Necrotizing funisitis and calcification of umbilical vein: case report and review

BMC Pregnancy Childbirth. 2021 Apr 12;21(1):296. doi: 10.1186/s12884-021-03743-3.

Abstract

Background: Necrotising funisitis (NF) is a rare, chronic stage of funisitis, a severe inflammation of the umbilical cord and an important risk factor for fetal adverse outcomes. NF is characterized by yellow-white bands running parallel to the umbilical blood vessels. These bands consist of inflammatory cells, necrotic debris, and calcium deposits. Calcification is visible in ultrasonography, which makes it possible to suspect NF when umbilical vascular wall calcification is detected by prenatal ultrasonography.

Case presentation: Ultrasonography revealed calcification of the umbilical venous wall in an expectant 31-year-old woman who was gravida 1, para 0. The woman required emergency cesarean section because of fetal distress and suspected umbilical cord torsion at 31 weeks gestation. The root of the umbilical cord was quite fragile and broke during the operation. The pathological results on the placenta showed histologic chorioamnionitis and NF. The infant was diagnosed to have neonatal sepsis and acidosis after delivery but was discharged without severe complications after a one-month hospitalization that included antibiotic and supportive therapy.

Conclusion: NF is a rare and severe inflammation of the umbilical cord. Umbilical vascular wall calcification discovered in prenatal ultrasonography is diagnostically helpful.

Keywords: Intrauterine infection; Necrotizing funisitis; Prenatal diagnosis; Ultrasonography; Umbilical vein calcification.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Cesarean Section
  • Chorioamnionitis / diagnosis*
  • Chorioamnionitis / pathology
  • Chorioamnionitis / surgery
  • Female
  • Humans
  • Imaging, Three-Dimensional
  • Infant, Newborn
  • Infant, Very Low Birth Weight
  • Male
  • Necrosis / diagnosis
  • Necrosis / etiology
  • Pregnancy
  • Severity of Illness Index
  • Treatment Outcome
  • Ultrasonography, Doppler, Color
  • Ultrasonography, Prenatal
  • Umbilical Cord / blood supply
  • Umbilical Cord / diagnostic imaging
  • Umbilical Cord / pathology*
  • Umbilical Veins / diagnostic imaging
  • Umbilical Veins / pathology
  • Vascular Calcification / complications
  • Vascular Calcification / diagnosis*