HISTOPATHOLOGICAL CHANGES OF THE UMBILICAL CORD IN COMPLİCATED PREGNANCIES

Year 2019, , 43 - 54, 01.04.2019

Seval Kaya , Yusuf Nergiz , A. Kadir Turgut

https://doi.org/10.23884/ijhsrp.2019.4.1.05

Abstract

Preeclampsia, hellp
syndrome and gestational diabetes are quite common complication in pregnancy. In this study,ıt is aimed to compare the thickness  of
 basal  lamina
and vascular structure of umbilical cord. by
comparing preeclampsia,
hellp syndrome, gestational diabetes and normal pregnant women.
In
the study, sanples were taken from postpartium
umbilical cords of
normal pregnant
women, preeclampsia, gestational diabetes and pregnant women diagnosed
with
hellp syndrome. Umblical cord samples taken during maternity, followed by routine paraffin through fixing 10% neutral formalin. In this performed as totally sixty
facts through
taking fifteen
umbilical cords from each of four groups, Hematoxyline-eosin, Masson trichrom, periodic
acid Schiff,
and toluidine
blue stain were applied
on to the serial histological sections obtained from paraffin blocks. The obtained slides
were evaluated
with
Zeiss Imager 2 Microscope by taking micrographs. Morphometric measurements were statistically analyzed with SPSS software. In cases of gestational diabetes due to increased collagen production, thickening and excessive narrowing of the lumen and differentiation of Wharton jelly were observed in the umbilical artery. Differentiations are observed in the vacuolization of smooth muscle cells and muscle fibers that make up the media while camber and damage are observed in
endothelial. The most significant structural changes of preeclamptic placentas are obtained
as
the thickening
and
the endothelial injury. In the umbilical cord artery medial layer, due to
the
growth of collagen fiber. In HELLP
cases due to the increase in media diffuse edema
between muscle fibers and in collagen,
the
thickening of umbilical
artery wall and the
narrowing of luminal are seen
as extremely significant. Another striking symptom
with HELLP cases is the observing of
intramuscular hemorrhages in the umbilical artery wall as an
unattained case in preeclampsia and gestational diabetes. In most of the cases, differentiation in Wharton jelly, metaplastic changes in the amniotic epithelium and thickening
of the basal
lamina are observed. 

Keywords

Umbilical cord, Preeclampsia, Gestational diabetes, Hellp syndrome

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