Collins Kim A, Popek Edwina
Acad Forensic Pathol. 2018 Dec;8(4):788-864. doi: 10.1177/1925362118821468. Epub 2018 Dec 19.
Injury to a fetus or neonate during delivery can be due to several factors involving the fetus, placenta, mother, and/or instrumentation. Birth asphyxia results in hypoxia and ischemia, with global damage to organ systems. Birth trauma, that is mechanical trauma, can also cause asphyxia and/or morbidity and mortality based on the degree and anatomic location of the trauma. Some of these injuries resolve spontaneously with little or no consequence while others result in permanent damage and severe morbidity. Unfortunately, some birth injuries are fatal. To understand the range of birth injuries, one must know the risk factors, clinical presentations, pathology and pathophysiology, and postmortem autopsy findings. It is imperative for clinicians and pathologists to understand the causes of birth injury; recognize the radiographic, gross, and microscopic appearances of these injuries; differentiate them from inflicted postpartum trauma; and work to prevent future cases.
分娩过程中胎儿或新生儿受到的损伤可能由涉及胎儿、胎盘、母亲和/或器械的多种因素引起。出生窒息会导致缺氧和缺血,对器官系统造成全身性损害。出生创伤,即机械性创伤,也可根据创伤的程度和解剖位置导致窒息和/或发病及死亡。其中一些损伤可自行缓解,几乎没有或没有后果,而另一些则会导致永久性损伤和严重发病。不幸的是,一些出生损伤是致命的。为了了解出生损伤的范围,必须知道其危险因素、临床表现、病理和病理生理学以及尸检结果。临床医生和病理学家必须了解出生损伤的原因;识别这些损伤的影像学、大体和显微镜下表现;将它们与产后遭受的创伤区分开来;并努力预防未来的病例。