Fetal listeriosis during the second trimester of gestation.

Listeriosis is common and is implicated in about 3% of second-term abortions examined in our laboratory. Maternal fever was followed rapidly in all instances by the expulsion of a nonmacerated fetus. Chorioamnionitis was always present and was associated with placental microabscesses. Leukocytic infiltrates were frequent in fetal tissues, being present in adrenal, lung, and skin. Listeria monocytogenes was isolated from 8 of the 205 abortions that had microbiological cultures (3.9%). The clinical features and morphological lesions were so characteristic that the diagnosis of listeriosis could be made in 5 of the 217 fixed abortuses received during the same period, but without culture. In contrast to the third trimester of pregnancy, there were no inflammatory lesions in the central nervous system in our small series.

Fetal adrenal development during the second trimester of gestation.

Four hundred and fifty pairs of adrenals were studied from human fetuses ranging in age from 15 to 27 weeks of gestation (menstrual age). They were collected from spontaneous and medical abortions. The adrenal weight increased from 0.2 to 1.5 g during the second trimester. The left adrenal was significantly heavier than the right for the same gestational age. The length (L1), the height (L2) and the thickness (L3) of the adrenals were measured. The index of length (L1 x L2 x L3) correlated well with the fetal age, except for the Potter Syndrome in which it was decreased. This index could be a useful indicator for ultrasonographic and pathologic studies of the fetal adrenal gland. The cells of the fetal cortex contained lipid droplets during the first weeks of the mid-trimester, and this storage progressively decreased after 20-21 weeks. The fatty transformation that is used as an indicator of the mode of death of stillborn infants cannot be applied to abortions during the second trimester. In a few instances, hypoxia was associated with adrenal hypertrophy.