Document Detail


Hepatic subcapsular hematomas in fetuses and neonatal infants.
MedLine Citation:
PMID:  10191344     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In fetuses and neonates hepatic subcapsular hematomas are relatively common lesions and may be life-threatening. Conditions previously associated with these hematomas include trauma, coagulopathies, hypoxia, sepsis, pneumothorax, maternal diseases, and placental lesions. In this study of 755 perinatal autopsies, hepatic subcapsular hematomas were found in 52 (6.9%) cases, including 31 stillborn fetuses and 21 liveborn infants. The average body weight was 690 g. A comparison group consisted of 52 temporally proximal autopsies of fetuses and neonates without hematomas. Body weights, gender, maternal age, and stillbirth or postnatal survival were matched as closely as possible while evaluating the presence or absence of sepsis, pneumothorax, cerebral germinal matrix hemorrhage, trauma, coagulopathy, placental lesions, and maternal diseases. Sepsis was associated with 62% of the cases with hepatic subcapsular hematomas and with 25% of the comparison group (P =.0001). Group B streptococcus infection was the most common cause of sepsis, but many different organisms were isolated. Cerebral germinal matrix hemorrhages were present in 35% of the cases with hematomas and in 14% of the comparison group (P =.0001). No other lesions or conditions were statistically different in the study group versus the comparison group. The delicacy of the hepatic capsule and its connections to the collagen along the sinusoids provide insight for the pathogenesis of hematomas in premature fetuses and neonates. We conclude that sepsis is present in most perinatal cases of hepatic subcapsular hematomas and that such patients also frequently have cerebral germinal matrix hemorrhages. Each of these lesions is a greater hazard among very small premature fetuses or neonates than among older fetuses and neonates.
Authors:
D B Singer; C Neave; C E Oyer; H Pinar
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology Society     Volume:  2     ISSN:  1093-5266     ISO Abbreviation:  Pediatr. Dev. Pathol.     Publication Date:    1999 May-Jun
Date Detail:
Created Date:  1999-05-06     Completed Date:  1999-05-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9809673     Medline TA:  Pediatr Dev Pathol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  215-20     Citation Subset:  IM    
Affiliation:
Developmental and Pediatric Pathology Program, Brown University School of Medicine, Providence, RI 02912, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Autopsy
Female
Fetal Diseases / microbiology*
Hematoma / microbiology*,  pathology
Humans
Infant, Newborn
Liver Diseases / microbiology*,  pathology
Male
Pregnancy
Sepsis / complications,  microbiology
Streptococcus / isolation & purification

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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