Immunofluorescence diagnosis of the herpesvirus stillborn infection.

Congenital herpes infection belongs to the category of actual problems of Perinatal Medicine. Pathological diagnosis of this disease is not effective in the routine method of autopsy studies without virological research. Objective. Determination of the value of the fluorescent antibody technique in the diagnosis of congenital herpes infection of the stillborn is a promising approach to medical diagnosis. subjects and methods. In 96 cases of stillbirth immunofluorescent identification of herpes simplex virus types 1 and 2 and cytomegalovirus in the placenta and internal organs (brain, heart, lungs, and liver) was implemented. The findings were compared with the results of a complete histological examination of the heart, including its rhythmogenic centers. Results. The herpes viruses were found in 51 observations (53.1%). Among them, HSV-1 were found in 16 observations (16.7%), HSV-2, in 19 (19.7%), CMV, in 16 (16.7%). In 34 stillbirths (35.8%) the pathological signs of herpetic atrial myocarditis were observed, which were regarded as the cause of death. Conclusion. The use of the fluorescent antibody technique in the autopsy practice is an effective way of diagnosis of intrauterine infection caused by the herpes simplex virus and cytomegalovirus.

[Introduction into fetal nosology].

The urgent social and medical problems of intrauterine death of alive fetuses require that pathomorphological studies of the fetoplacental complex be improved to diagnose major fetal abnormalities. It is proposed to refuse the universal diagnosis of symptomatic intrauterine hypoxia and to shift to its nosological diagnosis. Particular emphasis should be placed on the detection of placental-umbilical and cardiovascular pathology and hematogenic, hemorrhagic, and other fetal diseases.

[Specialised pediatric pathology service].

Leningrad Regional Children's Bureau of Pathology was established in May 1992. The program of this bureau consisted of: revealing causes of early and late abortions; assessment of ultrasound diagnosis of congenital deficiencies of fetus development and clinical assessment of chronic placental insufficiency; pathogenetic explanation of intrauterine fetuses death; prognosis of neonatal pathology; systemic analysis of dynamics of perinatal, natal and infant mortality; organisation of independant expertise of medical causes of reproductive losses. The following principles in the work of the bureau were established: 1) mass investigation of placentas of newborns; 2) use of urgent pathomorphological diagnosis which allows to present information about placentas not later than 24 hrs after the delivery; 3) complex investigation of placentas with the use of various methods; 4) systemic informational analysis of placental pathology; 5) constant updating of physicians knowledge in the field of practical placentology. Results of mass placentas investigation show a principal pathogenetic role of ascending infection in perinatal mortality in opportunistic pathogenic microflora with the development of inflammatory responses in the system mother-placenta-fetus.

[The importance of specialised pathology service in diagnosis of ascending infection of the reproductive system in pregnant women].

Practical results of screening cytological diagnosis of urogenital infections in pregnant women and mass pathomorphological investigations of newborn placentas performed by bureaus of pathology in Leningrad region and Cheboksary city are reviewed. Important place of the ascending bacterial infection in the structure of reproductive mortality is emphasized.

[Independent expertise of medical service quality in perinatal, infantile and children's mortality].

Information on principles and practical results of intraoffice expertise of medical documents in cases of the above mortality is presented.

[Some problems of anatomopathological diagnosis in perinatology]. / Nekotorye problemy patologo-anatomicheskogo diagnoza v perinatologii.

The authors discuss the problems of adequate documentation of autopsy diagnosis in death of fetuses and newborns and relations to ICD-10. It is suggested to legitimize and perfect the structure of diagnosis in perinatology.

[Pathogenetic basis of hormonal endometrial hypertrophy in early spontaneous abortions]. / Patogeneticheskie osnovy gormonal'noi gipotrofii éndometriia pri rannikh samoproizvol'nykh vykidyshakh.

Pathogenetic role of hormonal dissociation produced by disturbances of biochemical transformation of testosteron to estradiol in the mechanism of deficient gestational endometrial transformation is shown.

[Pathomorphological and hormonal criteria in the diagnosis of causes of spontaneous abortions]. / Patomorfologicheskie i gormonal'nye kriterii v diagnostike prichin samoproizvol'nykh vykidyshei.

The authors think it necessary to research causes of each case of spontaneous abortion more thoroughly. Pathomorphological manifestations of chromosomal, endocrine, immune and infectious pathology of the fetal bubble and endometrium are described. These criteria are compared to then content of sex steroid hormones in the circulating blood of pregnant women.

[Pathogenetic characteristics of late spontaneous miscarriage in ascending infection of amnion: reaction of placenta]. / Patogeneticheskie osobennosti pozdnikh samoproizvol'nykh vykidyshei pri voskhodiashchem infitsirovanii plodnogo puzyria: reaktsiia posleda.

Results of pathomorphological examination of placenta in 262 cases of late spontaneous miscarriages produced by ascending infection of fetal liquids with opportunistic microflora are presented. Sequential involvement in the exudative inflammatory process of the fetal membranes was observed (placenta and umbilical cord) depending on the term of pregnancy and duration of placenta contact with the infected fetal liquids. Exudative funiculitis was observed not infrequently this indicating direct involvement of the fetus in the intrauterine infectious process.

[Pathogenic basis of intrauterine infections]. / Patogeneticheskie osnovy vnutriutrobnykh infektsii.

The literature and the authors' own results on pathogenesis of intrauterine infections are reviewed. Special attention is paid to the mechanisms of contamination, disease stages and cellular-humoral responses of the fetus. Implications of the above factors in the formation of multiple clinicomorphological manifestations of the intrauterine infections are pointed out.

[Status and perspectives of development of a pediatric pathology service in Saint Petersburg and the Leningrad region]. / Sostoianie i perspektivy razvitiia detskoi patologoanatomicheskoi sluzhby Sankt-Peterburga i Leningradskoi oblasti.

The structure, development and perspectives of the pathology service in St.-Petersburg and Leningrad Region are described. Preliminary data on the proportion of various diseases in children dying during perinatal period and miscarriages are presented, high incidence of intrauterine infections is indicated.

[Pathogenetic characteristics of cervical erosion in puerperae]. / Patogeneticheskie osobennosti érozii sheiki matki u rodil'nits.

A study of 72 cervical biopsy specimens from puerperants revealed several pathogenetic features of endocervicitis, glandular ectropions, and authentic erosions. In particular, pseudoerosions were the result of excessive cervical gland hyperplasia that combined, in nearly all cases, with decidual transformation and chronic stromal inflammation. Ectropions were most likely to have been due to inversion of a moderately hyperplastic mucosa during delivery. In contrast, true erosions developed where the stratified squamous epithelium was hyperkeratotic and atrophic, and were often complicated by acute cervicitis.