Low J A, Robertson D M, Simpson L L
Department of Obstetrics and Gynaecology, Queens University, Kingston, Ontario, Canada.
Am J Obstet Gynecol. 1989 Mar;160(3):608-14. doi: 10.1016/s0002-9378(89)80040-7.
The neuropathologic conditions in 120 perinatal deaths attributed to fetal or newborn asphyxia were examined. Central nervous system necrosis was present in 16 of these deaths. The approximate time of asphyxial insult was established by determining the duration of the process, based on the findings of neuronal necrosis, macrophage response, or an astrocyte response, in conjunction with clinical data. The time of the asphyxial insult for the 16 perinatal deaths was as follows: antepartum fetal asphyxia, two cases; antepartum-intrapartum fetal asphyxia, five cases; intrapartum fetal asphyxia, four cases; and neonatal asphyxia, five cases. These observations indicate that an asphyxial insult may occur in the antepartum period, in the prodromal period of preterm labor, in the intrapartum period, and in the neonatal period. Five to ten percent of the asphyxial insults in each reproductive time period were initially sublethal, allowing necrosis of the brain of the fetus or newborn to develop.
对120例归因于胎儿或新生儿窒息的围产期死亡病例的神经病理学情况进行了检查。其中16例存在中枢神经系统坏死。通过根据神经元坏死、巨噬细胞反应或星形胶质细胞反应的结果并结合临床数据确定病程持续时间，来确定窒息损伤的大致时间。这16例围产期死亡的窒息损伤时间如下：产前胎儿窒息2例；产前-产时胎儿窒息5例；产时胎儿窒息4例；新生儿窒息5例。这些观察结果表明，窒息损伤可能发生在产前、早产前驱期、产时和新生儿期。每个生殖时间段5%至10%的窒息损伤最初是亚致死性的，可导致胎儿或新生儿脑坏死的发生。
