Table of Contents
ISRN Obstetrics and Gynecology
Volume 2011, Article ID 320246, 3 pages
Case Report

Prolonged Fetal Bradycardia as the Presenting Clinical Sign in Congenital Syphilis Complicated by Necrotizing Funisitis: A Case Report

1Department of Obstetrics and Gynecology, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
2Department of Pathology, National Center for Global Health and Medicine, Shinju-ku, Tokyo 162-8655, Japan

Received 27 January 2011; Accepted 16 March 2011

Academic Editor: A. M. Abou-Setta

Copyright © 2011 Jun Kakogawa et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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.