HISTOMORPHOMETRICAL EVALUATION OF THE CHANGES IN UMBLICAL CORD VASCULATURE IN PREECLAMPSIA

Safa A. Al-Gebori, May F. Al-Habib, Manal T. Al- Obaidy, Mohammad Oda Selman

Abstract


Background: PE is one of the most common pathological disorders associated with pregnancy which is characterized by generalized edema, hypertension and proteinuria presenting after 20th week of gestation. It occurs in 2-3% of all pregnancies and is a major contributor to maternal and neonatal morbidity and mortality. The umbilical cord could be a good model for studying fetal vascular complications. Objectives: Evaluate the histomorphometrical changes in umbilical cord vessels and the changes in the thickness of basement membrane in normal and preeclamptic pregnancies.
Methods: Morphological changes in umbilical cord were examined on formalin fixed, paraffin embedded sections. The total cord area, Wharton's jelly area, total arterial area, arterial smooth muscle and intimal layer areas and total wall area of the vein were measured in systematic random samples using image j program. Statistical analysis was done using SPSS program.
Results: In pre-eclamptic group there is a reduction in total cord area, jelly area, total arterial area and smooth muscle area of umbilical artery and total wall area of the vein as compared to normal group. While the basement membrane thickness increased. The difference was highly significant (P value <0.001). The changes in intimal layer of the umbilical artery were not significant.
Conclusion: The histomorphometrical changes in umbilical cord could be a good predictor for the changes in umbilical cord and its reflection on the outcome neonates in preeclamptic patients.
Key wards: pre-eclampsia, umblical cord and histomorphometry

References


References:

- Kliman HJ. Umbilical cord in Encyclopedia of Reproduction. Yale university school of medicine. 2006.

- Bimpong S. Quantitative evaluation of the umbilical cord and placental indices and pregnancy outcome. MSC thesis. Kwame Nkrumah university of science and technology, Kumasi: 2012.

- Blanco MV, et al. Histopathology and histomorphometry of umbilical cord blood vessels. Findings in normal and high risk pregnancies, Artery Research 2011; 5(2): 50-57.

- Eroschenko V. Difiore's atlas of histology with functional correlations. 11 Edition, USA, Lippincott Williams & Wilkins: 2008.

- Benirschke K. Pathology of the human placenta. 6th Edition. Springer verlag Berlin Heidelberg : 2012.

- Al-Okail M, and Al-Attas OS. Histological changes in placental syncytiotrophoblast of poorly controlled gestational diabetic patients. Endocrnology journal 1994; 41(4): 355-360.

- Yao AC, et al. Closure of umbilical artery, a physiological demonstration of Burton’s theory. European journal of obstetric, gynecology and reproductive biology 1977; 7(6): 365-368.

- Mammaro A, et al. Hypertensive Disorders in Pregnancy. Journal of Prenatal Medicine 2009; 3 (1): 1-5.

- Bernardi CF, et al. Plasma nitric oxide, endothelin-1, arginase and superoxide dismutase in the plasma and placentae from preeclamptic patients. An acad bras cienc 2015; 87 (2): 713-719.

- Barnwal M, et al. Histomorphometry of umbilical cord and its vessels in Preeclampsia as compared to Normal Pregnancies. National journal of gynecology 2012; 7(1): 28-32.

- Ilie et al. Histological modifications of the umbilical cord in pregnancy induced hypertension. Journal pediatrului 2007; X(39-40): 12-16.

- Inan S. et al. Comparative morphological differences between umbilical cords from chronic hypertensive and preeclamptic pregnancies. Acta medica okamya 2002; 56(4): 177-186.

- Barnwal M, et al. Histomorphometry of Umbilical Cord and its Vessels in Preeclampsia as Compared to Normal Pregnancies. National journal of gynecology 2012; 7(1): 28- 32.

- Bhutia KL, et al. Image J Analysis of tunica media of Hyrtl‟s anastomosis in Pregnancy Induced Hypertension. GSTF Journal of Advances in Medical Research 2014; 1(2): 54-60.

- Junek T. et al. Pre-eclampsia associated alterations of the elastic fibre system in umbilical cord vessels. Anatomy and embryology 2000; 201(4): 291-303.

- Blanco MD, et al. Histomorphometry of Umbilical Cord Blood Vessels in Preeclampsia. The journal of clinical hypertension 2011; 13(1): 30-34.

- Dadak C, Ulrich W, and Sinzinger H. Morphological changes in the umbilical arteries of babies born to preeclamptic mothers: an ultrastructural study. Placenta 1984; 5: 419-426.

- Cetin A, Kukner A, and Ozturk F. Ultra structure of human umbilical vessels in preeclampsia. J Matern Fetal Neonatal Med 2002; 12:178-184.

- Bruch JF. et al. Computerized microscopic morphometry of umbilical vessels from pregnancies with intrauterine growth retardation and abnormal umbilical artery Doppler. Obstetric and Gynecology 1997; 28: 1139-1145.

- Balask D, et al. Severe pre-eclampsia complicated by HELLP syndrome alterations in the structure of the umbilical cord (morphometric and immunohistochemical study). Biotechnology & Biotechnological Equipment 2015; 29(2): 345-350.

- Emilie H. et al. Abnormal vascular umbilical cord morphology in vascular related pregnancy complications. An International Journal of Women’s Cardiovascular Health 2013; 3: 67-99.

- Kim KS, et al. Nanoscale Imaging of Morphological Changes of Umbilical Cord in Preeclampsia. Microscopy Research and Technique 2012; 75(10): 1445-1451.

- Singhal A, and Lucas A. Early origins of cardiovascular disease: is there a unifying hypothesis. Lancet 2004; 363(9421): 1642-1645.

- Blanco VM, Roisinblit J, and Grosso O, et al. Left ventricular function impairment in pregnancy-induced hypertension. American journal of Hypertension 2001;14(3): 271-275.

- Raio L. et al. Altered Sonographic Umbilical Cord Morphometry in Early-Onset Preeclampsia. The American College of Obstetricians and Gynecologists 2002; 100(2): 311-316.

- Carbillon L, Uzan M, and Uzan S. Pregnancy, vascular tone, and maternal hemodynamics: A crucial adaptation. Obstetric and Gynecology Surv 2000; 55:574–81.

- Srivastava SS, et al. Changes in Wharton’s Jelly in Hypertensive

Pregnancy: An Original Study from Rural Indian Population. International journal of scientific research 2014; 3(11): 11-13.

- Romanowicz L, and Sobolewski K. Extracellular matrix components of the wall of umbilical cord vein and their alterations in preeclampsia. Journal of prenatal medicin 2000; 28(2): 140-146.


Refbacks

  • There are currently no refbacks.


Home  Journals  Conferences  Store  Services  About Us  Contact Us