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Necrotizing funisitis.

R D Craver¹, V J Baldwin

¹Department of Pathology, Louisiana State University Medical School, New Orleans.

Obstetrics and Gynecology

|January 1, 1992

Summary

This summary is machine-generated.

Necrotizing funisitis, an umbilical cord lesion, is linked to stillbirths and small for gestational age (SGA) infants. A potential toxin in amniotic fluid may cause these adverse outcomes.

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Area of Science:

Perinatology
Pathology
Obstetrics

Background:

Necrotizing funisitis is an umbilical cord lesion characterized by perivascular necrotic Wharton jelly and inflammatory cells.
This condition affects fetal outcomes, with potential links to intrauterine factors.

Purpose of the Study:

To investigate the clinical significance and potential causes of necrotizing funisitis.
To compare outcomes in infants with necrotizing funisitis versus those with acute funisitis.

Main Methods:

Histological review of 60 cases of necrotizing funisitis.
Comparison with 45 age-matched controls with acute funisitis.
Analysis of clinical data, including birth weight and infectious complications.

Main Results:

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Infants with necrotizing funisitis showed increased rates of stillbirth, small for gestational age (SGA), infectious complications, and necrotizing enterocolitis.
No specific infectious agents or maternal factors were consistently identified.
Cord neovascularization was associated with SGA infants.

Conclusions:

Necrotizing funisitis may be caused by a diffusible amniotic fluid toxin affecting fetal development.
The lesion's pattern suggests a localized effect, potentially neutralized at the placenta.
Underlying factors may predispose to secondary inflammatory conditions like vasculitis and chorioamnionitis.