Placenta - Umbilical vasculitis and funisitis

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Placenta

Umbilical cord

Umbilical vasculitis and funisitis

Reviewers: Mandolin Ziadie, M.D. (see Reviewers page)
Revised: 12 November 2011, last major update November 2011
Copyright: (c) 2003-2011, PathologyOutlines.com, Inc.

Definition
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● The fetal inflammatory response to intrauterine infection manifests as inflammation of the umbilical vessels (vasculitis) and Wharton’s jelly (funisitis)
● Higher incidence of major perinatal morbidity in preterm vs. term placentas (Hum Pathol 2001;32:623)

Etiology
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● Associated with any intrauterine infection, which is often due to a combination of several organisms which may include bacteria, Candida (associated with peripheral funisitis), actinomyces, HSV (associated with necrotizing funisitis) and syphilis

Gross description
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● In infections with Candida that cause peripheral funisitis, small white nodules may be noted on the umbilical cord surface

Micro description
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● Umbilical phlebitis: neutrophilic infiltration of the umbilical vein wall (stage 1 / early)
● Umbilical arteritis: neutrophilic infiltration of the umbilical arterial wall (stage 2 / intermediate)
● Necrotizing funisitis: neutrophilic infiltration through the vessel walls into the surrounding Wharton’s jelly (stage 3 / severe)
● May be associated with evidence of meconium exposure, sometimes with meconium-induced myocyte necrosis
● Peripheral funisitis: microabcesses on the surface of the umbilical cord; associated with Candida-like organisms

End of Placenta > Umbilical cord > Umbilical vasculitis and funisitis

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