By Jean W. Keeling (auth.), Jean W. Keeling MB, BS, FRCPath (eds.)
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Extra resources for Fetal and Neonatal Pathology
The pulmonary veins join to form a trunk which may run to join a superior vena cava or downwards through the diaphragm to join the portal venous system (Fig. 20) or, occasionally, the inferior vena cava. Evisceration At this point, the prosector has a number of options for evisceration of the body. One of the important The Perinatal Necropsy differences between necropsy examination of babies and adults is that organs should not be removed individually but rather in continuity as one, two or three large blocks.
Cutting lines used to expose the brain without injury to dural folds or venous sinuses. (Courtesy of Dr. S. A. S. Knowles. Adelaide) 22 The Perinatal Necropsy Fig. 28. Characteristic gyral pattern of the fetal brain from 22 to 40 weeks' gestation (brains brought to same size). (Dorovini- Zis and Dolman 1977) mal appearances will alert the prosector to these possibilities. The head is then tipped forwards and laterally and the occipital pole gently lifted with a finger or scalpel handle so that the falx and tentorium can be inspected for haemorrhage and tears.
If a wide bucket is used. some of the saline can be removed with a ladle and replaced by formalin to permit fixation without the need for transfer to another container. thus minimising the risk of· damage. The base of the brain can be inspected through this supporting fluid and the need for suspension of the brain to maintain its normal contour during fixation is removed by maintaining the hypertonicity of the solution. Isaacson (1984) describes a similar method for removal of infant brains under water.