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Pathology of the
                               newborn



                           Basic definitions

                           Apgar score

                           Mors praenatalis

                           Mors neonatalis

Pathology of the newborn   Pneumopatology
                           of the newborn
Pathology of the
Basic definitions                                               newborn


    Abortion
                                                           Basic definitions
    Delivery                                               Apgar score

    Fetus immaturus non vitalis                            Mors praenatalis

                                                           Mors neonatalis
    Fetus immaturus vitalis
                                                           Pneumopatology
                                                           of the newborn
    Fetus maturus
    Fetus permaturus



    dead born fetus < 1000 g
    alive born fetus < 500 g, if survives no longer than
    24 hours
Pathology of the
Basic definitions                                               newborn


    Abortion
                                                           Basic definitions
    Delivery                                               Apgar score

    Fetus immaturus non vitalis                            Mors praenatalis

                                                           Mors neonatalis
    Fetus immaturus vitalis
                                                           Pneumopatology
                                                           of the newborn
    Fetus maturus
    Fetus permaturus



    alive born fetus over 500 g
    alive born fetus under 500 g, surviving more than 24
    hours
Pathology of the
Basic definitions                           newborn


    Abortion
                                       Basic definitions
    Delivery                           Apgar score

    Fetus immaturus non vitalis        Mors praenatalis

                                       Mors neonatalis
    Fetus immaturus vitalis
                                       Pneumopatology
                                       of the newborn
    Fetus maturus
    Fetus permaturus



    weight less than 1000 g
    usual length under 38 cm
    born before 28 week of gestation
Pathology of the
Basic definitions                      newborn


    Abortion
                                  Basic definitions
    Delivery                      Apgar score

    Fetus immaturus non vitalis   Mors praenatalis

                                  Mors neonatalis
    Fetus immaturus vitalis
                                  Pneumopatology
                                  of the newborn
    Fetus maturus
    Fetus permaturus



    weight 1000 – 2500
    29 – 38 week
Pathology of the
Basic definitions                      newborn


    Abortion
                                  Basic definitions
    Delivery                      Apgar score

    Fetus immaturus non vitalis   Mors praenatalis

                                  Mors neonatalis
    Fetus immaturus vitalis
                                  Pneumopatology
                                  of the newborn
    Fetus maturus
    Fetus permaturus
Pathology of the
Basic definitions                          newborn


    Abortion
                                      Basic definitions
    Delivery                          Apgar score

    Fetus immaturus non vitalis       Mors praenatalis

                                      Mors neonatalis
    Fetus immaturus vitalis
                                      Pneumopatology
                                      of the newborn
    Fetus maturus
    Fetus permaturus



    weight over 4000 g
    length over 52 cm
    born after 41 week of gestation
Pathology of the
Hypotrophy of the fetus          newborn


    Small for date
                             Basic definitions
    Multiple pregnancy       Apgar score

                             Mors praenatalis

                             Mors neonatalis

                             Pneumopatology
                             of the newborn
    placental insufficiency
    metabolic diseases
    alcohol
    ...
Pathology of the
Hypotrophy of the fetus                                  newborn


    Small for date
                                                     Basic definitions
    Multiple pregnancy                               Apgar score

                                                     Mors praenatalis

                                                     Mors neonatalis

                                                     Pneumopatology
                                                     of the newborn
    physiological
    child is small, but usually quickly catches up
Pathology of the
Apgar score                         newborn


   Heart rate
                                Basic definitions
   Respiration                  Apgar score

   Muscular tone                Mors praenatalis

                                Mors neonatalis
   Reaction to nasal catether
                                Pneumopatology
                                of the newborn
   Color



   not present (0 points)
   under 100 (1 point)
   over 100 (2 points)
Pathology of the
Apgar score                         newborn


   Heart rate
                                Basic definitions
   Respiration                  Apgar score

   Muscular tone                Mors praenatalis

                                Mors neonatalis
   Reaction to nasal catether
                                Pneumopatology
                                of the newborn
   Color



   not present (0 points)
   slow, irregular (1 point)
   good, cry (2 points)
Pathology of the
Apgar score                          newborn


   Heart rate
                                 Basic definitions
   Respiration                   Apgar score

   Muscular tone                 Mors praenatalis

                                 Mors neonatalis
   Reaction to nasal catether
                                 Pneumopatology
                                 of the newborn
   Color



   week (0 points)
   extremities flexed (1 point)
   active movements (2 points)
Pathology of the
Apgar score                         newborn


   Heart rate
                                Basic definitions
   Respiration                  Apgar score

   Muscular tone                Mors praenatalis

                                Mors neonatalis
   Reaction to nasal catether
                                Pneumopatology
                                of the newborn
   Color



   no response (0 points)
   grimase (1 point)
   cry (2 points)
Pathology of the
Apgar score                                        newborn


   Heart rate
                                               Basic definitions
   Respiration                                 Apgar score

   Muscular tone                               Mors praenatalis

                                               Mors neonatalis
   Reaction to nasal catether
                                               Pneumopatology
                                               of the newborn
   Color



   general cyanosis (0 points)
   body pink, extremities cyanotic (1 point)
   whole newborn is pink (2 points)
Pathology of the
Results of Apgar score       newborn


    AS < 2
                         Basic definitions
    AS 4 – 6             Apgar score

    AS > 7               Mors praenatalis

                         Mors neonatalis

                         Pneumopatology
                         of the newborn


    mortality 50 %
Pathology of the
Results of Apgar score       newborn


    AS < 2
                         Basic definitions
    AS 4 – 6             Apgar score

    AS > 7               Mors praenatalis

                         Mors neonatalis

                         Pneumopatology
                         of the newborn


    mortality 20 %
Pathology of the
Results of Apgar score                newborn


    AS < 2
                                  Basic definitions
    AS 4 – 6                      Apgar score

    AS > 7                        Mors praenatalis

                                  Mors neonatalis

                                  Pneumopatology
                                  of the newborn


    almost all newborns survive
Pathology of the
Mors praenatalis                                 newborn


    No signs of life
                                             Basic definitions
    Maceration (I. – III. grade)             Apgar score

    Intrauterine asphyxia                    Mors praenatalis

                                             Mors neonatalis

                                             Pneumopatology
                                             of the newborn


    no respiration, heart action, movement
Pathology of the
Mors praenatalis                                  newborn


    No signs of life
                                              Basic definitions
    Maceration (I. – III. grade)              Apgar score

    Intrauterine asphyxia                     Mors praenatalis

                                              Mors neonatalis

                                              Pneumopatology
                                              of the newborn


    I.: skin
    II.: organs, brain
    III.: softening of ligaments and joints
Pathology of the
Mors praenatalis                                        newborn


    No signs of life
                                                    Basic definitions
    Maceration (I. – III. grade)                    Apgar score

    Intrauterine asphyxia                           Mors praenatalis

                                                    Mors neonatalis

                                                    Pneumopatology
                                                    of the newborn


    alteration of the heart rate
    petechiae, ecchymoses
    release of meconium into the amnial fluid
    premature activation of respiration
    aspiration of amniotic fluid (lanugo, meconium
    bodies)
Pathology of the
Macerace, gr. III.       newborn



                     Basic definitions

                     Apgar score

                     Mors praenatalis

                     Mors neonatalis

                     Pneumopatology
                     of the newborn
Pathology of the
Macerace, gr. III.       newborn



                     Basic definitions

                     Apgar score

                     Mors praenatalis

                     Mors neonatalis

                     Pneumopatology
                     of the newborn
Pathology of the
Mors neonatalis                                      newborn


    Before the 28th day
                                                 Basic definitions
    Mechanical trauma during the delivery        Apgar score

    Ischemia during the delivery                 Mors praenatalis

                                                 Mors neonatalis
    Morbus haemorrhagicus neonatorum
                                                 Pneumopatology
                                                 of the newborn
    Sepsis neonatorum
    Congenital malformations, genetic diseases
    Congenital tumors



    early newborns: up to 7th day
Pathology of the
Mors neonatalis                                      newborn


    Before the 28th day
                                                 Basic definitions
    Mechanical trauma during the delivery        Apgar score

    Ischemia during the delivery                 Mors praenatalis

                                                 Mors neonatalis
    Morbus haemorrhagicus neonatorum
                                                 Pneumopatology
    Sepsis neonatorum                            of the newborn


    Congenital malformations, genetic diseases
    Congenital tumors



    CNS hemorrhage
    rupture of the tentorium
    spinal column trauma
    bone fractures
    hematomas
Pathology of the
Mors neonatalis                                           newborn


    Before the 28th day
                                                      Basic definitions
    Mechanical trauma during the delivery             Apgar score

    Ischemia during the delivery                      Mors praenatalis

                                                      Mors neonatalis
    Morbus haemorrhagicus neonatorum
                                                      Pneumopatology
                                                      of the newborn
    Sepsis neonatorum
    Congenital malformations, genetic diseases
    Congenital tumors



    damage and bleeding into the CNS (especially in
    immature newborns)
Pathology of the
Mors neonatalis                                      newborn


    Before the 28th day
                                                 Basic definitions
    Mechanical trauma during the delivery        Apgar score

    Ischemia during the delivery                 Mors praenatalis

                                                 Mors neonatalis
    Morbus haemorrhagicus neonatorum
                                                 Pneumopatology
                                                 of the newborn
    Sepsis neonatorum
    Congenital malformations, genetic diseases
    Congenital tumors



    heemorhagic diathesis (lack of vitamin K)
    multiple organ bleedings
Pathology of the
Mors neonatalis                                        newborn


    Before the 28th day
                                                   Basic definitions
    Mechanical trauma during the delivery          Apgar score

    Ischemia during the delivery                   Mors praenatalis

                                                   Mors neonatalis
    Morbus haemorrhagicus neonatorum
                                                   Pneumopatology
                                                   of the newborn
    Sepsis neonatorum
    Congenital malformations, genetic diseases
    Congenital tumors



    abruption of the placenta
    chorioamnionitis
    generalized infection of the mother
    respirators, catethers (umbilical catethers)
Pathology of the
Mors neonatalis                                         newborn


    Before the 28th day
                                                    Basic definitions
    Mechanical trauma during the delivery           Apgar score

    Ischemia during the delivery                    Mors praenatalis

                                                    Mors neonatalis
    Morbus haemorrhagicus neonatorum
                                                    Pneumopatology
                                                    of the newborn
    Sepsis neonatorum
    Congenital malformations, genetic diseases
    Congenital tumors



    organ malformations (CNS, the heard and blood
    vesels, urogenital tract)
Pathology of the
Mors neonatalis                                      newborn


    Before the 28th day
                                                 Basic definitions
    Mechanical trauma during the delivery        Apgar score

    Ischemia during the delivery                 Mors praenatalis

                                                 Mors neonatalis
    Morbus haemorrhagicus neonatorum
                                                 Pneumopatology
    Sepsis neonatorum                            of the newborn

    Congenital malformations, genetic diseases
    Congenital tumors



    teratomas
    Willms tumor
    nephroblastoma
    retinoblastoma
    hepatoblastoma
Pathology of the
Immaturity                                                newborn


    Lungs
                                                      Basic definitions
    CNS                                               Apgar score

    Kidney                                            Mors praenatalis

                                                      Mors neonatalis
    Intestine
                                                      Pneumopatology
                                                      of the newborn




    to 24. week: tubuloalveolar
    to 28. week: transformation to alveolar lung
    to 29. week: the lungs are fully alveolar
    further development, pneumocytes of the 1st and
    2nd type, surfactant production
Pathology of the
Immaturity                                                     newborn


    Lungs
                                                           Basic definitions
    CNS                                                    Apgar score

    Kidney                                                 Mors praenatalis

                                                           Mors neonatalis
    Intestine
                                                           Pneumopatology
                                                           of the newborn




    gyrification of the brain: after 6th month
    persistency of the germinative periventricular layer
Pathology of the
Immaturity                   newborn


    Lungs
                         Basic definitions
    CNS                  Apgar score

    Kidney               Mors praenatalis

                         Mors neonatalis
    Intestine
                         Pneumopatology
                         of the newborn




    immature glomeruli
Pathology of the
Immaturity          newborn


    Lungs
                Basic definitions
    CNS         Apgar score

    Kidney      Mors praenatalis

                Mors neonatalis
    Intestine
                Pneumopatology
                of the newborn
Pathology of the
Pneumopatology of the newborn               newborn


   Hyaline membranes
                                        Basic definitions
   Bronchopulmonary dysplasia           Apgar score

   Interstitial emphysema               Mors praenatalis

                                        Mors neonatalis
   Aspiration of amniotic fluid
                                        Pneumopatology
                                        of the newborn
   Adnate bronchopneumonia
   Atelectasis



   immaturity of pulmonary parenchyma
   affects immature newborns
Pathology of the
Pneumopatology of the newborn                                newborn


   Hyaline membranes
                                                         Basic definitions
   Bronchopulmonary dysplasia                            Apgar score

   Interstitial emphysema                                Mors praenatalis

                                                         Mors neonatalis
   Aspiration of amniotic fluid
                                                         Pneumopatology
                                                         of the newborn
   Adnate bronchopneumonia
   Atelectasis



   affects newborns, who survived the RDS with hyaline
   membranes
   corresponds to reparation of pulmonary tissue
Pathology of the
Pneumopatology of the newborn                                 newborn


   Hyaline membranes
                                                          Basic definitions
   Bronchopulmonary dysplasia                             Apgar score

   Interstitial emphysema                                 Mors praenatalis

                                                          Mors neonatalis
   Aspiration of amniotic fluid
                                                          Pneumopatology
                                                          of the newborn
   Adnate bronchopneumonia
   Atelectasis



   caused by arteficial ventilation of the newborns with
   atelectasis
   gas bubbles enter the the interstitium
   may get as far as soft tissues of the mediastinum
Pathology of the
Pneumopatology of the newborn                          newborn


   Hyaline membranes
                                                   Basic definitions
   Bronchopulmonary dysplasia                      Apgar score

   Interstitial emphysema                          Mors praenatalis

                                                   Mors neonatalis
   Aspiration of amniotic fluid
                                                   Pneumopatology
                                                   of the newborn
   Adnate bronchopneumonia
   Atelectasis



   fetal asphyxia
   premature activation of the respiratory reflex
Pathology of the
Pneumopatology of the newborn        newborn


   Hyaline membranes
                                 Basic definitions
   Bronchopulmonary dysplasia    Apgar score

   Interstitial emphysema        Mors praenatalis

                                 Mors neonatalis
   Aspiration of amniotic fluid
                                 Pneumopatology
                                 of the newborn
   Adnate bronchopneumonia
   Atelectasis



   infection of the mother
   amniotic fluid infection
Pathology of the
Pneumopatology of the newborn            newborn


   Hyaline membranes
                                     Basic definitions
   Bronchopulmonary dysplasia        Apgar score

   Interstitial emphysema            Mors praenatalis

                                     Mors neonatalis
   Aspiration of amniotic fluid
                                     Pneumopatology
                                     of the newborn
   Adnate bronchopneumonia
   Atelectasis



   not enough air within the lungs
Pathology of the
Hyaline membrane syndrome                     newborn


   Affects immature newborns
                                          Basic definitions
   RDS, immature lung                     Apgar score

   Oxygen administration is necessary     Mors praenatalis

                                          Mors neonatalis
   Toxic oxygen damages alveolar lining
                                          Pneumopatology
                                          of the newborn




   under 2000 g
Pathology of the
Hyaline membrane syndrome                            newborn


   Affects immature newborns
                                                 Basic definitions
   RDS, immature lung                            Apgar score

   Oxygen administration is necessary            Mors praenatalis

                                                 Mors neonatalis
   Toxic oxygen damages alveolar lining
                                                 Pneumopatology
                                                 of the newborn




   no surfactant (pneumocytes of the 2nd type)
   the lung collapses during the expirium
   inspiration requires increased effort
Pathology of the
Hyaline membrane syndrome                                newborn


   Affects immature newborns
                                                     Basic definitions
   RDS, immature lung                                Apgar score

   Oxygen administration is necessary                Mors praenatalis

                                                     Mors neonatalis
   Toxic oxygen damages alveolar lining
                                                     Pneumopatology
                                                     of the newborn




   increased concetration of oxygen is inevitable
   (incubator)
   it is necessary to keep oxygen levels as low as
   possible
   lung damage
   retinal damage (retrolental fibroplasia)
Pathology of the
Hyaline membrane syndrome                                    newborn


   Affects immature newborns
                                                         Basic definitions
   RDS, immature lung                                    Apgar score

   Oxygen administration is necessary                    Mors praenatalis

                                                         Mors neonatalis
   Toxic oxygen damages alveolar lining
                                                         Pneumopatology
                                                         of the newborn




   necrotic alveolar lining and exsudate forms hyaline
   membranes
   especially ventilated alveoli are damaged
   the condition improves in surviving patients
Pathology of the
Hyaline membranes       newborn



                    Basic definitions

                    Apgar score

                    Mors praenatalis

                    Mors neonatalis

                    Pneumopatology
                    of the newborn
Pathology of the
Bronchopulmonary dysplasia                                  newborn


   Clinical signs
                                                        Basic definitions
   Pathogenesis                                         Apgar score

   Histology                                            Mors praenatalis

                                                        Mors neonatalis

                                                        Pneumopatology
                                                        of the newborn


   immature newborns
   survived RDS, who were treated with oxygen therapy
   and artifitial ventilation
   changes develop gradually during months
   death often within 6 months, surviving have
   pulmonary disease
Pathology of the
Bronchopulmonary dysplasia                                     newborn


   Clinical signs
                                                           Basic definitions
   Pathogenesis                                            Apgar score

   Histology                                               Mors praenatalis

                                                           Mors neonatalis

                                                           Pneumopatology
                                                           of the newborn


   ventilated alveoli damaged by oxygen disappear
   (fibrosis)
   perialveolar fibrosis develops in partially damaged
   alveoli
   previously unventilated (atelectatic) alveoli develop
   normally (or get hyperexpanded)
Pathology of the
Bronchopulmonary dysplasia                                      newborn


   Clinical signs
                                                            Basic definitions
   Pathogenesis                                             Apgar score

   Histology                                                Mors praenatalis

                                                            Mors neonatalis

                                                            Pneumopatology
                                                            of the newborn



   the surface of the lungs is uneven
   fibrosis, irregular dilatation of alveoli (compensatory
   emphysema)
Pathology of the
Bronchopulmonary dysplasia       newborn



                             Basic definitions

                             Apgar score

                             Mors praenatalis

                             Mors neonatalis

                             Pneumopatology
                             of the newborn
Pathology of the
Aspiration of the amniotic fluid                                newborn


    Problem with blood supply of the fetus
                                                           Basic definitions
    Clinical picture                                       Apgar score

    Histology                                              Mors praenatalis

                                                           Mors neonatalis
    Prognosis
                                                           Pneumopatology
                                                           of the newborn




    insufficiency of the placenta
    strangulation of the umbilical cord
    large infarcions of the placenta and other placental
    pathology
Pathology of the
Aspiration of the amniotic fluid                         newborn


    Problem with blood supply of the fetus
                                                    Basic definitions
    Clinical picture                                Apgar score

    Histology                                       Mors praenatalis

                                                    Mors neonatalis
    Prognosis
                                                    Pneumopatology
                                                    of the newborn




    alteration of fetal sounds
    stress of the fetus leads to meconium release
    activation of the respiratory reflex
Pathology of the
Aspiration of the amniotic fluid                            newborn


    Problem with blood supply of the fetus
                                                       Basic definitions
    Clinical picture                                   Apgar score

    Histology                                          Mors praenatalis

                                                       Mors neonatalis
    Prognosis
                                                       Pneumopatology
                                                       of the newborn




    tiny keratotic squames, lanugo, meconium bodies,
    amnial cells are aspired to bronchi and alveoli
    variable extent
Pathology of the
Aspiration of the amniotic fluid                             newborn


    Problem with blood supply of the fetus
                                                        Basic definitions
    Clinical picture                                    Apgar score

    Histology                                           Mors praenatalis

                                                        Mors neonatalis
    Prognosis
                                                        Pneumopatology
                                                        of the newborn




    massive aspiration is lethal
    condition may be complicated by bronchopneumonia,
    especially in infected amnial fluid
Pathology of the
Aspiration of the amniotic fluid       newborn



                                  Basic definitions

                                  Apgar score

                                  Mors praenatalis

                                  Mors neonatalis

                                  Pneumopatology
                                  of the newborn
Pathology of the
Aspiration of the amniotic fluid       newborn



                                  Basic definitions

                                  Apgar score

                                  Mors praenatalis

                                  Mors neonatalis

                                  Pneumopatology
                                  of the newborn
Pathology of the
Adnate pneumonia                                          newborn


   Inflammation of the lung before, during and short
                                                      Basic definitions
   after the delivery                                 Apgar score

   Etiology                                           Mors praenatalis

                                                      Mors neonatalis
   Prognosis
                                                      Pneumopatology
                                                      of the newborn
Pathology of the
Adnate pneumonia                                          newborn


   Inflammation of the lung before, during and short
                                                      Basic definitions
   after the delivery                                 Apgar score

   Etiology                                           Mors praenatalis

                                                      Mors neonatalis
   Prognosis
                                                      Pneumopatology
                                                      of the newborn




   disease of mother (virosis. . . )
   aspiration of infected amniotic fluid
   incubator
Pathology of the
Adnate pneumonia                                                newborn


   Inflammation of the lung before, during and short
                                                            Basic definitions
   after the delivery                                       Apgar score

   Etiology                                                 Mors praenatalis

                                                            Mors neonatalis
   Prognosis
                                                            Pneumopatology
                                                            of the newborn




   serious complication of overall condition of the child
Pathology of the
Adnate pneumonia       newborn



                   Basic definitions

                   Apgar score

                   Mors praenatalis

                   Mors neonatalis

                   Pneumopatology
                   of the newborn
Pathology of the
Adnate pneumonia       newborn



                   Basic definitions

                   Apgar score

                   Mors praenatalis

                   Mors neonatalis

                   Pneumopatology
                   of the newborn
Pathology of the
Atelectasis                                                   newborn


    Areas of unventilated lung in a newborn
                                                          Basic definitions
    Usually alteration with areas ventilad normally       Apgar score

    Etiology                                              Mors praenatalis

                                                          Mors neonatalis
    Prognosis
                                                          Pneumopatology
                                                          of the newborn




    firm, dark areas of consolidated tissue
    alveoli contain no air (therefore protected against
    toxic oxygen)
    (collapse: not ventilated pulmonary tissue, which
    was ventilated previously)
Pathology of the
Atelectasis                                                     newborn


    Areas of unventilated lung in a newborn
                                                            Basic definitions
    Usually alteration with areas ventilad normally         Apgar score

    Etiology                                                Mors praenatalis

                                                            Mors neonatalis
    Prognosis
                                                            Pneumopatology
                                                            of the newborn




    surrounding tissue is hyperventilated
    prominent especially in artificially ventilated babies
    (emphysema)
Pathology of the
Atelectasis                                               newborn


    Areas of unventilated lung in a newborn
                                                      Basic definitions
    Usually alteration with areas ventilad normally   Apgar score

    Etiology                                          Mors praenatalis

                                                      Mors neonatalis
    Prognosis
                                                      Pneumopatology
                                                      of the newborn




    immaturity of pulmonary tissue
    aspiration
Pathology of the
Atelectasis                                               newborn


    Areas of unventilated lung in a newborn
                                                      Basic definitions
    Usually alteration with areas ventilad normally   Apgar score

    Etiology                                          Mors praenatalis

                                                      Mors neonatalis
    Prognosis
                                                      Pneumopatology
                                                      of the newborn




    tendency to spontaneous healing
Pathology of the
Atelectases, tetralogy of Fallot       newborn



                                   Basic definitions

                                   Apgar score

                                   Mors praenatalis

                                   Mors neonatalis

                                   Pneumopatology
                                   of the newborn

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Pedi en

  • 1. Pathology of the newborn Basic definitions Apgar score Mors praenatalis Mors neonatalis Pathology of the newborn Pneumopatology of the newborn
  • 2. Pathology of the Basic definitions newborn Abortion Basic definitions Delivery Apgar score Fetus immaturus non vitalis Mors praenatalis Mors neonatalis Fetus immaturus vitalis Pneumopatology of the newborn Fetus maturus Fetus permaturus dead born fetus < 1000 g alive born fetus < 500 g, if survives no longer than 24 hours
  • 3. Pathology of the Basic definitions newborn Abortion Basic definitions Delivery Apgar score Fetus immaturus non vitalis Mors praenatalis Mors neonatalis Fetus immaturus vitalis Pneumopatology of the newborn Fetus maturus Fetus permaturus alive born fetus over 500 g alive born fetus under 500 g, surviving more than 24 hours
  • 4. Pathology of the Basic definitions newborn Abortion Basic definitions Delivery Apgar score Fetus immaturus non vitalis Mors praenatalis Mors neonatalis Fetus immaturus vitalis Pneumopatology of the newborn Fetus maturus Fetus permaturus weight less than 1000 g usual length under 38 cm born before 28 week of gestation
  • 5. Pathology of the Basic definitions newborn Abortion Basic definitions Delivery Apgar score Fetus immaturus non vitalis Mors praenatalis Mors neonatalis Fetus immaturus vitalis Pneumopatology of the newborn Fetus maturus Fetus permaturus weight 1000 – 2500 29 – 38 week
  • 6. Pathology of the Basic definitions newborn Abortion Basic definitions Delivery Apgar score Fetus immaturus non vitalis Mors praenatalis Mors neonatalis Fetus immaturus vitalis Pneumopatology of the newborn Fetus maturus Fetus permaturus
  • 7. Pathology of the Basic definitions newborn Abortion Basic definitions Delivery Apgar score Fetus immaturus non vitalis Mors praenatalis Mors neonatalis Fetus immaturus vitalis Pneumopatology of the newborn Fetus maturus Fetus permaturus weight over 4000 g length over 52 cm born after 41 week of gestation
  • 8. Pathology of the Hypotrophy of the fetus newborn Small for date Basic definitions Multiple pregnancy Apgar score Mors praenatalis Mors neonatalis Pneumopatology of the newborn placental insufficiency metabolic diseases alcohol ...
  • 9. Pathology of the Hypotrophy of the fetus newborn Small for date Basic definitions Multiple pregnancy Apgar score Mors praenatalis Mors neonatalis Pneumopatology of the newborn physiological child is small, but usually quickly catches up
  • 10. Pathology of the Apgar score newborn Heart rate Basic definitions Respiration Apgar score Muscular tone Mors praenatalis Mors neonatalis Reaction to nasal catether Pneumopatology of the newborn Color not present (0 points) under 100 (1 point) over 100 (2 points)
  • 11. Pathology of the Apgar score newborn Heart rate Basic definitions Respiration Apgar score Muscular tone Mors praenatalis Mors neonatalis Reaction to nasal catether Pneumopatology of the newborn Color not present (0 points) slow, irregular (1 point) good, cry (2 points)
  • 12. Pathology of the Apgar score newborn Heart rate Basic definitions Respiration Apgar score Muscular tone Mors praenatalis Mors neonatalis Reaction to nasal catether Pneumopatology of the newborn Color week (0 points) extremities flexed (1 point) active movements (2 points)
  • 13. Pathology of the Apgar score newborn Heart rate Basic definitions Respiration Apgar score Muscular tone Mors praenatalis Mors neonatalis Reaction to nasal catether Pneumopatology of the newborn Color no response (0 points) grimase (1 point) cry (2 points)
  • 14. Pathology of the Apgar score newborn Heart rate Basic definitions Respiration Apgar score Muscular tone Mors praenatalis Mors neonatalis Reaction to nasal catether Pneumopatology of the newborn Color general cyanosis (0 points) body pink, extremities cyanotic (1 point) whole newborn is pink (2 points)
  • 15. Pathology of the Results of Apgar score newborn AS < 2 Basic definitions AS 4 – 6 Apgar score AS > 7 Mors praenatalis Mors neonatalis Pneumopatology of the newborn mortality 50 %
  • 16. Pathology of the Results of Apgar score newborn AS < 2 Basic definitions AS 4 – 6 Apgar score AS > 7 Mors praenatalis Mors neonatalis Pneumopatology of the newborn mortality 20 %
  • 17. Pathology of the Results of Apgar score newborn AS < 2 Basic definitions AS 4 – 6 Apgar score AS > 7 Mors praenatalis Mors neonatalis Pneumopatology of the newborn almost all newborns survive
  • 18. Pathology of the Mors praenatalis newborn No signs of life Basic definitions Maceration (I. – III. grade) Apgar score Intrauterine asphyxia Mors praenatalis Mors neonatalis Pneumopatology of the newborn no respiration, heart action, movement
  • 19. Pathology of the Mors praenatalis newborn No signs of life Basic definitions Maceration (I. – III. grade) Apgar score Intrauterine asphyxia Mors praenatalis Mors neonatalis Pneumopatology of the newborn I.: skin II.: organs, brain III.: softening of ligaments and joints
  • 20. Pathology of the Mors praenatalis newborn No signs of life Basic definitions Maceration (I. – III. grade) Apgar score Intrauterine asphyxia Mors praenatalis Mors neonatalis Pneumopatology of the newborn alteration of the heart rate petechiae, ecchymoses release of meconium into the amnial fluid premature activation of respiration aspiration of amniotic fluid (lanugo, meconium bodies)
  • 21. Pathology of the Macerace, gr. III. newborn Basic definitions Apgar score Mors praenatalis Mors neonatalis Pneumopatology of the newborn
  • 22. Pathology of the Macerace, gr. III. newborn Basic definitions Apgar score Mors praenatalis Mors neonatalis Pneumopatology of the newborn
  • 23. Pathology of the Mors neonatalis newborn Before the 28th day Basic definitions Mechanical trauma during the delivery Apgar score Ischemia during the delivery Mors praenatalis Mors neonatalis Morbus haemorrhagicus neonatorum Pneumopatology of the newborn Sepsis neonatorum Congenital malformations, genetic diseases Congenital tumors early newborns: up to 7th day
  • 24. Pathology of the Mors neonatalis newborn Before the 28th day Basic definitions Mechanical trauma during the delivery Apgar score Ischemia during the delivery Mors praenatalis Mors neonatalis Morbus haemorrhagicus neonatorum Pneumopatology Sepsis neonatorum of the newborn Congenital malformations, genetic diseases Congenital tumors CNS hemorrhage rupture of the tentorium spinal column trauma bone fractures hematomas
  • 25. Pathology of the Mors neonatalis newborn Before the 28th day Basic definitions Mechanical trauma during the delivery Apgar score Ischemia during the delivery Mors praenatalis Mors neonatalis Morbus haemorrhagicus neonatorum Pneumopatology of the newborn Sepsis neonatorum Congenital malformations, genetic diseases Congenital tumors damage and bleeding into the CNS (especially in immature newborns)
  • 26. Pathology of the Mors neonatalis newborn Before the 28th day Basic definitions Mechanical trauma during the delivery Apgar score Ischemia during the delivery Mors praenatalis Mors neonatalis Morbus haemorrhagicus neonatorum Pneumopatology of the newborn Sepsis neonatorum Congenital malformations, genetic diseases Congenital tumors heemorhagic diathesis (lack of vitamin K) multiple organ bleedings
  • 27. Pathology of the Mors neonatalis newborn Before the 28th day Basic definitions Mechanical trauma during the delivery Apgar score Ischemia during the delivery Mors praenatalis Mors neonatalis Morbus haemorrhagicus neonatorum Pneumopatology of the newborn Sepsis neonatorum Congenital malformations, genetic diseases Congenital tumors abruption of the placenta chorioamnionitis generalized infection of the mother respirators, catethers (umbilical catethers)
  • 28. Pathology of the Mors neonatalis newborn Before the 28th day Basic definitions Mechanical trauma during the delivery Apgar score Ischemia during the delivery Mors praenatalis Mors neonatalis Morbus haemorrhagicus neonatorum Pneumopatology of the newborn Sepsis neonatorum Congenital malformations, genetic diseases Congenital tumors organ malformations (CNS, the heard and blood vesels, urogenital tract)
  • 29. Pathology of the Mors neonatalis newborn Before the 28th day Basic definitions Mechanical trauma during the delivery Apgar score Ischemia during the delivery Mors praenatalis Mors neonatalis Morbus haemorrhagicus neonatorum Pneumopatology Sepsis neonatorum of the newborn Congenital malformations, genetic diseases Congenital tumors teratomas Willms tumor nephroblastoma retinoblastoma hepatoblastoma
  • 30. Pathology of the Immaturity newborn Lungs Basic definitions CNS Apgar score Kidney Mors praenatalis Mors neonatalis Intestine Pneumopatology of the newborn to 24. week: tubuloalveolar to 28. week: transformation to alveolar lung to 29. week: the lungs are fully alveolar further development, pneumocytes of the 1st and 2nd type, surfactant production
  • 31. Pathology of the Immaturity newborn Lungs Basic definitions CNS Apgar score Kidney Mors praenatalis Mors neonatalis Intestine Pneumopatology of the newborn gyrification of the brain: after 6th month persistency of the germinative periventricular layer
  • 32. Pathology of the Immaturity newborn Lungs Basic definitions CNS Apgar score Kidney Mors praenatalis Mors neonatalis Intestine Pneumopatology of the newborn immature glomeruli
  • 33. Pathology of the Immaturity newborn Lungs Basic definitions CNS Apgar score Kidney Mors praenatalis Mors neonatalis Intestine Pneumopatology of the newborn
  • 34. Pathology of the Pneumopatology of the newborn newborn Hyaline membranes Basic definitions Bronchopulmonary dysplasia Apgar score Interstitial emphysema Mors praenatalis Mors neonatalis Aspiration of amniotic fluid Pneumopatology of the newborn Adnate bronchopneumonia Atelectasis immaturity of pulmonary parenchyma affects immature newborns
  • 35. Pathology of the Pneumopatology of the newborn newborn Hyaline membranes Basic definitions Bronchopulmonary dysplasia Apgar score Interstitial emphysema Mors praenatalis Mors neonatalis Aspiration of amniotic fluid Pneumopatology of the newborn Adnate bronchopneumonia Atelectasis affects newborns, who survived the RDS with hyaline membranes corresponds to reparation of pulmonary tissue
  • 36. Pathology of the Pneumopatology of the newborn newborn Hyaline membranes Basic definitions Bronchopulmonary dysplasia Apgar score Interstitial emphysema Mors praenatalis Mors neonatalis Aspiration of amniotic fluid Pneumopatology of the newborn Adnate bronchopneumonia Atelectasis caused by arteficial ventilation of the newborns with atelectasis gas bubbles enter the the interstitium may get as far as soft tissues of the mediastinum
  • 37. Pathology of the Pneumopatology of the newborn newborn Hyaline membranes Basic definitions Bronchopulmonary dysplasia Apgar score Interstitial emphysema Mors praenatalis Mors neonatalis Aspiration of amniotic fluid Pneumopatology of the newborn Adnate bronchopneumonia Atelectasis fetal asphyxia premature activation of the respiratory reflex
  • 38. Pathology of the Pneumopatology of the newborn newborn Hyaline membranes Basic definitions Bronchopulmonary dysplasia Apgar score Interstitial emphysema Mors praenatalis Mors neonatalis Aspiration of amniotic fluid Pneumopatology of the newborn Adnate bronchopneumonia Atelectasis infection of the mother amniotic fluid infection
  • 39. Pathology of the Pneumopatology of the newborn newborn Hyaline membranes Basic definitions Bronchopulmonary dysplasia Apgar score Interstitial emphysema Mors praenatalis Mors neonatalis Aspiration of amniotic fluid Pneumopatology of the newborn Adnate bronchopneumonia Atelectasis not enough air within the lungs
  • 40. Pathology of the Hyaline membrane syndrome newborn Affects immature newborns Basic definitions RDS, immature lung Apgar score Oxygen administration is necessary Mors praenatalis Mors neonatalis Toxic oxygen damages alveolar lining Pneumopatology of the newborn under 2000 g
  • 41. Pathology of the Hyaline membrane syndrome newborn Affects immature newborns Basic definitions RDS, immature lung Apgar score Oxygen administration is necessary Mors praenatalis Mors neonatalis Toxic oxygen damages alveolar lining Pneumopatology of the newborn no surfactant (pneumocytes of the 2nd type) the lung collapses during the expirium inspiration requires increased effort
  • 42. Pathology of the Hyaline membrane syndrome newborn Affects immature newborns Basic definitions RDS, immature lung Apgar score Oxygen administration is necessary Mors praenatalis Mors neonatalis Toxic oxygen damages alveolar lining Pneumopatology of the newborn increased concetration of oxygen is inevitable (incubator) it is necessary to keep oxygen levels as low as possible lung damage retinal damage (retrolental fibroplasia)
  • 43. Pathology of the Hyaline membrane syndrome newborn Affects immature newborns Basic definitions RDS, immature lung Apgar score Oxygen administration is necessary Mors praenatalis Mors neonatalis Toxic oxygen damages alveolar lining Pneumopatology of the newborn necrotic alveolar lining and exsudate forms hyaline membranes especially ventilated alveoli are damaged the condition improves in surviving patients
  • 44. Pathology of the Hyaline membranes newborn Basic definitions Apgar score Mors praenatalis Mors neonatalis Pneumopatology of the newborn
  • 45. Pathology of the Bronchopulmonary dysplasia newborn Clinical signs Basic definitions Pathogenesis Apgar score Histology Mors praenatalis Mors neonatalis Pneumopatology of the newborn immature newborns survived RDS, who were treated with oxygen therapy and artifitial ventilation changes develop gradually during months death often within 6 months, surviving have pulmonary disease
  • 46. Pathology of the Bronchopulmonary dysplasia newborn Clinical signs Basic definitions Pathogenesis Apgar score Histology Mors praenatalis Mors neonatalis Pneumopatology of the newborn ventilated alveoli damaged by oxygen disappear (fibrosis) perialveolar fibrosis develops in partially damaged alveoli previously unventilated (atelectatic) alveoli develop normally (or get hyperexpanded)
  • 47. Pathology of the Bronchopulmonary dysplasia newborn Clinical signs Basic definitions Pathogenesis Apgar score Histology Mors praenatalis Mors neonatalis Pneumopatology of the newborn the surface of the lungs is uneven fibrosis, irregular dilatation of alveoli (compensatory emphysema)
  • 48. Pathology of the Bronchopulmonary dysplasia newborn Basic definitions Apgar score Mors praenatalis Mors neonatalis Pneumopatology of the newborn
  • 49. Pathology of the Aspiration of the amniotic fluid newborn Problem with blood supply of the fetus Basic definitions Clinical picture Apgar score Histology Mors praenatalis Mors neonatalis Prognosis Pneumopatology of the newborn insufficiency of the placenta strangulation of the umbilical cord large infarcions of the placenta and other placental pathology
  • 50. Pathology of the Aspiration of the amniotic fluid newborn Problem with blood supply of the fetus Basic definitions Clinical picture Apgar score Histology Mors praenatalis Mors neonatalis Prognosis Pneumopatology of the newborn alteration of fetal sounds stress of the fetus leads to meconium release activation of the respiratory reflex
  • 51. Pathology of the Aspiration of the amniotic fluid newborn Problem with blood supply of the fetus Basic definitions Clinical picture Apgar score Histology Mors praenatalis Mors neonatalis Prognosis Pneumopatology of the newborn tiny keratotic squames, lanugo, meconium bodies, amnial cells are aspired to bronchi and alveoli variable extent
  • 52. Pathology of the Aspiration of the amniotic fluid newborn Problem with blood supply of the fetus Basic definitions Clinical picture Apgar score Histology Mors praenatalis Mors neonatalis Prognosis Pneumopatology of the newborn massive aspiration is lethal condition may be complicated by bronchopneumonia, especially in infected amnial fluid
  • 53. Pathology of the Aspiration of the amniotic fluid newborn Basic definitions Apgar score Mors praenatalis Mors neonatalis Pneumopatology of the newborn
  • 54. Pathology of the Aspiration of the amniotic fluid newborn Basic definitions Apgar score Mors praenatalis Mors neonatalis Pneumopatology of the newborn
  • 55. Pathology of the Adnate pneumonia newborn Inflammation of the lung before, during and short Basic definitions after the delivery Apgar score Etiology Mors praenatalis Mors neonatalis Prognosis Pneumopatology of the newborn
  • 56. Pathology of the Adnate pneumonia newborn Inflammation of the lung before, during and short Basic definitions after the delivery Apgar score Etiology Mors praenatalis Mors neonatalis Prognosis Pneumopatology of the newborn disease of mother (virosis. . . ) aspiration of infected amniotic fluid incubator
  • 57. Pathology of the Adnate pneumonia newborn Inflammation of the lung before, during and short Basic definitions after the delivery Apgar score Etiology Mors praenatalis Mors neonatalis Prognosis Pneumopatology of the newborn serious complication of overall condition of the child
  • 58. Pathology of the Adnate pneumonia newborn Basic definitions Apgar score Mors praenatalis Mors neonatalis Pneumopatology of the newborn
  • 59. Pathology of the Adnate pneumonia newborn Basic definitions Apgar score Mors praenatalis Mors neonatalis Pneumopatology of the newborn
  • 60. Pathology of the Atelectasis newborn Areas of unventilated lung in a newborn Basic definitions Usually alteration with areas ventilad normally Apgar score Etiology Mors praenatalis Mors neonatalis Prognosis Pneumopatology of the newborn firm, dark areas of consolidated tissue alveoli contain no air (therefore protected against toxic oxygen) (collapse: not ventilated pulmonary tissue, which was ventilated previously)
  • 61. Pathology of the Atelectasis newborn Areas of unventilated lung in a newborn Basic definitions Usually alteration with areas ventilad normally Apgar score Etiology Mors praenatalis Mors neonatalis Prognosis Pneumopatology of the newborn surrounding tissue is hyperventilated prominent especially in artificially ventilated babies (emphysema)
  • 62. Pathology of the Atelectasis newborn Areas of unventilated lung in a newborn Basic definitions Usually alteration with areas ventilad normally Apgar score Etiology Mors praenatalis Mors neonatalis Prognosis Pneumopatology of the newborn immaturity of pulmonary tissue aspiration
  • 63. Pathology of the Atelectasis newborn Areas of unventilated lung in a newborn Basic definitions Usually alteration with areas ventilad normally Apgar score Etiology Mors praenatalis Mors neonatalis Prognosis Pneumopatology of the newborn tendency to spontaneous healing
  • 64. Pathology of the Atelectases, tetralogy of Fallot newborn Basic definitions Apgar score Mors praenatalis Mors neonatalis Pneumopatology of the newborn