title: Prolonged fetal bradycardia as the presenting clinical sign in congenital syphilis complicated by necrotizing funisitis: a case report.
abstract: Syphilis remains a serious cause of neonatal morbidity and mortality worldwide. In this paper, we describe a case of congenital syphilis that was fully supported by abnormal fetal heart rate patterns and placental histopathological evidence. A 24-year-old para 4 woman, who did not attend antenatal care, was admitted to our hospital with a complaint of abdominal discomfort at an estimated 31-week gestation. Fetal heart rate monitoring showed prolonged bradycardia. A neonate weighting 1,423 g with severe birth asphyxia was immediately delivered by cesarean section. Following delivery, the mother and the neonate were diagnosed with syphilis. Histopathological examination confirmed severe chorioamnionitis and necrotizing funisitis with numerous Treponema pallidum. Conclusions. Challenges in establishing the diagnosis of necrotizing funisitis are essential for optimal management of a fetus with a systemic inflammatory response in utero.
authors.affiliation: Department of Obstetrics and Gynecology, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Kakogawa
authors.forename: Miyuki
authors.initials: M
authors.lastname: Sadatsuki
authors.forename: Norio
authors.initials: N
authors.lastname: Masuya
authors.forename: Hideto
authors.initials: H
authors.lastname: Gomibuchi
authors.forename: Shigeki
authors.initials: S
authors.lastname: Minoura
authors.forename: Kazuhusa
authors.initials: K
authors.lastname: Hoshimoto