Hypoplasia of the parabrachial/kölliker-fuse complex in perinatal death

We report the first observation of perinatal death attributable to morphological alterations of the parabrachial/K?lliker-Fuse complex. In an infant, born at 41 weeks of gestation with severe signs of asphyxia and dead 20 h after delivery, we observed the presence of rare and immature neurons in the brain stem areas of both lateral and medial parabrachial nuclei and the absence of the characteristic neurons of the K?lliker-Fuse nucleus. Such hypoplasia was associated with severe hypoplasia of the arcuate nucleus and pulmonary hypoplasia.     

An assessment of the microsocial environment of children diagnosed as “sudden infant death” using the “process” inventory

An assessment of the microsocial environment of infants dying unexpectedly was carried out using the Paediatric Review and Observation of Children's Environmental Support and Stimulation (PROCESS) inventory. We studied 48 families where the diagnosis of sudden infant death was confirmed by full necropsy and who died in St. Petersburg from 1986 to 1991. A control group consisted of an equal number of age, sex and observer matched live controls from the same city. The infants presenting as unexpected deaths had significantly lower estimates of developmental stimulation, organisation, total parent questionnaire and clinical observation scores. The total PROCESS score values were also lower in the families with sudden infant death than in the controls. A defect in developmental stimulation may be a contributory factor in some babies presenting as unexpected infant deaths.