Human umbilical cord and its vessels: a histomorphometric study in difference severity of hypertensive disorders of pregnancy

Abstract

The umbilical cord (UC) is a platform for fetal nourishment and growth. The fetus, mother and placenta with UC form a triad, which contributes to pregnancy outcome. When pregnancy is complicated by a medical condition like hypertension, affects both maternal and fetal health. Being a fetal structure it can be used as a window to know the maternal dysfunctions and their impacts on fetal wellbeing. The present study is to explore the histomorphometric changes of the UC and its vessels involved in the development of hypertension during pregnancy. Sixty UCs were used and the following parameters, total UC area; total vessel area; jelly area; wall area, luminal area and wall thickness of umbilical arteries 1 and 2 and vein were studied using ImageJ software. From the results, the mean differences of above parameters of hypertensive UCs were found to be lesser than control and it was significantly higher in cases of severe preeclampsia (P≤0.05). From the present study, we conclude hypertensive cords and its vessels are associated with significant structural changes. Since it is a global health issue it is important to know the factors contributing it to diagnose and prevent.

Reduced angiovasculogenic and increased inflammatory profiles of cord blood cells in severe but not mild preeclampsia

“…Indeed, half of the patients with severe PE bore children with IUGR while one fifth for mild PE and none for normal pregnancy 27 . Studies reported that early-onset/severe PE has defective fetal vasculature and this may contribute to IUGR 28,29 . Fetuses from early-onset PE with IUGR had defective cardiovascular function, and they presented a higher chance of having ischemic cardiovascular disease post-delivery 1,30 .…”

Clinical Importance of the Human Umbilical Artery Potassium Channels

“…Hypertension is the most common medical problem encountered during pregnancy (6–20% of all pregnancies), and it is highly responsible for maternal and perinatal mortality and morbidity. In addition, it is associated with an increased risk of developing CVDs in pregnant women [ 13 ]. On the other hand, pre-eclampsia comprises 3–5% of hypertensive disorders in pregnancy.…”

“…Gestational hypertension and pre-eclampsia are multifactorial disorders and are important risk factors in the development of CV complications that endanger not only the health of the mother but also the health of the fetus. As evidenced, studies on the UC vasculature and, in particular, HUA are practically scarce, even though morphological changes have been associated with these pathologies [ 13 ]. Thus, further studies are needed to understand what mechanisms underlie these pathologies, namely, with concern to the involvement of HUA K + channels.…”

“…This artery does not have nerve endings, so the regulation of its tonus is completely dependent on the locally released vasoactive mediators, substances carried by the bloodstream, and some ions, such as K + and Ca 2+ [ 11 , 12 ]. Therefore, HUA is much more susceptible to hemodynamic changes caused by vascular disorders [ 13 ]. Moreover, its SMCs appear to play an important role in the control of fetoplacental blood flow.…”

“…Moreover, vascular SMCs are responsible for the vascular tone by responding to various hormonal and hemodynamic stimuli [ 9 , 14 ]. In this sense, being a fetal structure, the umbilical cord (UC) can be used as a window to learn about maternal dysfunctions and their impacts on fetal well-being [ 13 ], namely, regarding HUA K + -channels. The elucidation of the exact mechanisms regulating HUA contractile status is extremely important to detect potential targets for the treatment of pregnancy-related pathologies, mainly gestational hypertension and preeclampsia.…”