Related Experiment Video
Updated: Aug 29, 2026
Isolation of Leukocytes from the Human Maternal-fetal Interface
Published on: May 21, 2015
Maternal and fetal inflammatory responses in unexplained fetal death
S Blackwell1, R Romero, T Chaiworapongsa
1Department of Obstetrics and Gynecology, Wayne State University/Hutzel Hospital, Detroit, Michigan, 48201, USA.
Objective:
The role of intra-amniotic infection in the etiology of fetal death has been proposed. This study was conducted to determine the prevalence of microbial invasion of the amniotic cavity (MIAC) and the frequency of maternal and/or fetal inflammation in patients presenting with a fetal death.
Methods:
A prospective study was conducted in patients with a fetal death. Amniocenteses were performed for clinical indications (karyotype), as well as to assess the microbiological and cytological state of the amniotic cavity. Fluid was cultured for aerobic and anaerobic bacteria and genital mycoplasmas. An amniotic fluid white blood cell count and glucose determinations were also performed. Histological examination of the placenta was conducted to identify a maternal inflammatory response (acute chorioamnionitis) or a fetal inflammatory response (funisitis).
Results:
This study included 44 patients with intrauterine fetal death. The median gestational age at diagnosis was 30.1 weeks (range 16.3-40.4 weeks). One patient had documented MIAC (1/44). Acute histological chorioamnionitis was found in 20.9% (9/43), but a fetal inflammatory response was observed in only 2.3% (1/43) of cases. One patient had a positive amniotic fluid culture for Streptococcus agalactiae (group B streptococcus).
Conclusion:
Histological chorioamnionitis was present in 20.9% of cases, but MIAC could be demonstrated with conventional microbiological techniques in only one case. A fetal inflammatory response was nine times less frequent than a maternal inflammatory response (maternal 20.9% vs. fetal 2.3%, p = 0.008) in cases of fetal death.
Insights
Intra-amniotic infection is rarely detected in fetal death cases, despite frequent maternal inflammation. Fetal inflammation is significantly less common than maternal inflammation in unexplained fetal demise.
Area of Science:
- Perinatology
- Obstetrics
- Infectious Disease
Background:
- Intra-amniotic infection is a suspected cause of fetal death.
- Microbial invasion of the amniotic cavity (MIAC) and associated inflammation are key areas of investigation.
Purpose of the Study:
- To determine the prevalence of MIAC in fetal death.
- To assess the frequency of maternal and fetal inflammation in cases of fetal death.
Main Methods:
- Prospective study of 44 patients with intrauterine fetal death.
- Amniotic fluid analysis for microbial and cytological assessment.
- Histological examination of placenta for maternal (chorioamnionitis) and fetal (funisitis) inflammatory responses.
Main Results:
- Microbial invasion of the amniotic cavity (MIAC) was documented in only one case (1/44).
- Acute histological chorioamnionitis (maternal inflammation) was present in 20.9% of cases.
- Fetal inflammatory response (funisitis) was observed in only 2.3% of cases.
Conclusions:
- Conventional microbiological techniques rarely detect MIAC in fetal death.
- Maternal inflammation (chorioamnionitis) is significantly more frequent than fetal inflammation (funisitis) in fetal death cases (20.9% vs 2.3%).
Related Concept Videos
01:25Acute Inflammation III: Local and Systemic Effects
01:30Inflammatory Response I: Vascular and Cellular
01:22Development of Immunocompetence
The initial cells that migrate from the fetal thymus settle within the skin and epithelial tissues lining the mouth, digestive tract, and in females, the uterus and vagina. These cells, including skin-based dendritic cells, serve as antigen-presenting cells, playing a key role in T cell activation.
Subsequent T...