Morphometric characteristics of the umbilical cord and vessels in fetal growth restriction and pre-eclampsia

Sharony, Reuven; Keltz, Eran; Biron‐Shental, Tal; Kidron, Debora

doi:10.1016/j.earlhumdev.2015.11.006

Cited by 10 publications

(6 citation statements)

References 21 publications

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“…Only the lumen cross-sectional area of the umbilical arteries differed between the IUGR and control group. Our finding of non-significantly decreased arterial vessel wall thickness conforms to the published literature [29, 30]. …”

Section: Discussionsupporting

confidence: 93%

Maternal Hematological Parameters and Placental and Umbilical Cord Histopathology in Intrauterine Growth Restriction

et al. 2019

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Objective: To investigate the placental and umbilical cord histopathology in intrauterine growth restriction (IUGR) and their relation to second-trimester maternal hematological parameters. Materials and Methods: Patients were selected for the IUGR group based on estimated fetal weight below the 10th percentile. Patients were recruited into the control group randomly. Patients were followed up with ultrasound, and blood samples were taken between the 20th and 24th gestational weeks. After delivery and formalin fixation, weight and volume of the placenta were recorded and histologic samples were processed. Results: Maternal platelet count strongly correlates with placental weight (r = 0.766). On the other hand, neonatal weight correlates with placental volume (r = 0.572) rather than with placental weight (r = 0.469). Umbilical arterial lumen cross-sectional area correlates with birth weight (r = 0.338). Conclusions: Maternal hematological parameters do not seem to affect neonatal outcome. Our main findings are the correlation of maternal platelet count with placental weight, the correlation of placental volume with birth weight being stronger than the correlation of placental weight with birth weight, and the correlation of umbilical artery lumen cross-sectional area with neonatal weight. Mild histopathologic alterations might occur in normal pregnancies; however, sufficient fetal nutrition can be maintained. This compensatory function of the placenta seems to be insufficient when two or more pathologies are present, which is characteristic for IUGR.

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Section: Discussionsupporting

confidence: 93%

Maternal Hematological Parameters and Placental and Umbilical Cord Histopathology in Intrauterine Growth Restriction

et al. 2019

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“…This study shows a significant decrease in umbilical cord area in FGR and FGR with PreE. This is driven by a decrease in the Wharton's Jelly area similar to previous studies [27]. There were no significant differences in the area of the umbilical artery and vein.…”

Section: Discussionsupporting

confidence: 89%

“…Previous studies have shown changes in the umbilical cord structure in FGR and PreE. The cross sectional area of the umbilical cord and Wharton's Jelly has been shown to be significantly smaller in FGR [9,27]. Additionally, vascular changes have been seen in patients with PreE with umbilical artery tunica media areas larger in the outer layer, inner layer, and lumen [12].…”

Section: Discussionmentioning

confidence: 99%

Proteomic analysis of the umbilical cord in fetal growth restriction and preeclampsia

et al. 2022

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Fetal growth restriction (FGR) is associated with adverse perinatal outcomes. Pre-eclampsia (PreE) increases the associated perinatal morbidity and mortality. The structure of the umbilical cord in the setting of FGR and PreE is understudied. This study aimed to examine changes in the umbilical cord (UC) composition in pregnancies complicated by FGR and FGR with PreE. UC from gestational age-matched pregnancies with isolated FGR (n = 5), FGR+PreE (n = 5) and controls (n = 5) were collected, and a portion of the UC was processed for histologic and proteomic analysis. Manual segmentation analysis was performed to measure cross-section analysis of umbilical cord regions. Wharton’s Jelly samples were analyzed on a tims-TOF Pro. Spectral count and ion abundance data were analyzed, creating an intersection dataset from multiple mass spectrometry search and inference engines. UCs from FGR and FGR with PreE had lower cross-sectional area and Wharton’s Jelly area compared with control (p = 0.03). When comparing FGR to control, 28 proteins were significantly different in abundance analysis and 34 in spectral count analysis (p < 0.05). Differential expression analysis between PreE with FGR vs controls demonstrated that 48 proteins were significantly different in abundance and 5 in spectral count. The majority of changes occurred in proteins associated with extracellular matrix, cellular process, inflammatory, and angiogenesis pathways. The structure and composition of the UC is altered in pregnancies with FGR and FGR with PreE. Future work in validating these proteomic differences will enable identification of therapeutic targets for FGR and FGR with PreE.

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“…It is well established that, in humans, an increased placental vascular resistance occurs in FGR which is commonly expressed as an increased umbilical artery pulsatility and resistance index. Nonetheless, several studies show that this increased vascular tone is associated with a reduction in the umbilical artery wall thickness (Bruch et al, 1997; Yoshimatsu et al, 2006; Burkhardt et al, 2009; Sharony et al, 2016) and maximal contractile force in response to KCl (Krause et al, 2013). Therefore, the increase in umbilical artery pulsatility and resistance index mainly represents downstream placental vascular resistance, which correlates with FGR and multisystem effects of placental deficiency (Harman and Baschat, 2003).…”

Section: Discussionmentioning

confidence: 99%

Fetal Growth Restriction Induces Heterogeneous Effects on Vascular Biomechanical and Functional Properties in Guinea Pigs (Cavia porcellus)

et al. 2017

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Aim: Fetal growth restriction (FGR) is associated with a variety of cardiometabolic diseases in adulthood which could involve remodeling processes of the vascular walls that could start in the fetal period. However, there is no consensus whether this remodeling affects in a similar way the whole vascular system. We aimed to determine the effects of FGR on the vasoactive and biomechanical properties of umbilical and systemic vessels in fetal guinea pigs.Methods: FGR was induced by implanting ameroid occluders at mid-gestation in uterine arteries of pregnant guinea pigs, whilst the control group was exposed to simulated surgery. At the term of gestation, systemic arteries (aorta, carotid and femoral) and umbilical vessels were isolated to determine ex vivo contractile and biomechanical responses (stretch-stress until rupture) on a wire myograph, as well as opening angle and residual stresses. Histological characteristics in tissue samples were measured by van Gieson staining.Results: Aorta and femoral arteries from FGR showed an increased in biomechanical markers of stiffness (p < 0.01), contractile capacity (p < 0.05) and relative media thickness (p < 0.01), but a reduced internal diameter (p < 0.001), compared with controls. There were no differences in the biomechanical properties of carotid and umbilical from control and FGR fetuses, but FGR umbilical arteries had a decreased contractile response to KCl (p < 0.05) along with a reduced relative media thickness (p < 0.05).Conclusion: Altogether, these changes in functional, mechanical and morphological properties suggest that FGR is associated with a heterogeneous pro-constrictive vascular remodeling affecting mainly the lower body fetal arteries. These effects would be set during a pathologic pregnancy in order to sustain the fetal blood redistribution in the FGR and may persist up to adulthood increasing the risk of a cardiovascular disease.

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Morphometric characteristics of the umbilical cord and vessels in fetal growth restriction and pre-eclampsia

Cited by 10 publications

References 21 publications

Maternal Hematological Parameters and Placental and Umbilical Cord Histopathology in Intrauterine Growth Restriction

Maternal Hematological Parameters and Placental and Umbilical Cord Histopathology in Intrauterine Growth Restriction

Proteomic analysis of the umbilical cord in fetal growth restriction and preeclampsia

Fetal Growth Restriction Induces Heterogeneous Effects on Vascular Biomechanical and Functional Properties in Guinea Pigs (Cavia porcellus)

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