Answer: Candida funisitis

Histology: The membrane section shows acute chorioamnionitis characterized by neutrophils invading into the chorion from the decidua. The umbilical cord shows funisitis with distinct clusters of degenerated neutrophils associated with necrosis located at the cord’s periphery. A GMS stain confirms the presence of yeast and pseudohyphae in these areas, typical of Candida funisitis.

Discussion: Acute chorioamnionitis is often associated with fetal response manifested as funisitis, but usual bacterial chorioamnionitis does not lead to eccentric, superficial neutrophils within the umbilical cord. Such a finding should prompt suspicion of Candida funisitis. Knotting of the umbilical cord is typically associated with marked hemorrhage and congestion. Gastrischisis has been associated with prominent vacuolization of the amniotic epithelium of the placenta.