histological examination of the fetal adnexa disclosed the presence of chorioamnionitis (7 cases), an abnormally short umbilical cord (1 case), and placental infection by parvovirus (1 case). These lesions were associated with brainstem lesions, i.e., hypoplasia of the arcuate nucleus, inflammatory infiltrates in the brainstem, hypoplasia of the raphe obscurus nucleus, hypoplasia of the parabrachial Kölliker-Fuse complex, hypoplasia of the pre-Bötzinger complex, agenesis of the facial/parafacial complex, as well as conduction system lesions, i.e., dispersion or septation of the atrio-ventricular junction (9 cases), islands of the conduction system inside the central fibrous body (5 cases) resorptive degeneration (4 cases), cartilaginous meta-hyperplasia (2 cases), Mahaim fibers (1 case). The SIUD «gray zone» are hereby described as those cases in which the lesions of the fetal adnexa alone might not have accounted for the sudden deaths, had it not been for the concomitant presence of brainstem and cardiac conduction lesions. Our cases are consistent with the triple-risk model, a hypothesis introduced for SIDS postulating an underlying biological vulnerability to exogenous stressors or triggering factors in a critical developmental period.File | Dimensione | Formato | |
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