PRENATAL BRAIN DAMAGE AND PLACENTAL INFARCTION –AN AUTOPSY STUDY

@article{Burke1995PRENATALBD,
  title={PRENATAL BRAIN DAMAGE AND PLACENTAL INFARCTION –AN AUTOPSY STUDY},
  author={Christopher J. Burke and Anthony E. G. Tannenberg},
  journal={Developmental Medicine \& Child Neurology},
  year={1995},
  volume={37}
}
The histopathological abnormalities seen at autopsy in the brains and corresponding placentas of a consecutive four‐year series of stillborn infants are presented. After excluding stillbirths with major cerebral malformations, the brains of 175 cases and the corresponding placentas in 165 cases were available for assessment. 70 of the 175 brains (40 per cent) showed microscopic evidence of ischaemie cerebral injury, using a combination of haematoxylin‐eosin and glial fibrillary acid protein… 
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The correspondence between the time courses of histological features of chorioamnionitis, neuronal karyorrhexis, and thymic involution points to irreversible central nervous system injury being common 12–48 hours prior to in utero demise.
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A variety of abnormalities are found in the brains of stillborns, the most common including cerebral white matter necrosis (periventricular leukomalacia) or gliosis, germinal matrix or intraventricular hemorrhage, cerebral infarcts, pontosubicular necrosis, and spinal cord or brainstem necrosis.
Placental pathology and cerebral palsy.
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Severely abnormal cord blood analysis results correlate significantly with neuronal necrosis and show a trend toward white matter injury; however, the absence of these abnormal results does not preclude the presence of brain injury.
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Placentas from infants with NI can contribute to an understanding of the mechanisms that contribute to NI at term, and logistic regression findings suggest that placental pathology can help understand these mechanisms.
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  • 2014
TLDR
Findings indicate brain injury predated the time period immediately before delivery in 9 of 10 fetuses, and in the fetuses with established brain injury the onset of acute illness was possibly >72 h before delivery.
Correlation of Placental Pathology with Perinatal Brain Injury.
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Fetal Central Nervous System Injury in Third Trimester Stillbirth: A Clinicopathologic Study of 63 Cases
TLDR
Brain injury, most frequently established gray matter damage, is seen in the majority of stillborn infants with unexplained demise, indicating that the brain injury predates the period immediately before death.
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