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Published on: May 24, 2016
Immunohistochemical detection of myocardial necrosis in stillbirth and neonatal death
E J Lazda1, W H Batchelor, P M Cox
1Department of Histopathology, Imperial College School of Medicine, Hammersmith Hospital, London W12 0NN, UK.
Insights
Immunohistochemical staining for C9 effectively detects myocardial necrosis in fetuses and neonates, including macerated stillborns. This method is valuable for investigating cardiac ischemia during the fetal and perinatal periods.
Area of Science:
- Perinatal pathology
- Immunohistochemistry
- Cardiovascular research
Background:
- Diagnosing myocardial necrosis in fetuses and neonates presents challenges.
- Current methods may have limitations in early or subtle cases of cardiac ischemia.
Purpose of the Study:
- To evaluate the utility of C9 immunohistochemical staining for identifying myocardial necrosis in fetal and neonatal hearts.
- To assess the applicability of this technique in cases of stillbirth and neonatal death.
Main Methods:
- Hearts from stillborn and neonatally deceased infants were analyzed.
- Immunohistochemical staining using antibodies to C9 was performed.
- Staining patterns were correlated with histological findings (H&E) and clinical data.
Main Results:
- All five cases with confirmed myocardial infarction showed positive C9 staining, primarily in infarcted areas.
- One neonate with extra-cardiac ischemic lesions exhibited scattered fiber staining.
- Positive C9 staining was observed in six out of ten macerated stillborn hearts.
Conclusions:
- Immunohistochemical staining for C9 can detect myocardial necrosis in neonates from 24 weeks gestation.
- C9 staining in macerated stillborns likely indicates myocardial necrosis.
- This technique holds significant potential for diagnosing cardiac ischemia in the perinatal period.
Abstract:
The aims of this study were to determine whether immunohistochemical staining for C9 can demonstrate myocardial necrosis in the fetus and neonate. Hearts from cases of stillbirth or neonatal death with confirmed myocardial necrosis (in neonates) or with ischemic lesions outside the heart (in neonates and stillborns) were stained immunohistochemically with antibodies to C9. All five cases with confirmed myocardial infarction showed positive immunohistochemical staining for C9, largely localized to the infarcted areas. The youngest subject was born at 24 weeks gestation and died at 4 days of age. One of two neonates without myocardial necrosis on H&E staining but with pathological evidence of ischemic lesions elsewhere showed staining of scattered fibers. Six out of ten hearts from macerated stillborn infants showed varying degrees of positive staining. Immunohistochemical staining for C9 detects myocardial necrosis in neonates of a gestational age of 24 weeks or more. C9 is also demonstrable immunohistochemically in macerated stillborns, and this is likely to represent myocardial necrosis. The method is of great potential value in the investigation of cardiac ischemia in the fetal and perinatal period.
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