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  • 1. Pathology of the newborn Basic definitions Apgar score Mors praenatalis Mors neonatalisPathology of the newborn Pneumopatology of the newborn
  • 2. Pathology of theBasic 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 theBasic 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 theBasic 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 theBasic 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 theBasic 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 theBasic 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 theHypotrophy 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 theHypotrophy 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 theApgar 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 theApgar 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 theApgar 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 theApgar 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 theApgar 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 theResults 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 theResults 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 theResults 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 theMors 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 theMors 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 theMors 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 theMacerace, gr. III. newborn Basic definitions Apgar score Mors praenatalis Mors neonatalis Pneumopatology of the newborn
  • 22. Pathology of theMacerace, gr. III. newborn Basic definitions Apgar score Mors praenatalis Mors neonatalis Pneumopatology of the newborn
  • 23. Pathology of theMors 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 theMors 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 theMors 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 theMors 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 theMors 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 theMors 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 theMors 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 theImmaturity 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 theImmaturity 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 theImmaturity newborn Lungs Basic definitions CNS Apgar score Kidney Mors praenatalis Mors neonatalis Intestine Pneumopatology of the newborn immature glomeruli
  • 33. Pathology of theImmaturity newborn Lungs Basic definitions CNS Apgar score Kidney Mors praenatalis Mors neonatalis Intestine Pneumopatology of the newborn
  • 34. Pathology of thePneumopatology 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 thePneumopatology 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 thePneumopatology 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 thePneumopatology 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 thePneumopatology 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 thePneumopatology 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 theHyaline 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 theHyaline 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 theHyaline 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 theHyaline 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 theHyaline membranes newborn Basic definitions Apgar score Mors praenatalis Mors neonatalis Pneumopatology of the newborn
  • 45. Pathology of theBronchopulmonary 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 theBronchopulmonary 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 theBronchopulmonary 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 theBronchopulmonary dysplasia newborn Basic definitions Apgar score Mors praenatalis Mors neonatalis Pneumopatology of the newborn
  • 49. Pathology of theAspiration 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 theAspiration 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 theAspiration 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 theAspiration 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 theAspiration of the amniotic fluid newborn Basic definitions Apgar score Mors praenatalis Mors neonatalis Pneumopatology of the newborn
  • 54. Pathology of theAspiration of the amniotic fluid newborn Basic definitions Apgar score Mors praenatalis Mors neonatalis Pneumopatology of the newborn
  • 55. Pathology of theAdnate 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 theAdnate 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 theAdnate 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 theAdnate pneumonia newborn Basic definitions Apgar score Mors praenatalis Mors neonatalis Pneumopatology of the newborn
  • 59. Pathology of theAdnate pneumonia newborn Basic definitions Apgar score Mors praenatalis Mors neonatalis Pneumopatology of the newborn
  • 60. Pathology of theAtelectasis 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 theAtelectasis 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 theAtelectasis 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 theAtelectasis 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 theAtelectases, tetralogy of Fallot newborn Basic definitions Apgar score Mors praenatalis Mors neonatalis Pneumopatology of the newborn