There are numerous macroscopic changes in fetuses infected before they become immunocompetent (Fig. 6). These include a variable degree of stunting and sometimes an obvious loss of condition before other external changes are apparent; occasionally, an increased prominence of blood vessels over the surface of the fetus due to congestion and leakage of blood into contiguous tissues; congestion, edema, and hemorrhage with accumulation of serosanguineous fluids in body cavities; hemorrhagic discoloration becoming progressively darker after death; and dehydration (mummification). Many of these changes also apply to the placenta. Microscopic lesions consist primarily of extensive cellular necrosis in a wide variety of tissues and organs (Fig. 7A). Inflammation and intranuclear inclusions also have been described.