Lavezzi Anna M, Piscioli Francesco, Pusiol Teresa
Folia Neuropathol. 2017;55(3):235-241. doi: 10.5114/fn.2017.70489.
This report describes a case of sudden collapse of a 20-hour-old newborn, while he was placed close to their mother according to skin-to-skin care, attributed to developmental alterations of brainstem nuclei involved in regulation of the vital functions. The infant, after a normal pregnancy, appeared well developed at birth, with no evidence of malformations or trauma, but showing severe asphyxia. The routine autopsy did not reveal a possible cause of death. Only the in-depth anatomopathological examination of the autonomic nervous system, according to the protocol developed by the "Lino Rossi" Research Center of Milan University, provided an explanation of the pathogenetic mechanism of this early death. The sudden death, a few hours after birth, was the unavoidable outcome of a complex of abnormalities of brainstem nuclei, particularly of the Kölliker-Fuse nucleus, an essential structure for eupneic breathing at birth, exacerbated by the prone position implied by the skin-to-skin contact.
本报告描述了一例20小时大的新生儿突然虚脱的病例。当时，按照母婴皮肤接触护理的要求，他被安置在母亲身旁，虚脱原因是参与生命功能调节的脑干核团发育异常。该婴儿孕期正常，出生时发育良好，无畸形或创伤迹象，但有严重窒息。常规尸检未发现可能的死因。只有按照米兰大学“利诺·罗西”研究中心制定的方案，对自主神经系统进行深入的解剖病理学检查，才对这一早期死亡的发病机制作出了解释。出生后数小时内的猝死，是脑干核团尤其是柯利克 - 富斯核异常的综合结果，柯利克 - 富斯核是出生时正常呼吸的关键结构，而母婴皮肤接触所采用的俯卧位加剧了这种异常，最终导致了不可避免的死亡。
