From Big Medical Encyclopedia

FETOPATYI (Latin fetus generation, posterity + Greek pathos suffering, a disease) — the diseases of a fruit arising under the influence of exogenous influences in the fetalis period of pre-natal development. Fetopathies of a different etiology can be combined with diseases of other periods of a kiyematogenez (see Kiyematopatiya), is frequent with blastopatiya (see. Antenatal pathology) and embryopathies (see). The pathology of a fruit connected with inheritance of pathological genes — gametopathies does not belong to fetopathies (see). Therefore hereditary diseases (see) even if they are shown in the fetalis period, do not belong to fetopathies. T. can be the cause of still births, prematurity and diseases of newborns.

According to most of researchers, the fetalis period proceeds from 11 — the 12th week of pregnancy till the birth of the child. In this period there is an active development of bodies of a fruit (see) and generally fabric differentiation comes to the end. Character and speed of these processes are defined and regulated by functional system mother — a placenta — a fruit.

Depending on an etiology of a fetopathy it is accepted to divide on infectious and noninfectious, on a pathogeny — on early (arising to 28 — the 29th week of pregnancy) and late (since 28 — the 29th week of pregnancy).

Infectious F. develop under the influence of viruses of chicken pox, herpes, a koksaka, hepatitis B, a rubella, flu, a cytomegaly, and also a number of bacteria. These F. are shown in the form of an inborn cytomegaly (see), inborn hepatitis (see Hepatitis, fetalis hepatitis), inborn listeriosis (see), an inborn toxoplasmosis (see) etc.

Noninfectious F, develop under the influence of a hypoxia owing to pathology of a placenta (see Asphyxia of a fruit and the newborn) and the exchange disturbances of a fruit noted at late toxicoses pregnant or various hron. diseases of mother, especially at their aggravation during pregnancy. To noninfectious F. belong the hemolitic disease of newborns connected with isoimmune incompatibility of blood of mother and a fruit (see. Hemolitic disease of newborns), inborn generalized calcification of arteries (see Calcine oz), a fibroelastosis of a myocardium (see Fibers oelastoz sou en to r d it is also scarlet and y y), hypoxemic, diabetic, thyrocardiac, alcoholic and other fetopathies. Hypoxemic F. arise at chronic disturbances of uteroplacental blood circulation, napr, at late toxicosis of pregnant women (see Toxicoses of pregnant women), a nephropathy of pregnant women (see), diseases of cardiovascular system, diseases of blood at mother. Diabetic F. it is observed at prediabetes or diabetes at the pregnant woman (see a diabetes mellitus).

Fetopathies of any etiology have a number of the general characteristic kliniko-morphological features. At F. average values of the weight (weight) and length of a body of a fruit change. E.g., at infectious and some noninfectious F. the weight and length of a body of a fruit decrease; at diabetic and thyrocardiac F., and also an edematous form of a hemolitic disease of newborns the body weight of a fruit increases; at diabetic F. increases as well length of a body of a fruit. At nek-ry F. the delay of a fabric differentiation, preferential is observed by c. N of page, lungs, kidneys, hemopoietic bodies, thymus. Such immaturity of bodies of a fruit is shown by excess quantity of cambial cells (see. Fabric a cambium) in paraventrikulyarny departments of a brain; in lungs development only of the alveolar courses without signs of formation of alveolar sacks is observed; in cortical substance of kidneys there is bigger, than normal, a quantity of germinal renal balls; in iye ** en, a spleen, a thymus, a pancreas at the term fetus are defined the large centers of an extramedullary hemopoiesis; in a thymus of l other lymphoid bodies the insufficient quantity of lymphocytes is found. At early F. malformations of a brain in the form of a nanocephalia (see), microgyrias, porencephalias can be observed (see. Head .mozg, malformations).

Often, especially at infectious F., hemorrhagic diathesis meets (see. Hemorrhagic diathesis), shown petechias on skin, mucous membranes, hemorrhages in perigastriums and internals, and also the jaundice (see) caused by hemolysis of erythrocytes, disturbances of conjugation of an indirect bilirubin, a cholestasia, inborn hepatitis and other reasons, which is followed gepato-and a splenomegaly (see the Gepatoliyeialny syndrome).

In addition to the common features characteristic for F., there are specific features inherent in fetopathies of a certain etiology allowing to carry out the differential diagnosis. E.g., for diabetic F. cushingoid outward of a fruit — a crescent-shaped bloated face, a short neck, a wide shoulder girdle, crimson and cyanotic skin color is characteristic (see Cushing a syndrome). At morfol. a research in these cases reveal a hyperplasia of islands of a pancreas and dystrophy (3 cells, adenomas of cortical substance of adrenal glands, a hyperplasia of acidophilic cells of a front share of a hypophysis, generalized mikroangiopatiya, a decrease of a glycogen in a myocardium, skeletal muscles, a liver along with infiltration by a glycogen of proximal tubules of kidneys and fatty infiltration of hepatocytes.

Treatment depends on the reason which caused F., also it has to be directed to recovery of structure and function of the struck body or system of bodies.

Prevention F. it is connected with antenatal protection of a fruit and directed to early detection and treatment of diseases at mother to and during pregnancy.

See also Antenatal pathology, Perinatal pathology, Pneumopathies.

Bibliography: To gy T. F. Pathological anatomy rubeolyarny embrio-feto-latii, Arkh. patol., t. 41, JSfb 4, page 62, 1979; Metabolism in the uniform system «Mother — a Placenta — a Fruit», Questions of perinatal pathology, under the editorship of V. A. Ta-bolin, M., 1978; Pathological anatomy of diseases of a fruit and the child, under the editorship of T. E. Ivanovo and B. S. Gusman, t. 1, M., 1981; Perinatal pathology, under the editorship of M. Ya. Studenikin, etc., M., 1984; With and in the h e N to about in Yu. I. and L about y N-c e in K. S. Sketches of physiology and morphology of functional system mother — a fruit, M., 1980; The Teratology of the person, under the editorship of G. I. Lazyuk, page 72, M., 1979; P about t-t er E. L. ampere-second of of an i g J. M. Pathology of the fetus and the infant, L., 1976.

T. E. Ivanovskaya.