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Paediatric breast disorders represent a varied set of abnormalities. The bulk of breast pathology in children and adolescents consists of congenital and developmental anomalies, infections and tumours of which most are benign. As breast development represents an important, early manifestation of female sexuality, inadequate development often constitutes a major worry for the adolescent and her parents. We briefly discuss the normal embryologic and physiologic aspects of breast development, which will serve as an introduction to the congenital and developmental problems seen in young girls and adolescents. Keywords Amastia . Breast . Breast abcess . Breast asymmetry . Breast cyst . Breast hypertrophy . Breast hypoplasia . Breast tumour . Mastitis . Supernumerary breasts/nipples . Thelarche . Tuberous breast Early developmental aspectsBreast development is a progressive process that is initiated during embryonic life. At 4 weeks' gestation, a mammary ridge develops on either side of the ventral wall of the embryo. These symmetric thickenings of the ectoderm extend from the area of the future axilla to the future inguinal region. In humans, this so called "milk line" normally disappears during the 3rd month of intrauterine life except at the level of the 4th intercostal space where the breast starts to develop. There, the remnant of the mammary ridge begins to proliferate and produces the primary bud of the mammary gland in the 5th week. This bud grows down into the underlying mesenchyme. During the 10th week, the primary bud begins to branch, and by the 12th week, several secondary buds have formed. These buds lengthen and branch throughout fetal life. During the last trimester,

Vasa praevia constitutes a rare obstetric complication that is potentially lethal for the generally healthy infant. If unrecognized antenatally, the condition carries a higher fetal mortality rate than any other complication in pregnancy. Only in the past two decades have major diagnostic advances led to a dramatic improvement of perinatal survival and lower morbidity rates. Good outcomes depend primarily on prenatal diagnosis and appropriate management. The performance of a caesarean section before rupture of the membranes and the onset of labour is mandatory. Simple modifications of standard screening protocols and the recognition of high-risk patients will allow identification of most cases of vasa praevia. DefinitionIn normal circumstances, the umbilical cord is inserted into the chorionic plate (fetal surface) of the placenta (central or, more frequently, eccentric insertion) or on the placental edge (marginal insertion). The umbilical cord vessels course over the fetal surface before entering the placenta. In about 1% of singleton and 10% of twin pregnancies, however, the umbilical cord vessels separate from each other and start branching at a distance from the placental margin; they run through the membranes, surrounded only by a fold of amnion, before reaching the chorionic plate. If this so-called velamentous insertion is situated in the lower uterine segment, and the unprotected fetal vessels cross the region of the internal cervical os below the presenting fetal part, one speaks of vasa praevia. This aberrant vasculature can also be associated with bilobed or succenturiate placentas, in which case the vessels run between the accessory lobes.Vasa praevia is encountered rarely (1 of 2,500-5,000 deliveries), but even today they are associated with high fetal mortality (∼60%) and morbidity if undiagnosed antenatally [1]. The unprotected umbilical vessels are exposed to compression or rupture, especially during labour or at the time of rupture of the membranes. Laceration of the vasa praevia can rapidly lead to fetal exsanguination, shock (after as little as 60-ml blood loss, corresponding to 20-25% of the feto-placental blood volume) and intrauterine death. The fetus, indeed, has only a small circulatory volume of 80-100 ml/kg. The mother, on the other hand, is not at risk, in contrast to haemorrhages resulting from placenta praevia or abruptio placentae. AetiologySome placentas implant over the uterine isthmus or even over the internal cervical os. Due to the development of the lower uterine segment during the third trimester, the placenta appears to "move away" from the cervical region. The placenta preferentially grows in the better vascularised area of the corpus and may undergo atrophy in the lower parts of the uterus [2]. During this process, an aberrant vessel can persist over or close to the cervix. In cases where the placenta overlies the less vascularised internal os, it may undergo atrophy, which results in the development of a succenturiate lobe and connecting vasa praevia. Beside the aforement...

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