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Otimização de técnicas para exame macroscópico de encéfalos fetais e perinatais humanos
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A preservação de encéfalos fetais e perinatais humanos, órgãos particularmente frágeis e suscetíveis à autólise e maceração, é essencial para o exame anatomopatológico, não existindo consenso quanto à melhor técnica. Este estudo pretendeu avaliar três técnicas de preservação de encéfalos fetais/perinatais humanos e selecionar a mais adequada para implementar no diagnóstico. Foram estudados 18 encéfalos (fetos/recém-nascidos com diferentes idades gestacionais/1 dia de vida) através das técnicas: fixação em formol-acético (6), fixação em formol neutro tamponado a 10% (6) e fixação em formol-acético e posterior inclusão em ágar (6). A avaliação foi efetuada nas etapas do exame macroscópico, microtomia e análise microscópica das preparações histológicas coradas pela hematoxilina-eosina, usando escalas para categorização dos parâmetros selecionados. A técnica fixação em formol-acético e inclusão em ágar foi a que obteve as melhores pontuações em todas as etapas em estudo, destacando-se a do exame macroscópico por facilitar a realização de secções, manipulação das fatias e colheita de fragmentos. A técnica fixação em formol-acético e inclusão em ágar foi implementada no Serviço de Anatomia Patológica da Unidade Local de Saúde Santa Maria, tendo sido usada, até à data, na preservação de 80 encéfalos fetais e perinatais humanos, mostrando reprodutibilidade e utilidade diagnóstica em neuropatologia.
The preservation of human fetal and perinatal brains, organs that are particularly fragile and prone to autolysis and maceration, is essential for anatomopathological examination. However, no consensus has been reached regarding the best technique. This study aimed to evaluate three preservation techniques for human fetal/perinatal brains and to select the most appropriate one for diagnostic purposes. Eighteen brains (fetuses/newborns with different gestational ages/1 day of life) were examined using the following techniques: acetic formalin fixation (6), 10% neutral buffered formalin fixation (6), and pre-embedding in agar following fixation in acetic formalin (6). The evaluation was performed during the stages of macroscopic examination, microtomy, and microscopic analysis of histological preparations stained with hematoxylin-eosin, using scoring scales to categorize the selected parameters. Pre-embedding in agar following fixation in acetic formalin obtained the highest scores in all stages of the study, particularly in the macroscopic examination, as it facilitated the sectioning, slice manipulation and sampling. Pre-embedding in agar following fixation in acetic formalin was subsequently implemented in the Pathology Department of the Unidade Local de Saúde Santa Maria and has been applied in the preservation of 80 human fetal and perinatal brains to date, demonstrating reproducibility and diagnostic utility in neuropathology
The preservation of human fetal and perinatal brains, organs that are particularly fragile and prone to autolysis and maceration, is essential for anatomopathological examination. However, no consensus has been reached regarding the best technique. This study aimed to evaluate three preservation techniques for human fetal/perinatal brains and to select the most appropriate one for diagnostic purposes. Eighteen brains (fetuses/newborns with different gestational ages/1 day of life) were examined using the following techniques: acetic formalin fixation (6), 10% neutral buffered formalin fixation (6), and pre-embedding in agar following fixation in acetic formalin (6). The evaluation was performed during the stages of macroscopic examination, microtomy, and microscopic analysis of histological preparations stained with hematoxylin-eosin, using scoring scales to categorize the selected parameters. Pre-embedding in agar following fixation in acetic formalin obtained the highest scores in all stages of the study, particularly in the macroscopic examination, as it facilitated the sectioning, slice manipulation and sampling. Pre-embedding in agar following fixation in acetic formalin was subsequently implemented in the Pathology Department of the Unidade Local de Saúde Santa Maria and has been applied in the preservation of 80 human fetal and perinatal brains to date, demonstrating reproducibility and diagnostic utility in neuropathology
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Ágar Autópsia Sistema nervoso central Malformações congénitas Feto