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Fetopathology and developmental pathology of the embryo and fetus
Marta Ježová, Josef Feit et al.
Intrauterine Candida infection is quite rare in spite of of common occurrence of vaginal discharge in pregnant women. Most cases are associated with retained intrauterine device (IUD).
Intrauterine candida infection occurs as an ascending infection from the vagina. The most important risk factor is intrauterine foreign body — retained IUD, cervical cerclage.
It involves the fetal membranes producing chorionamnionitis. Involvement of the umbilical cord is common. Systemic fetal infection (pneumonitis, rash, meningitis, gastrointestinal) is uncommon, the cases are almost ofen associatied with maternal IUD.
White or yellow tiny plaques may be seen on the fetal surface of the placenta or on the surface of the umbilical cord.
Polymorphonuclear infiltration of the fetal membranes. Candida pseudohyphae are readily seen in hemotoxylin-eosin stains and special stains (Grocott, PAS ). Lesions of the umbilical cord are focal and subamnial.
25-year old woman with premature rupture of membranes in the 18 w.g. She became pregnant despite the intrauterine device in situ (confirmed by examination). The miscarriage was afebrile. Histological examination of the placenta and fetal tissues erevaled acute chorioamnionitis and congenital necrotizing pneumonia caused by Candida infection.
Placenta, candidosis (IUD in situ), HE 40x (72799)