A 24-year-old woman, gravida 1, para 0, at 33 weeks' gestation, is admitted to the hospital in active labor. She delivers a small male newborn. Apgar scores were 6 and 6 at 1 and 5 minutes, respectively. His mother received no prenatal care. On delivery, the placenta appears enlarged. In addition, the umbilical cord is inflamed with multiple areas of abscess-like foci of necrosis surrounding the umbilical vessels. Which of the following is the most likely cause of these findings?

Question

A 24-year-old woman, gravida 1, para 0, at 33 weeks' gestation, is admitted to the hospital in active labor. She delivers a small male newborn. Apgar scores were 6 and 6 at 1 and 5 minutes, respectively. His mother received no prenatal care. On delivery, the placenta appears enlarged. In addition, the umbilical cord is inflamed with multiple areas of abscess-like foci of necrosis surrounding the umbilical vessels.  Which of the following is the most likely cause of these findings?

Quizplus · Accepted Answer

Eductional Objective: Patients with an atypical delivery (eg, preterm) require placental evaluation.  Umbilical cord inflammation with abscess-like foci of necrosis suggests congenital syphilis (ie, spirochete infection with Treponema pallidum).

A 24-Year-Old Woman, Gravida 1, Para 0, at 33 Weeks