Infection Induced Fetal Inflammatory Response Syndrome (FIRS): State-of- the-Art and Medico-Legal Implications—A Narrative Review
Fetal inflammatory response syndrome (FIRS) represents the fetal inflammatory reaction to intrauterine infection or injury, potentially leading to multiorgan impairment, neonatal mortality, and morbidity. Infections induce FIRS after chorioamnionitis (CA), defined as acute maternal inflammatory resp...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-04-01
|
| Series: | Microorganisms |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2076-2607/11/4/1010 |
| _version_ | 1827744259297509376 |
|---|---|
| author | Elena Giovannini Maria Paola Bonasoni Jennifer Paola Pascali Arianna Giorgetti Guido Pelletti Giancarlo Gargano Susi Pelotti Paolo Fais |
| author_facet | Elena Giovannini Maria Paola Bonasoni Jennifer Paola Pascali Arianna Giorgetti Guido Pelletti Giancarlo Gargano Susi Pelotti Paolo Fais |
| author_sort | Elena Giovannini |
| collection | DOAJ |
| description | Fetal inflammatory response syndrome (FIRS) represents the fetal inflammatory reaction to intrauterine infection or injury, potentially leading to multiorgan impairment, neonatal mortality, and morbidity. Infections induce FIRS after chorioamnionitis (CA), defined as acute maternal inflammatory response to amniotic fluid infection, acute funisitis and chorionic vasculitis. FIRS involves many molecules, i.e., cytokines and/or chemokines, able to directly or indirectly damage fetal organs. Therefore, due to FIRS being a condition with a complex etiopathogenesis and multiple organ dysfunction, especially brain injury, medical liability is frequently claimed. In medical malpractice, reconstruction of the pathological pathways is paramount. However, in cases of FIRS, ideal medical conduct is hard to delineate, due to uncertainty in diagnosis, treatment, and prognosis of this highly complex condition. This narrative review revises the current knowledge of FIRS caused by infections, maternal and neonatal diagnosis and treatments, the main consequences of the disease and their prognoses, and discusses the medico-legal implications. |
| first_indexed | 2024-03-11T04:43:11Z |
| format | Article |
| id | doaj.art-077852bb90ed43efa93f291987113e37 |
| institution | Directory Open Access Journal |
| issn | 2076-2607 |
| language | English |
| last_indexed | 2024-03-11T04:43:11Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Microorganisms |
| spelling | doaj.art-077852bb90ed43efa93f291987113e372023-11-17T20:33:44ZengMDPI AGMicroorganisms2076-26072023-04-01114101010.3390/microorganisms11041010Infection Induced Fetal Inflammatory Response Syndrome (FIRS): State-of- the-Art and Medico-Legal Implications—A Narrative ReviewElena Giovannini0Maria Paola Bonasoni1Jennifer Paola Pascali2Arianna Giorgetti3Guido Pelletti4Giancarlo Gargano5Susi Pelotti6Paolo Fais7Unit of Legal Medicine, Department of Medical and Surgical Sciences, University of Bologna, Via Irnerio 49, 40126 Bologna, ItalyPathology Unit, Azienda USL-IRCCS di Reggio Emilia, Via Amendola 2, 42122 Reggio Emilia, ItalyDepartment of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35127 Padova, ItalyUnit of Legal Medicine, Department of Medical and Surgical Sciences, University of Bologna, Via Irnerio 49, 40126 Bologna, ItalyUnit of Legal Medicine, Department of Medical and Surgical Sciences, University of Bologna, Via Irnerio 49, 40126 Bologna, ItalyNeonatal Intensive Care Unit, Azienda USL-IRCCS di Reggio Emilia, Via Amendola 2, 42122 Reggio Emilia, ItalyUnit of Legal Medicine, Department of Medical and Surgical Sciences, University of Bologna, Via Irnerio 49, 40126 Bologna, ItalyUnit of Legal Medicine, Department of Medical and Surgical Sciences, University of Bologna, Via Irnerio 49, 40126 Bologna, ItalyFetal inflammatory response syndrome (FIRS) represents the fetal inflammatory reaction to intrauterine infection or injury, potentially leading to multiorgan impairment, neonatal mortality, and morbidity. Infections induce FIRS after chorioamnionitis (CA), defined as acute maternal inflammatory response to amniotic fluid infection, acute funisitis and chorionic vasculitis. FIRS involves many molecules, i.e., cytokines and/or chemokines, able to directly or indirectly damage fetal organs. Therefore, due to FIRS being a condition with a complex etiopathogenesis and multiple organ dysfunction, especially brain injury, medical liability is frequently claimed. In medical malpractice, reconstruction of the pathological pathways is paramount. However, in cases of FIRS, ideal medical conduct is hard to delineate, due to uncertainty in diagnosis, treatment, and prognosis of this highly complex condition. This narrative review revises the current knowledge of FIRS caused by infections, maternal and neonatal diagnosis and treatments, the main consequences of the disease and their prognoses, and discusses the medico-legal implications.https://www.mdpi.com/2076-2607/11/4/1010fetal inflammatory response syndromeplacental pathologycausal linkmedical liabilitymedico-legal compensation |
| spellingShingle | Elena Giovannini Maria Paola Bonasoni Jennifer Paola Pascali Arianna Giorgetti Guido Pelletti Giancarlo Gargano Susi Pelotti Paolo Fais Infection Induced Fetal Inflammatory Response Syndrome (FIRS): State-of- the-Art and Medico-Legal Implications—A Narrative Review Microorganisms fetal inflammatory response syndrome placental pathology causal link medical liability medico-legal compensation |
| title | Infection Induced Fetal Inflammatory Response Syndrome (FIRS): State-of- the-Art and Medico-Legal Implications—A Narrative Review |
| title_full | Infection Induced Fetal Inflammatory Response Syndrome (FIRS): State-of- the-Art and Medico-Legal Implications—A Narrative Review |
| title_fullStr | Infection Induced Fetal Inflammatory Response Syndrome (FIRS): State-of- the-Art and Medico-Legal Implications—A Narrative Review |
| title_full_unstemmed | Infection Induced Fetal Inflammatory Response Syndrome (FIRS): State-of- the-Art and Medico-Legal Implications—A Narrative Review |
| title_short | Infection Induced Fetal Inflammatory Response Syndrome (FIRS): State-of- the-Art and Medico-Legal Implications—A Narrative Review |
| title_sort | infection induced fetal inflammatory response syndrome firs state of the art and medico legal implications a narrative review |
| topic | fetal inflammatory response syndrome placental pathology causal link medical liability medico-legal compensation |
| url | https://www.mdpi.com/2076-2607/11/4/1010 |
| work_keys_str_mv | AT elenagiovannini infectioninducedfetalinflammatoryresponsesyndromefirsstateoftheartandmedicolegalimplicationsanarrativereview AT mariapaolabonasoni infectioninducedfetalinflammatoryresponsesyndromefirsstateoftheartandmedicolegalimplicationsanarrativereview AT jenniferpaolapascali infectioninducedfetalinflammatoryresponsesyndromefirsstateoftheartandmedicolegalimplicationsanarrativereview AT ariannagiorgetti infectioninducedfetalinflammatoryresponsesyndromefirsstateoftheartandmedicolegalimplicationsanarrativereview AT guidopelletti infectioninducedfetalinflammatoryresponsesyndromefirsstateoftheartandmedicolegalimplicationsanarrativereview AT giancarlogargano infectioninducedfetalinflammatoryresponsesyndromefirsstateoftheartandmedicolegalimplicationsanarrativereview AT susipelotti infectioninducedfetalinflammatoryresponsesyndromefirsstateoftheartandmedicolegalimplicationsanarrativereview AT paolofais infectioninducedfetalinflammatoryresponsesyndromefirsstateoftheartandmedicolegalimplicationsanarrativereview |