Danielle Walsh¹, Sandra Pawlus¹, Patricia Commins¹ and Paul H Hartel^2-4*

¹Department of Forensic Investigation and Analysis, Atlantic Technological University, Ireland
²Sligo University Hospital, Department of Pathology, Ireland
³National University of Ireland, Galway School of Medicine, Department of Pathology, Ireland
⁴West Virginia University School of Medicine, Department of Medicine, USA

*Corresponding Author: Paul H Hartel, Sligo University Hospital, Department of Pathology, Ireland.

Received: September 05, 2022; Published: September 13, 2022

Abstract

Single artery umbilical cords have conventionally been studied in relation to clinical abnormalities such as intrauterine growth restriction (IUGR) and chromosomal abnormalities. Literature on the histopathologic correlates of single artery umbilical cords is lacking. We evaluated umbilical cord, foetal membrane and placental histopathologic findings in 26 placentas with single artery umbilical cords to characterise any differences compared to normal three-vessel umbilical cord control cases. We found a greater prevalence of funisitis and acute chorioamnionitis, and greater prevalence of maternal vascular malperfusion. Umbilical cord and/or foetal membrane inflammation and placental histology of maternal vascular malperfusion often correlate with clinical infection and hypertension, respectively. Early in-utero detection of single artery umbilical cord may therefore help identify risk of potential infection and maternal/foetal hypertension and help prevent adverse clinical sequelae.

Keywords: Two-Vessel Umbilical Cord; Single Umbilical Artery; Funisitis; Chorioamnionitis; Maternal Vascular Malperfusion

References

1. Ebbing C., et al. “Single umbilical artery and risk of congenital malformation: population‐based study in Norway”. Ultrasound in Obstetrics and Gynecology 4 (2020): 510-515.
2. Pierce BT., et al. “Perinatal outcome following fetal single umbilical artery diagnosis.” Journal of Maternal-Fetal Medicine1 (2001): 59-63.
3. Ramesh S., et al. “Single umbilical artery”. Journal of Pharmacy and Bioallied Sciences 1 (2015): 83-84.
4. Ebbing C., et al. “Isolated single umbilical artery and the risk of adverse perinatal outcome and third stage of labor complications: A population-based study”. Acta Obstetricia et Gynecologica Scandinavica 3 (2020): 374-380.
5. Mantakas X., et al. “Placenta and Umbilical Cord Cause in Antepartum Deaths”. Cureus11 (2018): 3556.
6. Murphy-Kaulbeck L., et al. “Single umbilical artery risk factors and pregnancy outcomes”. Obstetrics and Gynecology 4 (2010): 843-850.
7. Catanzarite V.A., et al. “Prenatal diagnosis of the two-vessel cord: implications for patient counselling and obstetric management”. Ultrasound in Obstetrics and Gynecology 2 (1995): 98-105.
8. Heifetz SA. “Single umbilical artery. A statistical analysis of 237 autopsy cases and review of the literature”. Perspectives in Pediatric Pathology 4 (1984): 345-378.
9. Altshuler G., et al. “Single umbilical artery. Correlation of clinical status and umbilical cord histology”. The American Journal of Diseases of Children 6 (1975): 697-700.
10. Dane B., et al. (2009) “Fetuses with single umbilical artery: analysis of 45 cases”. Clinical and Experimental Obstetrics and Gynecology 2 (2009): 116-119.
11. Hu T., et al. (2021) “Prenatal chromosomal microarray analysis in 2466 fetuses with ultrasonographic soft markers: a prospective cohort study”. American Journal of Obstetrics and Gynecology 5 (2021): 1-16.
12. Viral G., et al. "Chorioamnionitis and Neonatal Outcomes”. Pediatric Research 2 (2022): 289-296.
13. Ernst LM. “Maternal vascular malperfusion of the placental bed”. APMIS 7 (2018): 551-560.
14. Chong Jai Kim RR. “Acute chorioamnionitis and funisitis: definition, pathologic features, and clinical significance”. American Journal of Obstetrics and Gynecology 4 (2015): 29-52.
15. Chappell LC., et al. “Pre-eclampsia”. Lancet10297 (2021): 341-354.

Citation

Citation: Paul H Hartel., et al. “Histologic Correlates of Single Artery Umbilical Cords with Clinical Implications". Acta Scientific Women's Health 4.10 (2022): 13-16.

Copyright

Copyright: © 2022 Paul H Hartel., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.