Transactions of the Twentieth Annual Meeting of the Society For Maternal-Fetal Medicine—ContinuedThe relationship among inflammatory lesions of the umbilical cord (funisitis), umbilical cord plasma interleukin 6 concentration, amniotic fluid infection, and neonatal sepsis☆,☆☆
Section snippets
Study design
The relationships between the presence of funisitis and the level of IL-6 in umbilical cord plasma at birth, the results of amniotic fluid culture, and the occurrence of congenital neonatal sepsis were examined in 315 consecutive singleton preterm births (20-35 weeks’ gestation) delivered at the Seoul National University Hospital (Seoul, Korea). Many patients included in this study had undergone transabdominal amniocentesis for either the evaluation of microbiologic status of the amniotic
Results
Funisitis was present in 25% of cases (78/315). Table I describes the clinical characteristics and outcomes of the study population according to the presence or absence of funisitis.Patients with funisitis had a lower gestational age at birth and higher rates of clinical chorioamnionitis, amniotic fluid culture positive for microorganisms, and congenital neonatal sepsis than did those without funisitis (Table I). After we adjusted for the effect of gestational age at birth, the presence of
Comment
Funisitis occurred more frequently among patients with preterm premature rupture of membranes, positive amniotic fluid culture results, clinical chorioamnionitis, and histologic evidence of inflammation of the amniochorial membranes. Moreover, neonates whose placentas demonstrated funisitis had a higher rate of congenital neonatal sepsis and were born at a lower gestational age than those without funisitis. We also noted that inflammation of the umbilical cord was extremely rare in the absence
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The neutrophil-to-lymphocyte ratio: A low-cost antenatal indicator of placental chorioamnionitis in women who deliver preterm without clinical signs and symptoms of infection
2023, European Journal of Obstetrics and Gynecology and Reproductive BiologyCitation Excerpt :A large proportion (70 %) of women who delivered early had confirmed inflammation on placental histology; incidence was inversely related to gestational age (R2 = −0.87). This suggests that infection is a more common aetiological factor at earlier gestations, as previously described [6]. The diagnosis of subclinical chorioamnionitis poses a significant clinical conundrum in obstetrics.
Does acute funisitis predict worse neonatal outcomes among term newborns?
2022, American Journal of Obstetrics and GynecologyCitation Excerpt :Acute funisitis, rather than the maternal immune response of histologic chorioamnionitis, serves as an indicator of fetal inflammatory response.3 To this end, studies have shown a strong relationship between acute funisitis and release of acute phase reactants in fetal circulation (eg, interleukin-6, interleukin-8, and matrix metalloproteinase 8).3–11 In contrast with histologic chorioamnionitis, acute funisitis has consistently been associated with culture-proven intraamniotic infection and adverse neonatal outcomes, including early-onset sepsis and retinopathy of prematurity.7,12,13
Placental histopathology and pregnancy outcome in placental abruption
2021, Thrombosis UpdateNecrotizing funisitis is an indicator that intra-amniotic inflammatory response is more severe and amnionitis is more frequent in the context of the extension of inflammation into Wharton's jelly
2021, Taiwanese Journal of Obstetrics and GynecologyAssessment of the fetal thymus gland: Comparing MRI-acquired thymus volumes with 2D ultrasound measurements
2021, European Journal of Obstetrics and Gynecology and Reproductive Biology
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Supported by grant 2000-N-NL-01-C-078 from the Korea Institute of Science and Technology Evaluation and Planning (KISTEP), Republic of Korea.
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Reprint requests: Bo Hyun Yoon, MD, PhD, Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, 110-744, Korea.