The Open Pathology Journal

2008, 2 : 24-27
Published online 2008 February 14. DOI: 10.2174/1874375700802010024
Publisher ID: TOPATJ-2-24

Chorioamnionitis and Congenital Abnormalities of the Brainstem (Arcuate Nucleus and Pre-Bötzinger Complex Hypoplasia) in a Case of Late Unexplained Stillbirth

Rosaria Mingrone , Ezio Fulcheri , Anna Maria Lavezzi and Luigi Matturri
Institute of Pathology, University of Milan, Via della Commenda, 19, 20122 Milan, Italy.

ABSTRACT

Background:

Fetal death (stillbirth), that occurs every 100-200 pregnancies in industrialized countries, has not significantly decreased in recent years, mostly because of scarce research activities in this field. Fetal death is often, in up to 60-80% of cases, unexplainable, even after routine diagnostic examinations.

Objectives:

This work aims to stress the importance of in-depth histopathological investigations of both the autonomic nervous system and the placenta in sudden fetal death.

Methods:

In a case of late fetal death at 40+3 weeks of pregnancy an in-depth histopathological examination of the brainstem and of the placenta was performed.

Results:

The case investigated showed severe hypoplasia of the arcuate nucleus as well as of the reticular formation and particularly of the pre-Bötzinger complex in the brainstem. Pulmonary hypoplasia was also present, associated with a picture of severe (grade 3) chorioamnionitis, with inflammatory infiltrate, vasculitis of the umbilical vein and amniochorionic vessels.

Conclusions:

The chorioamnionitis can allegedly contribute to stillbirth, through cytokine release, enhancing any chemoreceptor neuronal dysfunction..

Keywords:

Stillbirth, unexplained fetal death, arcuate nucleus.