title: Stillborn or liveborn? Comparing umbilical cord immunohistochemical expression of vitality markers (tryptase, alpha(1)-antichymotrypsin and CD68) by quantitative analysis and confocal laser scanning microscopy.
abstract: The distinction between stillborn and liveborn infants and the demonstration of a separate existence of fetuses are central issues in the daily practice of perinatologists and pathologists. The current knowledge about the chronology of responses of the tissue following the occurrence of a vital reaction, as well as the existence of numerous studies that aimed at identifying markers of vitality of cutaneous lesions, induced us to investigate the umbilical cord for the presence or absence of vitality indexes. We investigated 45 samples of umbilical cords obtained during post-mortem examinations of stillborns, as well as samples of umbilical cords taken from newborns after normal labor. On these samples, we performed a complete immunohistochemical study. Our results showed that some of the parameters investigated, such as tryptase for the mast cell, CD68, and alpha-1-antichymotrypsin, showed a statistically significant (p<0.0001) different expression in the two groups under study (stillborn and liveborn). Owing to the strong different expression of these markers in the samples of the umbilical cords from liveborns, compared to those from stillborns, one might regard them as reliable parameters, to which the pathologist may resort whenever he is dealing with the distinction between stillborns and liveborns.
authors.affiliation: Department of Forensic Pathology, University of Foggia, Ospedale Colonnello D'Avanzo, Foggia, Italy.
authors.forename: Margherita
authors.initials: M
authors.lastname: Neri
authors.forename: Stefano
authors.initials: S
authors.lastname: D'Errico
authors.forename: Carmela
authors.initials: C
authors.lastname: Fiore
authors.forename: Cristoforo
authors.initials: C
authors.lastname: Pomara
authors.forename: Roberto
authors.initials: R
authors.lastname: Rabozzi
authors.forename: Irene
authors.initials: I
authors.lastname: Riezzo
authors.forename: Emanuela
authors.initials: E
authors.lastname: Turillazzi
authors.forename: Pantaleo
authors.initials: P
authors.lastname: Greco
authors.forename: Vittorio
authors.initials: V
authors.lastname: Fineschi
mesh_terms: D000328:Adult; D015703:Antigens, CD / Q000378:metabolism*; D015214:Antigens, Differentiation, Myelomonocytic / Q000378:metabolism*; D015415:Biomarkers / Q000378:metabolism*; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D007124:Immunoenzyme Techniques; D007231:Infant, Newborn; D050498:Live Birth; D008264:Macrophages / Q000378:metabolism / Q000473:pathology; D008407:Mast Cells / Q000378:metabolism / Q000473:pathology; D018613:Microscopy, Confocal; D011247:Pregnancy; D050497:Stillbirth; D053802:Tryptases / Q000378:metabolism*; D014470:Umbilical Cord / Q000378:metabolism* / Q000473:pathology; D055815:Young Adult; D000514:alpha 1-Antichymotrypsin / Q000378:metabolism*; D000097382:CD68 Molecule
chemical_list: D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D015415:Biomarkers; D053802:Tryptases; D000514:alpha 1-Antichymotrypsin; C067980:CD68 antigen, human; D000097382:CD68 Molecule