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HISTOPATHOLOGICAL CHANGES OF THE UMBILICAL CORD IN COMPLİCATED PREGNANCIES

Year 2019, Volume 4, Issue 1, 43 - 54, 01.04.2019
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. 

References

  • [1] Çiftçioğlu MA, Kanadalı S., et al. Histopathologic changes of umbilical cord in preeclamptic pregnant women. MJAU, 28, 216-219, 1996.
  • [2] Turok DK, Ratcliffe SD., et al. Management of gestational diabetes mellitus. Am Fam Physician, 68, 1760-1772, 2003.
  • [3] Hauth JC, Ewell MG., et al. Pregnancy outcomes in healthy nulliparas who developed hypertension. Calsium for Preeklampsia Prevention Study Group. Obstet Gynecol., 95, 24-28, 2000.
  • [4] Vigil-De-Gracia P. Pregnancy complicated by preeclampsia-eclampsia with help syndrome. Int J Gynaecol Obstet., 72, 17-23, 2001.
  • [5] Martin JN Jr, Blake PG., et al. Pregnancy complicated by preeclampsia-eclampsia with the syndrome of hemolysis, elevated liver enzymes and low platelet count: How rapid is postpartum recovery? Obstet Gynecol., 76, 737-741, 1990.
  • [6] Weissman A, Jakobi P. Sonographic measurements of the umbilical cord in pregnancy complicated by gestational diabetes. J Ultrasound Med, 16, 691-694, 1997.
  • [7] Nadkarni BB. Congenital anomalies of the human umbilical cord and their clinical significance: alight and electron microscope study. Indian J Med Res., 57,1018-1057, 1999.
  • [8] Sepulveda W, Dezerega V. Fused umblical arteries. J Ultrasound Med., 20, 59-62, 2001.
  • [9]. Abuhamad A, Sclater AJ., et al. Umbilical artery Doppler waveform notching: is it a marker for cord and placental abnormalities? J Ultrasound Med., 21, 857-860, 2002.
  • [10] Sullivan JB, Charles D., et al. Gestational diabetes and perinatal mortality. Am J Obstet Gynecol., 116,901-904, 1973.
  • [11] Stocker TJ, Dehner LP. Pediatric Pathology, JB Lippincott, Philedelphia, 1992.
  • [12]. Junek T, Baum O., et al. Preeclampsia associated alterations of the elastin fibre system in umbilical cord vessels. Anat Embryol., 4, 291-303, 2001.
  • [13] Bertrand C, Duperron L., et al. Umbilical and placental vessels: Modification of their mechanical properties in preeclampsia. Am J Obstret Gynecol., 168, 1537-1546, 1993.
  • [14] Barnwal M, Rathi SK., et al. Histomorphometry of umbilical cord and its vessels in preeclampsia as compared to normal pregnancies. NJOG., 7, 28-32, 2012.
  • [15]. Romanowicz L and Sobolewski K. Extracellular matrix components of the wall of umbilical cord vein and their alterations in preeclampsia. J Perinat Med., 28, 140-146, 2000.
  • [16] Halim A, Kanayama N., et al. Hellp syndrome-like biochemical parameters obtained with endothelin-1 injections in rabbits. Gynecol Obstet Inverst., 35, 193-198, 1993.

Year 2019, Volume 4, Issue 1, 43 - 54, 01.04.2019
https://doi.org/10.23884/ijhsrp.2019.4.1.05

Abstract

References

  • [1] Çiftçioğlu MA, Kanadalı S., et al. Histopathologic changes of umbilical cord in preeclamptic pregnant women. MJAU, 28, 216-219, 1996.
  • [2] Turok DK, Ratcliffe SD., et al. Management of gestational diabetes mellitus. Am Fam Physician, 68, 1760-1772, 2003.
  • [3] Hauth JC, Ewell MG., et al. Pregnancy outcomes in healthy nulliparas who developed hypertension. Calsium for Preeklampsia Prevention Study Group. Obstet Gynecol., 95, 24-28, 2000.
  • [4] Vigil-De-Gracia P. Pregnancy complicated by preeclampsia-eclampsia with help syndrome. Int J Gynaecol Obstet., 72, 17-23, 2001.
  • [5] Martin JN Jr, Blake PG., et al. Pregnancy complicated by preeclampsia-eclampsia with the syndrome of hemolysis, elevated liver enzymes and low platelet count: How rapid is postpartum recovery? Obstet Gynecol., 76, 737-741, 1990.
  • [6] Weissman A, Jakobi P. Sonographic measurements of the umbilical cord in pregnancy complicated by gestational diabetes. J Ultrasound Med, 16, 691-694, 1997.
  • [7] Nadkarni BB. Congenital anomalies of the human umbilical cord and their clinical significance: alight and electron microscope study. Indian J Med Res., 57,1018-1057, 1999.
  • [8] Sepulveda W, Dezerega V. Fused umblical arteries. J Ultrasound Med., 20, 59-62, 2001.
  • [9]. Abuhamad A, Sclater AJ., et al. Umbilical artery Doppler waveform notching: is it a marker for cord and placental abnormalities? J Ultrasound Med., 21, 857-860, 2002.
  • [10] Sullivan JB, Charles D., et al. Gestational diabetes and perinatal mortality. Am J Obstet Gynecol., 116,901-904, 1973.
  • [11] Stocker TJ, Dehner LP. Pediatric Pathology, JB Lippincott, Philedelphia, 1992.
  • [12]. Junek T, Baum O., et al. Preeclampsia associated alterations of the elastin fibre system in umbilical cord vessels. Anat Embryol., 4, 291-303, 2001.
  • [13] Bertrand C, Duperron L., et al. Umbilical and placental vessels: Modification of their mechanical properties in preeclampsia. Am J Obstret Gynecol., 168, 1537-1546, 1993.
  • [14] Barnwal M, Rathi SK., et al. Histomorphometry of umbilical cord and its vessels in preeclampsia as compared to normal pregnancies. NJOG., 7, 28-32, 2012.
  • [15]. Romanowicz L and Sobolewski K. Extracellular matrix components of the wall of umbilical cord vein and their alterations in preeclampsia. J Perinat Med., 28, 140-146, 2000.
  • [16] Halim A, Kanayama N., et al. Hellp syndrome-like biochemical parameters obtained with endothelin-1 injections in rabbits. Gynecol Obstet Inverst., 35, 193-198, 1993.

Details

Primary Language English
Subjects Health Care Sciences and Services
Journal Section Article
Authors

Seval KAYA
Dicle University
0000-0001-6251-6529
Türkiye


Yusuf NERGİZ (Primary Author)
Dicle University
0000-0002-9988-9385
Türkiye


A. Kadir TURGUT
Dicle University
0000-0002-3156-2116
Türkiye

Publication Date April 1, 2019
Application Date February 28, 2019
Acceptance Date March 19, 2019
Published in Issue Year 2019, Volume 4, Issue 1

Cite

IEEE S. Kaya , Y. Nergiz and A. K. Turgut , "HISTOPATHOLOGICAL CHANGES OF THE UMBILICAL CORD IN COMPLİCATED PREGNANCIES", International Journal of Health Services Research and Policy, vol. 4, no. 1, pp. 43-54, Apr. 2019, doi:10.23884/ijhsrp.2019.4.1.05

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