Abstract
In light of the growing information on the pathophysiology and clinical aspects of unexpected perinatal loss and sudden infant death syndrome (SIDS), a novel approach to the inherent problems by pathologists has become necessary. Herein, we propose an up-to-date protocol for accurate examination of the central autonomic nervous system and of the cardiac conduction system, which can encompass morphological and/or functional abnormalities of reliable epicritical value in unexplained perinatal loss and SIDS, particularly in those cases (still quite numerous) lacking adequate clinical documentation. Anatomo-pathologic examination of the central autonomic nervous system includes an in-depth study on histological serial sections of the brainstem, cerebellum, and spinal cord, where the main structures participating in control of the vital functions are located. For the histological study of the cardiac conductions system, serial sections were obtained from two blocks, including the sino-atrial node and the atrio-ventricular system, respectively. This type of updated investigation is yielding important arguments for a broader discussion of the pathogenesis of unexpected stillbirth, early neonatal death, and SIDS, besides allowing a more complete forensic-medical documentation of individual cases.
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Acknowledgments
This study was supported by the Italian Lombardy Region target project n. 49210/2000 (Program of research and intervention for the reduction of the risk of SIDS and unexpected fetal death), by the agreement Lombardy Region-Pfizer Italia S.r.l. n. 814/2006, and by Ministry of Foreign Affairs (joined projects of particular relevance “Anatomopathologic and genetic study of the unexplained perinatal death and SIDS”) n. 269/P/0085087/2004 and n. 0083227/20006.
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“Lino Rossi” Research Center for the study and prevention of unexpected perinatal death and SIDS, Institute of Pathology, University of Milan, Italy.
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Matturri, L., Ottaviani, G. & Lavezzi, A.M. Guidelines for neuropathologic diagnostics of perinatal unexpected loss and sudden infant death syndrome (SIDS)—a technical protocol. Virchows Arch 452, 19–25 (2008). https://doi.org/10.1007/s00428-007-0527-z
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DOI: https://doi.org/10.1007/s00428-007-0527-z