Reliability and Feasibility of Frozen Umbilical Cord Sections for the Identification of Neonatal Early Onset Sepsis

Grant Application

Anne-Marie Rick, MD, PhD

Proposed Innovation

Neonatal sepsis is a rare but deadly bacterial blood infection that can occur in newborns after delivery. It’s a life-threatening condition requiring rapid treatment with antibiotics, but it is difficult to predict and diagnose. As a result, babies are often overtreated, which can potentially cause harm and increase risks, including antibiotic resistance.

This project will evaluate whether frozen umbilical cord sections can be used to rapidly and accurately identify potentially deadly sepsis in newborns. The goal is to create a screening tool that can be used to quickly treat infected infants while avoiding unnecessary testing and treatment of uninfected infants.

Improvements in Action

Inflammation of the umbilical cord has been found to identify up to 90% of sepsis cases in newborns while ruling out up to 65% of uninfected high-risk babies. But traditional histopathology takes three to five days, so it’s not useful in making real-time decisions about whether to start antibiotics. “Frozen section” — a pathological laboratory technique used in surgical specialties for rapid microscopic analysis — can provide results in less than 20 minutes.

This project will study and compare results of umbilical cord samples taken from the placenta of 300 high-risk mothers and processed by frozen section and traditional histopathology. Follow up of infants will be done to determine if they in fact have an infection and which test did a better job.

Intended Outcomes

If successful, this study is expected to transform neonatal care at UPMC and beyond. It will increase rapid identification of sepsis, reduce unnecessary laboratory evaluations and antibiotic treatments of uninfected infants, reduce hospital costs and length of stay, and keep families together.