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Female Reproductive System ORGAN SYSTEMS

Fetal inflammatory response syndrome (FIRS)

Fetal infection & inflammation inducing a systemic inflammatory response in fetus leading to progressive polyorganic derangement, septic shock and death.

Introduction

Fetal infection & inflammation inducing a systemic inflammatory response in fetus leading to progressive polyorganic derangement, septic shock and death.

  • Counterpart of the systemic inflammatory response syndrome (SIRS)

Aetiology

Risk factors:

  • Prematurity
  • Intra-amniotic infection and/or inflammation

Pathophysiology

Fetal microbial invasion or other insults may result in a systemic fetal inflammatory response that can progress toward multiple organ dysfunction, including the hematopoietic system, the adrenals, heart, kidneys, thymus and skin.

Fetal target organs during the fetal inflammatory response syndrome (FIRS). | Gotsch F, Romero R, Kusanovic JP et al, The fetal inflammatory response syndrome, Clinical Obstetrics and Gynecology; 50: 2007: 652-683

Clinical features

FIRS is most frequently characterised by subclinical course

FIRS results in severe damages of a foetus and newborn and remote residual health disorders in an infant, such as cerebral palsy and chronic lung disease

Complications:

  • FIRS is an independent risk factor for perinatal morbidity/mortality
  • Infection-related neonatal complications:
  • Bronchopulmonary dysplasia
  • Impaired neurological outcomes: Cerebral palsy

Diagnosis

Umbilical cord blood:

  • ↑ umbilical cord plasma interleukin (IL)-6 concentration2
  • Presence of funisitis
  • ↑ C-reactive protein umbilical cord blood

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