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

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  • Author(s): Stanek J;Stanek J
  • Source:
    Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology Society [Pediatr Dev Pathol] 2024 Jan-Feb; Vol. 27 (1), pp. 52-58. Date of Electronic Publication: 2023 Sep 28.
  • Publication Type:
    Journal Article
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: SAGE Publishing Country of Publication: United States NLM ID: 9809673 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1615-5742 (Electronic) Linking ISSN: 10935266 NLM ISO Abbreviation: Pediatr Dev Pathol Subsets: MEDLINE
    • Publication Information:
      Publication: 2017-: Thousand Oaks, CA : SAGE Publishing
      Original Publication: New York, NY : Springer, c1998-
    • Subject Terms:
      Single Umbilical Artery*/pathology ; Placenta Diseases*/pathology; Pregnancy ; Humans ; Female ; Placenta/pathology ; Umbilical Cord/pathology ; Fetal Growth Retardation/pathology ; Antigens, CD34
    • 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.
      Competing Interests: Declaration of Conflicting InterestsThe author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
    • Contributed Indexing:
      Keywords: CD34; fetal vascular malperfusion; placenta; single umbilical artery; umbilical cord
    • Accession Number:
      0 (Antigens, CD34)
    • Publication Date:
      Date Created: 20230929 Date Completed: 20240122 Latest Revision: 20240122
    • Publication Date:
      20240122
    • Accession Number:
      10.1177/10935266231200013
    • Accession Number:
      37771135