Clinically relevant umbilical cord inflammation identified based on CD15-associated vasculitis patterning

Area of Science:

• Perinatal pathology
• Immunohistochemistry
• Inflammation markers

Background:

• Acute funisitis, an umbilical cord inflammation, is linked to adverse perinatal outcomes.
• Current methods lack efficiency in detecting clinically significant umbilical cord inflammation.

Purpose of the Study:

• To develop an immunohistochemical method for identifying clinically relevant umbilical cord inflammation.
• To assess patterns of umbilical cord vasculitis using CD15.

Main Methods:

• Developed a five-tier scoring system using CD15, a granulocyte marker.
• Compared immunohistochemical findings with morphological assessments.
• Analyzed 261 cases from a single medical institute.

Main Results:

• Severe umbilical phlebitis (score 3) correlated with maternal inflammatory response.
• Severe umbilical arteriophlebitis (score 4) linked to low umbilical arterial pH, indicating fetal risk.
• CD15 immunohistochemistry identified vitelline vasculitis and improved detection of severe vasculitis with three sections.

Conclusions:

• CD15 immunohistochemistry is valuable for diagnosing umbilical vasculitis, especially in ambiguous cases.
• Analyzing three umbilical cord sections is efficient for detecting inflammation.
• This method aids in identifying risks for fetal mortality and morbidity.