Induction of hepatic granulopoiesis due to chorioamnionitis during the second trimester of development.
OBJECTIVE
To detect post mortem changes in fetal hematopoiesis consistent with infection from liver examination alone.


METHODS
We investigated the immunohistochemical expression of Glycophorin C, Neutrophilic elastase, and CD34, in the hepatic parenchyma from fetuses miscarried as a result of chorioamnionitis (caused by Chlamydia trachomatis) and correlated them with the equivalent from fetuses after voluntary abortion (gestational age: 16th, 20th, and 24th weeks).


RESULTS
A statistically significant difference was found in the Neutrophilic elastase positive cells to the advantage of cases with chorioamnionitis over voluntary abortions (24th week: P=0.0001, t-test) and also at the level of total hematopoiesis (20th and 24th week: P=0.041 and 0.004, respectively, t-test). There was no quantitative difference between the two settings at the level of erythropoiesis in the three examined periods.


CONCLUSIONS
Fetal infection can be diagnosed from the liver alone. After detection of changes in fetal hematopoiesis indicative of infection, examination of additional specimens of placenta and membranes will document the diagnosis of chorioamnionitis.
Tamiolakis
D
D
Department of Cytology, Regional Hospital of Alexandroupolis, 68100, Alexandroupolis, Greece.
Kotini
A
A
Jivannakis
T
T
Papadopoulos
N
N
D000022:Abortion, Spontaneous / Q000382:microbiology; D018952:Antigens, CD34 / Q000032:analysis; D002690:Chlamydia Infections; D002692:Chlamydia trachomatis; D002821:Chorioamnionitis / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D005260:Female; D005865:Gestational Age; D006098:Granulocytes; D006411:Hematopoiesis, Extramedullary; D006801:Humans; D007150:Immunohistochemistry; D008099:Liver / Q000196:embryology* / Q000473:pathology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000382:microbiology*
D018952:Antigens, CD34