Histopathology and histomorphometry of umbilical cord blood vessels. Findings in normal and high risk pregnancies

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• 作者：Manuel V&#xe1 ; zquez Blanco^a ; Hilda Ruda Vega^b ; Roberto A. Guerri-Guttenberg^c ; Rodolfo Giuliano^b ; Daniel R. Grana^c ; Francisco Azzato^c ; Jos&#xe9 ; Milei^c ; ^{ininca@fmed.uba.ar"" rel=""nofollow}
• 关键词：Umbilical cord ; Preeclampsia ; Hypertension ; Diabetes ; Histomorphometry ; PAI-1 ; TGF-β ; 1
• 刊名：Artery Research
• 出版年：2011
• 出版时间：June 2011
• 年：2011
• 卷：5
• 期：2
• 页码：50-57
• 全文大小：1867 K

文摘

Objective

A systematic histological, morphometric and immunohistochemical (PAI-1 and TGF-β1) study of umbilical vessels in normal and pathological conditions was undertaken in order to describe and compare the lesions found.

Methods

Segments of umbilical cords were obtained from 92 pregnancies/107 newborns from normal gestations (n = 20) or from gestational diabetes mellitus (n = 13), chronic hypertension (n = 14), preeclampsia (n = 9), intrahepatic cholestasis (n = 13), antiphospholipid syndrome (n = 11), fetal growth restriction (n = 9), oligohydramnios (n = 6), premature rupture of membranes (n = 12), antiphospholipid antibodies (n = 11) and fetal distress (n = 23). Thirty-four of these patients presented combined pathologies.

Results

“Pathological” umbilical cords presented perivascular/intraparietal hemorrhages with wall dissections, parietal recent thrombosis and focal moderate or extensive Wharton’s jelly hemorrhages. Pathological pregnancies presented more microscopic lesions (35/73; 48 % ) than normal pregnancies (4/20; 20 % ; p = 0.039). The wall:lumen ratio of arteries was significantly higher in all pathologies (32.6 ± 16) as compared to 3.1 ± 0.6 in the control group (p < 0.0001), also due to the significantly higher values belonging to outer plus inner layer areas in opposition to much less increases in luminal areas (p = 0.03). Concerning veins, wall:lumen ratio was also higher in the pathological groups (p = 0.0086) due to a 2-fold increase in wall areas.

Conclusion

Quantitative histomorphometry of the pathological alterations and pathophysiologic disorders of the umbilical cord has the potential to enhance investigation and treatment of maternal and fetal diseases.