[Compression-hypoxic birth injuries and skull configuration]

The fetus has birth traumatic, compression-hypoxic, and hypoxic-ischemic brain lesions during childbirth. There are problems in their differentiation in clinical and anatomopathological practice. It is proposed to divide birth traumatic injuries into two types: 1) obvious traumatic injuries and 2) compression-hypoxic traumatic injuries. Signs of compression-hypoxic birth injuries were found in 24.4% of the examined fetuses and newborns delivered via vacuum extraction and application of obstetric forceps. This allows compression hypoxia to be attributed to birth injury rather than to hypoxic-ischemic encephalopathy. It is proposed to use the concept of compression-hypoxic birth injury. The morphological signs that are characteristic of this type of birth injury are given. It is indicated that the impact of physical forces on the fetal head is mediated by its configuration. The mechanisms of birth traumatic injuries are systematized. The pathological configuration of the fetal head is shown to be of importance in explaining the cause of birth injury.

[Features of forensic research of fetuses and newborns]

Special scientific directions are developing in the world - pediatric pathology and pediatric (perinatal) forensic medicine. The article presents eleven important features of the autopsy of fetuses and newborns that must be observed for a high-quality diagnosis of diseases and causes of death of children. The reasons for the importance of observing these features both in pathoanatomical and forensic autopsies are indicated. A proposal has been made to include the considered features in the standard protocol of the pathological and anatomical autopsy of the fetus and newborns.

[Circulatory intranatal hypoxia]

The paper considers one of the types of intranatal fetal hypoxia - circulatory hypoxia. It discusses the issues of fetal head configuration during childbirth and the compensatory-adaptive mechanisms when the fetal head passes through the maternal parturient canal. The relationships and differences between circulatory hypoxia and birth trauma are investigated.

[Extended amniotic fluid embolism associated with labor]

The authors report two cases of extended amniotic fluid embolism (AFE) associated with the birth-giving process with the analysis of their causes and the discussion of the possible pathways through which the amniotic fluid penetrates into maternal blood. A rare cause of amniotic fluid embolism due to the rupture of placental membranes as a result of submembranous hemorrhage is described. The changes in the lungs associated with extended AFE are apparent in the presence of macroscopic emboli formed from the particles of the amniotic fluid. The article describes for the first time in the Russian-language literature the macroscopically visible emboli composed of the particles of the amniotic fluid present in the pulmonary blood vessels. It is also the first report of the rupture of the placental membranes resulting from subamniotic hemorrhage as a cause of the appearance of the amniotic fluid in the maternal circulation.

Damages of spinal cord in newborns after intraventricular hemorrhage

We studied the spinal cords of 14 dead premature newborn with intraventricular hemorrhages. In all cases, grade III intraventricular hemorrhage was followed by the translocation of blood into the subarachnoid space of the cervical, dorsal, and lumbar parts of the spinal cord. Ischemic changes were found in neurons of the cervical intumescence and other parts of the spinal cord. These changes are important during thanatogenesis. Three stages in the development of intraventricular hemorrhage were distinguished. Imperfections of clinical classification of this pathology were demonstrated.