Ultrastructure of human umbilical vessels: a possible role in amniotic fluid formation?

Gébrane-Younès, Jeannine; Minh, Hoang Ngoc; Orcel, L

doi:10.1016/s0143-4004(86)80008-x

Cited by 37 publications

(25 citation statements)

References 16 publications

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“…Moreover, the presence of a lean umbilical cord in the second half of pregnancy puts the fetus at increased risk of being small-for-gestational age and of having signs of distress at delivery 5,9,10 . This seems to be the consequence of a reduced amount of Wharton's jelly 7,11 a normal constituent of the umbilical cord which plays a crucial role in maintaining the normal architecture of the umbilical cord and in regulating the blood flow from the placenta to the fetus 12 .…”

Section: Introductionmentioning

confidence: 99%

First‐trimester sonographic umbilical cord diameter and the growth of the human embryo

Ghezzi

Raio

Naro

et al. 2001

Ultrasound in Obstet & Gyne

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Section: Introductionmentioning

confidence: 99%

First‐trimester sonographic umbilical cord diameter and the growth of the human embryo

Ghezzi

Raio

Naro

et al. 2001

Ultrasound in Obstet & Gyne

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“…It has been speculated that the cells of Wharton's jelly may participate in the regulation of umbilical blood flow, and the reduction in fetal growth could be a consequence of diminution of Wharton's jelly, leading to vascular hypoplasia of the umbilical vessels. 21,22 This finding and the reduction of water content with the increase in gestational age suggest a metabolically active role for the umbilical cord. 23 The helical twisting of the umbilical cord plays an important role in protection of the fragile vascular system.…”

Section: Discussionmentioning

confidence: 79%

Early second‐trimester low umbilical coiling index predicts small‐for‐gestational‐age fetuses.

Degani

Leibovich

Shapiro

et al. 2001

J of Ultrasound Medicine

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Objective. To evaluate the role of the early second-trimester Doppler velocimetric studies of the umbilical coiling index and umbilical cord cross-sectional area as tests for the prediction of small-for-gestationalage infants. Methods. Doppler blood flow studies in 147 singleton pregnancies at risk for delivery of a small-for-gestational-age neonate were performed at 15 ± 1 (SD) weeks' gestation from the uterine artery, umbilical artery, middle cerebral artery, inferior vena cava, and ductus venosus. Pulsatility index values were calculated for the arteries, and preload index values and systolic-atrial contraction ratios were calculated for the veins. The sonographic cross-sectional area of the umbilical cord was measured in a plane adjacent to the insertion into the fetal abdomen. The umbilical coiling index was calculated by using sonographic longitudinal views of cord vessels from several segments antenatally and by dividing the total number of helices by cord length (centimeters) postnatally. Small-for-gestational-age neonates were identified when the birth weight was below the 10th percentile for gestational age. Results. Among 147 pregnancies studied, 124 fulfilled the study criteria. Thirty-nine of the neonates were small for gestational age at birth (31.5%). The mean ± SD gestational age at delivery of the appropriate-for-gestational-age neonates was 39.7 ± 1.28 weeks, and that of the small-forgestational-age neonates was 36.4 ± 2.9 weeks (range, 28-40 weeks). The best single predictor of a small-for-gestational-age infant was the coiling index, with sensitivity of 79%, specificity of 86%, a positive predictive value of 72%, and a negative predictive value of 90%. Conclusion. The umbilical coiling index measured in the second trimester is useful in predicting the birth of a small-forgestational-age infant and may serve as a marker for subsequent growth restriction.

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“…Though, many publications to date described the structure of human umbilical vessels at term [5][6][7][8][9] , few of them compared the structure of these vessels during gestation [10,11] .…”

Section: Introductionmentioning

confidence: 99%

Development of Human Umbilical Vessels in The Second Trimester of Pregnancy: Histological, Immunohistochemical and Morphometric Study

EI-Nefiawy

2017

Egyptian Journal of Histology

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Introduction: There are many publications describing structure of full term umbilical vessels, however, few studies in early gestation. Aim: To elucidate changes in microstructure of developing umbilical vessels in the second trimester of pregnancy. Material and Methods: Twelve specimens of human umbilical cords were obtained from legal termination of uncomplicated pregnancies at gestational weeks 13, 16, and 20. Two centimeter segments of the cords were cut near the placenta. Specimens were processed for paraffin blocks, sectioned, and stained with haematoxylin & eosin, Masson Trichrome, Orcein, and Periodic Acid Schiff. Immunohistochemistry for alpha smooth muscle actin & laminin antibodies was performed. Morphometry and image analysis for vascular wall thickness & diameter of lumen, and diameter of umbilical cord were done. Results: Umbilical cord sections revealed two arteries (UA) and one vein (UV) embedded in Wharton's jelly and covered with amniotic epithelium formed of flat then cuboidal epithelium. Umbilical vessels composed of inner intima and outer media. Endothelium demonstrated areas of damage and adhesion of inflammatory cells. Internal elastic lamina was thin, interrupted initially, double layered, and well-developed finally. Smooth muscle cells (SMCs) migrated from vascular lumen or from media by a process of mesenchymal-endothelial transition to replace injured endothelium. The media was composed of immature SMCs initially (thin (morphometry), non-contractile, non-secretory as proved by different stains and collagen content. Wharton's jelly spindle shaped mesenchymal cells close to vessels revealed positive staining for alpha smooth muscle actin and contributed to the media to compensate for SMC migration. UAs showed thicker wall, narrower lumen than veins and cord diameter increased significantly at the 20 week. Conclusion: Development of umbilical vessels was the result of a continuous remodeling process initiated by secreted endothelial factors from damaged endothelium that influenced; SMCs of media, stem cells of cord blood and Wharton's jelly simulating early events of atherosclerosis.

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Ultrastructure of human umbilical vessels: a possible role in amniotic fluid formation?

Cited by 37 publications

References 16 publications

First‐trimester sonographic umbilical cord diameter and the growth of the human embryo

First‐trimester sonographic umbilical cord diameter and the growth of the human embryo

Early second‐trimester low umbilical coiling index predicts small‐for‐gestational‐age fetuses.

Development of Human Umbilical Vessels in The Second Trimester of Pregnancy: Histological, Immunohistochemical and Morphometric Study

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