Isolated acute funisitis in the absence of acute chorioamnionitis: What does it mean?

Tracy B Grossman1, Debra S Heller2, Rebecca N Baergen3

  • 1Weill Cornell Medical College, Department of Obstetrics & Gynecology, 525 E 68th St, New York, NY, 10065, USA.

Placenta
|February 5, 2019
PubMed
Abstract

Insights

Isolated funisitis (IF) is strongly linked to meconium exposure and umbilical vessel damage. Further research is needed to fully understand the implications of IF in pregnancy outcomes.

Area of Science:

  • Perinatal pathology
  • Obstetrics
  • Fetal medicine

Background:

  • Acute funisitis (AF) is typically associated with acute chorioamnionitis (AC) and ascending infections.
  • The clinical significance of isolated funisitis (IF), occurring without AC, remains unclear.

Purpose of the Study:

  • To investigate the clinical and pathological characteristics of isolated funisitis (IF).
  • To determine the significance of IF in pregnancy outcomes.

Main Methods:

  • Retrospective review of placental data from 1997 to 2017.
  • Comparison of 156 cases of IF with 181 control placentas lacking AF or AC.

Main Results:

  • IF cases showed a significantly higher prevalence of meconium (84.6%) and meconium-associated myonecrosis in umbilical vessels compared to controls (38.7%, p < .001).
  • A higher rate of intrauterine fetal demise (IUFD) was observed in the IF group (p = .027).
  • Controls had a higher rate of suspected intrauterine growth restriction (IUGR) (p = .014).

Conclusions:

  • Isolated funisitis (IF) is highly associated with meconium discharge and subsequent myonecrosis of umbilical vessels.
  • Meconium may cause damage to umbilical cord muscle fibers, potentially explaining the inflammation in IF.
  • Additional studies are required to elucidate the full significance of these findings in pregnancy.

Related Concept Videos

Acute Pharyngitis01:30

Acute Pharyngitis

Introduction
Acute pharyngitis is the inflammation of the back of the throat (pharynx), commonly resulting in a sore throat. It is a frequently encountered condition that prompts individuals to seek medical advice.
Classification
Acute pharyngitis can be categorized based on its underlying cause:
4.2K
Acute Pancreatitis I: Introduction01:27

Acute Pancreatitis I: Introduction

Pancreatitis is inflammation of the pancreas, an organ located behind the stomach. It can be either acute or chronic.
Acute pancreatitis is characterized by rapid inflammation of the pancreas, often caused by factors like gallstone blockage or excessive alcohol consumption. Chronic pancreatitis, on the other hand, is a slow, progressive inflammation that may result from long-term alcohol abuse, obstructions in the pancreatic duct, or genetic factors.
The causes of acute pancreatitis include:
1.2K
Acute Respiratory Failure-I01:21

Acute Respiratory Failure-I

Acute respiratory failure is a condition characterized by the inability of the lungs to perform their primary function: gas exchange. This failure leads to insufficient oxygen levels (hypoxemia) in the blood, elevated carbon dioxide levels (hypercapnia), or both, causing critical impairment in organ function.
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...
986
Acute Respiratory Failure-II01:21

Acute Respiratory Failure-II

Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
1.1K
Acute Respiratory Failure-V01:29

Acute Respiratory Failure-V

The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
499
Acute Pyelonephritis I: Introduction01:27

Acute Pyelonephritis I: Introduction

Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such...
635