Testing umbilical cords for funisitis due to Treponema pallidum infection,Bolivia

To establish the frequency of necrotizing funisitis in congenital syphilis, we conducted a prospective descriptive study of maternal syphilis in Boliv ia by testing 1,559 women at delivery with rapid plasma reagin (RPR). We ex amined umbilical cords of 66 infants whose mothers had positive RPR and flu orescent treponemal antibody absorption tests. Histologic abnormalities wer e detected in 28 (42%) umbilical cords (seven [11%] had necrotizing funisit is with spirochetes; three [4%] had marked funisitis without necrosis; and 18 [27%] had mild funisitis), and 38 [58%] were normal. Of 22 umbilical cor ds of infants from mothers without syphilis (controls), only two (9%) showe d mild funisitis; the others were normal. Testing umbilical cords by using immunohistochemistry is a research tool that can establish the frequency of funisitis due to Treponema pallidum infection.