Leukocytic Infiltration of the Umbilical Cord in Twins

Abstract

Leukocytic infiltration of the umbilical cord, particularly of the umbilical vein, is common both after normal and abnormal delivery (Tab. I).The significance and the cause(s) of this phenomenon, however, are still highly controversed subjects (Tab. II). According to some authors (Benirschke, i960; Benirschke and Clifford 1959; Blanc 1961; and Kelsall et al, 1967), cord infiltration may be an indication of intrauterine fetal infection. As a consequence, the terms vasculitis, umbilical phlebitis and funiculitis have been introduced. Other authors (Barter, 1962, and Dominguez et al, 1960), mostly impressed by the discrepancy between the incidence of clinically evident neonatal infection and funiculitis, as well as by the significant association of cord infiltration with prolonged labor and clinical signs of fetal distress, have come to the conclusion that leukocytic infiltration of the umbilical cord must predominantly be the effect of fetal hypoxia. Dominguez et al (i960) go even further and postulate “that the examination of the umbilical cord for leukocytic infiltration affords a means for a long term study of children to determine the effect of intrauterine hypoxia on their ultimate growth and development”.One way to check the validity of the latter hypothesis, is to investigate the umbilical cords of twins. Since our group has proven that, compared to the first-born twin, the second-born infant is as a rule significantly more hypoxic at birth (Derom and Thiery, 1969), one may expect that intragroup comparison of the incidence of leukocytic infiltration of twin cords should at least permit to disprove the validity of Dominguez assumptions.