Immunohistochemical detection of meconium in the fetal membrane, placenta and umbilical cord

Abstract

Objective: To develop the immunohistochemistry specific for meconium in the placenta, fetal membrane and umbilical cord.

Study design: We previously reported the specific presence of zinc coproporphyrin I (ZnCP-I) in human meconium and demonstrated the possible diagnostic use of an elevation in maternal plasma ZnCP-I levels in cases of amniotic fluid embolism. In this study, we developed a new specific monoclonal antibody for ZnCP-I and applied it to the immunostaining of meconium in the placenta, fetal membrane, and umbilical cord.

Results: Immunoreactivity of ZnCP-I clearly and specifically identified meconium in the placenta, fetal membrane, and umbilical cord. It was especially useful in cases of severe chorioamnionitis to detect meconium in the macrophages surrounded by numerous neutrophils. In more than half of the cases, meconium was detected in clear amniotic fluid at delivery, suggesting previous exposure.

Conclusions: Immunohistochemical detection of ZnCP-I is a highly sensitive histological diagnosis of meconium.