Sudden Unexpected Infant and Perinatal Death: Pathological Findings of the Cardiac Conduction System
<b>Objective:</b> Sudden infant death syndrome (SIDS), sudden neonatal unexpected death (SNUD), and sudden intrauterine unexpected death (SIUD) are major unsolved, shocking forms of death that occur frequently and without warning. The body of literature on the anatomo-pathological substr...
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2025-06-01
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| author | Giulia Ottaviani Patrizia Leonardi Massimo Del Fabbro Simone G. Ramos |
| author_facet | Giulia Ottaviani Patrizia Leonardi Massimo Del Fabbro Simone G. Ramos |
| author_sort | Giulia Ottaviani |
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| description | <b>Objective:</b> Sudden infant death syndrome (SIDS), sudden neonatal unexpected death (SNUD), and sudden intrauterine unexpected death (SIUD) are major unsolved, shocking forms of death that occur frequently and without warning. The body of literature on the anatomo-pathological substrates in the cardiac conduction system of SIDS-SIUD and their possible relationship with risk factors and triggers is fragmentary and scarce. The work aims is to analyze the cardiac conduction system findings collected at the national referral center for SIDS-SIUD. <b>Methods:</b> A total of 123 autopsied cases of SIDS (59.35% males, 40.65% females, mean age ± SD: 103.49 ± 67.17 days), 36 cases of SNUD (61.11% males, 38.89% females, mean age ± SD: 8.4 ± 9.17 days), and 127 cases of SIUD (45.67% males, 54.33% females, mean age ± SD: 36 ± 4.59 gestational weeks) were analyzed. In-depth pathological examinations of the cardiac conduction system were performed on serial sections according to the Lino Rossi Research Center’s protocol. <b>Results:</b> Among the studied cases, the following findings were observed: resorptive degeneration (SIDS: 88.7%, SNUD: 88.88%, SIUD: 56.69%), fetal dispersion (SIDS: 73.17%, SNUD: 91.66%, SIUD: 78.74%), Mahaim fibers (SIDS: 40.65%, SNUD: 44.44%, SIUD: 32.28%), cartilaginous meta-hyperplasia (SIDS: 56.91%, SNUD: 25%, SIUD: 33.07%), septated atrio-ventricular junction (AVJ) (SIDS: 21.14%, SNUD: 33.33%, SIUD: 38.58%), AVJ duplicity (SIDS: 6.5%, SNUD: 11.11%, SIUD: 2.36%), intramural bifurcation (SIDS: 3.25%, SNUD: 2.77%, SIUD: 4.72%). <b>Conclusions:</b> The prevalence of cardiac conduction findings was consistent across the SIDS, SNUD and SIUD groups. These findings provide valuable insights into the pathological characteristics of the cardiac conduction system in SIDS-SIUD that are potential morphological substrates for the development of cardiac arrhythmias. Further investigation and study of the conduction system are needed to understand the underlying mechanisms of these forms of death. |
| format | Article |
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| institution | DOAJ |
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| spelling | doaj-art-d040f58affef4cef9261872d80a60db92025-08-20T03:16:43ZengMDPI AGDiagnostics2075-44182025-06-011513163710.3390/diagnostics15131637Sudden Unexpected Infant and Perinatal Death: Pathological Findings of the Cardiac Conduction SystemGiulia Ottaviani0Patrizia Leonardi1Massimo Del Fabbro2Simone G. Ramos3Lino Rossi Research Center for the Study, Prevention of Unexpected Perinatal Death, SIDS, Anatomic Pathology, Department of Biomedical, Surgical and Dental Sciences, Università Degli Studi Di Milano, 20122 Milan, ItalyLino Rossi Research Center for the Study, Prevention of Unexpected Perinatal Death, SIDS, Anatomic Pathology, Department of Biomedical, Surgical and Dental Sciences, Università Degli Studi Di Milano, 20122 Milan, ItalyDepartment of Biomedical, Surgical and Dental Sciences, Università Degli Studi Di Milano, 20122 Milan, ItalyPathology and Legal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14040-900, Brazil<b>Objective:</b> Sudden infant death syndrome (SIDS), sudden neonatal unexpected death (SNUD), and sudden intrauterine unexpected death (SIUD) are major unsolved, shocking forms of death that occur frequently and without warning. The body of literature on the anatomo-pathological substrates in the cardiac conduction system of SIDS-SIUD and their possible relationship with risk factors and triggers is fragmentary and scarce. The work aims is to analyze the cardiac conduction system findings collected at the national referral center for SIDS-SIUD. <b>Methods:</b> A total of 123 autopsied cases of SIDS (59.35% males, 40.65% females, mean age ± SD: 103.49 ± 67.17 days), 36 cases of SNUD (61.11% males, 38.89% females, mean age ± SD: 8.4 ± 9.17 days), and 127 cases of SIUD (45.67% males, 54.33% females, mean age ± SD: 36 ± 4.59 gestational weeks) were analyzed. In-depth pathological examinations of the cardiac conduction system were performed on serial sections according to the Lino Rossi Research Center’s protocol. <b>Results:</b> Among the studied cases, the following findings were observed: resorptive degeneration (SIDS: 88.7%, SNUD: 88.88%, SIUD: 56.69%), fetal dispersion (SIDS: 73.17%, SNUD: 91.66%, SIUD: 78.74%), Mahaim fibers (SIDS: 40.65%, SNUD: 44.44%, SIUD: 32.28%), cartilaginous meta-hyperplasia (SIDS: 56.91%, SNUD: 25%, SIUD: 33.07%), septated atrio-ventricular junction (AVJ) (SIDS: 21.14%, SNUD: 33.33%, SIUD: 38.58%), AVJ duplicity (SIDS: 6.5%, SNUD: 11.11%, SIUD: 2.36%), intramural bifurcation (SIDS: 3.25%, SNUD: 2.77%, SIUD: 4.72%). <b>Conclusions:</b> The prevalence of cardiac conduction findings was consistent across the SIDS, SNUD and SIUD groups. These findings provide valuable insights into the pathological characteristics of the cardiac conduction system in SIDS-SIUD that are potential morphological substrates for the development of cardiac arrhythmias. Further investigation and study of the conduction system are needed to understand the underlying mechanisms of these forms of death.https://www.mdpi.com/2075-4418/15/13/1637sudden infant death syndrome (SIDS)sudden neonatal unexpected deathsudden intrauterine unexpected death (SIUD)cardiac conduction systempost-mortem examination |
| spellingShingle | Giulia Ottaviani Patrizia Leonardi Massimo Del Fabbro Simone G. Ramos Sudden Unexpected Infant and Perinatal Death: Pathological Findings of the Cardiac Conduction System Diagnostics sudden infant death syndrome (SIDS) sudden neonatal unexpected death sudden intrauterine unexpected death (SIUD) cardiac conduction system post-mortem examination |
| title | Sudden Unexpected Infant and Perinatal Death: Pathological Findings of the Cardiac Conduction System |
| title_full | Sudden Unexpected Infant and Perinatal Death: Pathological Findings of the Cardiac Conduction System |
| title_fullStr | Sudden Unexpected Infant and Perinatal Death: Pathological Findings of the Cardiac Conduction System |
| title_full_unstemmed | Sudden Unexpected Infant and Perinatal Death: Pathological Findings of the Cardiac Conduction System |
| title_short | Sudden Unexpected Infant and Perinatal Death: Pathological Findings of the Cardiac Conduction System |
| title_sort | sudden unexpected infant and perinatal death pathological findings of the cardiac conduction system |
| topic | sudden infant death syndrome (SIDS) sudden neonatal unexpected death sudden intrauterine unexpected death (SIUD) cardiac conduction system post-mortem examination |
| url | https://www.mdpi.com/2075-4418/15/13/1637 |
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