Comparative morphological differences between umbilical cords from chronic hypertensive and preeclamptic pregnancies

Area of Science:

• Perinatology
• Pathology
• Medical Imaging

Background:

• Hypertension and preeclampsia significantly impact pregnancy outcomes.
• Umbilical artery Doppler ultrasonography (FVW) assesses fetal well-being.
• Morphological changes in umbilical cords may reflect placental dysfunction.

Purpose of the Study:

• To compare umbilical cord morphology in chronic hypertensive and preeclamptic patients.
• To correlate morphological changes with umbilical artery Doppler FVW results.
• To investigate mechanisms underlying placental insufficiency in these conditions.

Main Methods:

• Studied umbilical cords from normotensive, chronic hypertensive, and preeclamptic women (35-40 weeks gestation).
• Utilized stereology for unbiased measurement of umbilical cord and vessel dimensions.
• Analyzed histopathological findings and correlated them with Doppler FVW data.

Main Results:

• In chronic hypertensive and preeclamptic groups with normal Doppler, reduced cord/lumen area suggested vasoconstriction.
• In preeclamptic group with pathologic Doppler, all cord parameters were reduced, indicating hypoplasia.
• Histopathology revealed contracted smooth muscle cells in vessel walls.

Conclusions:

• Umbilical cord histopathological changes vary between chronic hypertensive and preeclamptic patients based on Doppler results.
• Doppler FVW indices are valuable for predicting intrauterine growth retardation in preeclampsia.
• Understanding these changes aids in managing pregnancies complicated by hypertension.