Single Umbilical Artery Umbilical Cord Is Associated With High-Grade Distal Fetal Vascular Malperfusion.

IF 1.3 4区医学 Q3 PATHOLOGY

Pediatric and Developmental Pathology Pub Date : 2024-01-01 Epub Date: 2023-09-28 DOI:10.1177/10935266231200013

Jerzy Stanek

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引用次数: 0

Abstract

Purpose and context: Umbilical cord abnormalities with clinical signs of cord compromise are frequently associated with fetal vascular malperfusion (FVM). Single umbilical artery (SUA) has been reported to be associated with high-grade FVM in fetal growth restriction but not in an unselected population; our study aimed to address this issue.

Methods: Clinical and placental phenotypes of 55 consecutive placentas with SUA (Group 1) were compared with those of 655 placentas with 3-vessel umbilical cord (Group 2) from patients who were in the second half of their pregnancy. The placentas were histologically examined using hematoxylin and eosin (H&E) staining and CD 34 immunostaining.

Key results: Several umbilical cord phenotypes and high-grade distal FVM, based on H&E staining and endothelial fragmentation by CD34 were significantly more common in Group 1, whereas decidual clusters of multinucleate trophoblasts were more common in Group 2. Notably, H&E staining or CD34 immunostaining evaluated separately showed that high-grade distal FVM was more common in Group 1 than in Group 2, but the difference was not statistically significant.

Conclusions: SUA predisposes to remote, advanced, and recent high-grade distal villous FVM, with a pathogenesis partly different from that of stasis-induced FVM, likely related to fetal anomalies associated with SUA.

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单脐动脉脐带与胎儿远端高级别血管灌注不良有关。

目的和背景：具有脐带损害临床症状的脐带异常通常与胎儿血管灌注不良（FVM）有关。据报道，在胎儿生长受限中，单脐动脉（SUA）与高级别FVM相关，但在未选择的人群中没有；我们的研究旨在解决这个问题。方法：将55例连续SUA胎盘（第1组）的临床和胎盘表型与655例妊娠后半期患者的3血管脐带胎盘（第2组）进行比较。使用苏木精和伊红（H&E）染色和CD34免疫染色对胎盘进行组织学检查。关键结果：基于H&E染色和CD34内皮碎片化的几种脐带表型和高级别远端FVM在第1组中显著更常见，而多核滋养层蜕膜簇在第2组中更常见。值得注意的是，单独评估的H&E染色或CD34免疫染色显示，高级别远端FVM在第1组比在第2组更常见，但差异无统计学意义。结论：SUA易患远端、晚期和近期高级别绒毛膜远端FVM，其发病机制与瘀血诱导的FVM部分不同，可能与SUA相关的胎儿异常有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric and Developmental Pathology 医学-病理学

CiteScore

3.70

自引率

5.30%

发文量

审稿时长

6-12 weeks

期刊介绍： The Journal covers the spectrum of disorders of early development (including embryology, placentology, and teratology), gestational and perinatal diseases, and all diseases of childhood. Studies may be in any field of experimental, anatomic, or clinical pathology, including molecular pathology. Case reports are published only if they provide new insights into disease mechanisms or new information.