A SILENT THREAT IN SECOND TRIMESTER FETAL LOSS: INTRAUTERINE DEVICE- RELATED FUNGAL FUNISITIS AND CANDIDA CHORIOAMNIONITIS
CUKUROVA 17th INTERNATIONAL SCIENTIFIC RESEARCHES CONFERENCE, Adana, Türkiye, 10 - 12 Temmuz 2026, ss.1539-1540, (Özet Bildiri)
- Yayın Türü: Bildiri / Özet Bildiri
- Basıldığı Şehir: Adana
- Basıldığı Ülke: Türkiye
- Sayfa Sayıları: ss.1539-1540
- Recep Tayyip Erdoğan Üniversitesi Adresli: Evet
Özet
INTRODUCTION: Although vulvovaginal candidiasis is detected in approximately 15% of
pregnancies, Candida-induced chorioamnionitis is quite rare (0.3%). Despite its rarity, this condition
can lead to devastating complications. Predisposing factors include gestational diabetes, cervical
cerclage, amniocentesis, and, most notably, intrauterine devices. Fungal funisitis represents a severe
form of chorioamnionitis in which the umbilical cord is directly involved in the infection and often
results in rapid fetal loss.
CASE PRESENTATION: A 39-year-old patient, 21 weeks pregnant, presented to the emergency
department with abdominal pain. At the time of admission, the patient's general condition was good,
vital signs were stable, and there was no fever. Ultrasonography revealed an intrauterine device and no fetal heartbeat, and fetal death was considered confirmed. Postpartum laboratory findings showed an
inflammatory response. Macroscopic evaluation of the placenta revealed no specific gross lesions.
Histopathological examination of the placenta and umbilical cord revealed acute chorioamnionitis. A
critical finding was the presence of microabscess foci in the umbilical cord and acute vasculitis, leading
to a diagnosis of funisitis. Periodic Acid-Schiff staining revealed numerous fungal hyphae and spores in
the umbilical cord and placental membranes.
The case was reported as acute chorioamnionitis and fungal funisitis caused by Candida.
RESULTS: Chorioamnionitis and funisitis due to Candida infection are quite rare and can cause serious
perinatal and neonatal complications such as premature birth, premature rupture of membranes, and
stillbirth. Candida albicans is the most common fungal organism causing acute chorioamnionitis and
funisitis.
CONCLUSION: In second-trimester fetal loss associated with IUDs, a high index of suspicion for
fungal etiology is essential, even in the absence of fever. The presence of microabscesses in the umbilical
cord is a morphological "red flag" requiring routine use of specialized stains. Histopathological
examination of the placenta remains the gold standard for clarifying the etiology of "silent" fetal loss
and managing subsequent pregnancies.