Frozen Section of Placental Membranes and Umbilical Cord: A Valid Diagnostic Tool for Early-Onset Neonatal Sepsis Management

Author:

Parrella Veronica1ORCID,Paudice Michele12,Pittaluga Michela3,Allodi Alessandra4ORCID,Fulcheri Ezio15,Buffelli Francesca5ORCID,Barra Fabio6ORCID,Ferrero Simone78ORCID,Arioni Cesare4,Vellone Valerio Gaetano15ORCID

Affiliation:

1. Department of Integrated Surgical and Diagnostic Sciences (DISC), University of Genoa, Viale Benedetto XV, 14, 16132 Genoa, Italy

2. Pathology University Unit, IRCCS Ospedale Policlinico San Martino, Largo R.Benzi, 10, 16132 Genoa, Italy

3. Department of Internal Medicine (DIMI), University of Genoa, Viale Benedetto XV, 14, 16132 Genoa, Italy

4. Neonatology Unit, IRCCS Ospedale Policlinico San Martino, Largo R.Benzi, 10, 16132 Genoa, Italy

5. Pathology Unit, IRCCS Istituto Giannina Gaslini, Via G.Gaslini, 5, 16147 Genoa, Italy

6. Obstetrics and Gynecology Unit, ASL4, Via Don Giovanni Battista Bobbio, 25, 16033 Lavagna, Italy

7. Obstetrics and Gynecology University Unit, IRCCS Ospedale Policlinico San Martino, Largo R.Benzi, 10, 16132 Genoa, Italy

8. Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, L.go Paolo Daneo 3, 16132 Genoa, Italy

Abstract

Early-onset neonatal sepsis (EONS), a serious infection in newborns within 3 days, is challenging to diagnose. The current methods often lack accuracy, leading to unnecessary antibiotics or delayed treatment. This study investigates the role of the frozen section examination of placental membranes and umbilical cord (FSMU) to improve EONS diagnosis in the daily lab practice. This retrospective study reviewed data from 59 neonates with EONS risk factors who underwent FSMU according to our institutional protocol. Concordance between the FSMU and the Final Pathological Report (FPR) was assessed. The FSMU demonstrated a high concordance (Kappa = 0.88) for funisitis diagnosis, with excellent accuracy (98.3%). A moderate concordance was observed for chorioamnionitis stage and grade. The FSMU shows promise as a rapid and accurate tool for diagnosing EONS, particularly for funisitis. This study suggests that the FSMU could be a valuable tool for EONS diagnosis, enabling a more judicious antibiotic use and potentially improving outcomes for newborns.

Publisher

MDPI AG

Reference26 articles.

1. Recognising early onset neonatal sepsis: An essential step in appropriate anti-microbial use;Stocker;J. Infect.,2016

2. MSD Manuals (2024, February 15). Neonatal Sepsis. Available online: https://www.merckmanuals.com/en-pr/professional/pediatrics/infections-in-neonates/neonatal-sepsis.

3. National Institutes of Health (2024, February 15). Neonatal Sepsis, Available online: https://www.ncbi.nlm.nih.gov/books/NBK531478.

4. Risk factors for neonatal sepsis: An overview;J. Pediatr. Neonatal Individ. Med.,2020

5. Early-Onset Sepsis in Neonates—A Population-Based Study in South-West Norway From 1996 to 2018;Vatne;Front. Pediatr.,2021

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