Discordant umbilical arteries in the umbilical cord entanglement: a light microscope study

Abstract

Objective The present study aimed to examine the histopathological diagnosis of the umbilical artery discordance in cases with single or multiple umbilical cord entanglement and pregnancy outcomes. Methods The vascular structure of the umbilical cord, histopathological findings of the placenta and obstetric outcomes were retrospectively examined in 50 cases. The cases were divided into two groups by the number of cord entanglement (single-multiple) and their histopathological findings and neonatal Apgar scores were assessed. Results Out of 50 cases, 38 (76%) had single and 12 (24%) had multiple cord entanglement. In 50 cases, the mean gestational age was 39.16±1.06 weeks, neonatal Apgar scores were 8.7±0.58 at 1 minute and 9.64±0.56 at 5 minute. No statistically significant difference was detected between single and multiple groups in terms of gestational age (p=0.79), 1-minute Apgar score (p=0.832) and 5-minute Apgar score (p=0.656). In histopathological examination, the diameters of umbilical arteries 1 and 2 were found to be 0.11±0.12, 0.09±0.05 µm, respectively in the single group (p=0.756) and 0.13±0.14, 0.06±0.02 µm, respectively in the multiple group (p=0.131). When the umbilical arterial diameters were compared by group, the diameter of the umbilical artery 2 was detected 0.09±0.05 µm in the single and 0.06±0.02 µm in the multiple group and statistically significant difference was detected (p=0.037). Out of 50 cases, placental hypoxia finding was detected as chorangiosis only in 10 cases (2 multiple, 8 single). Conclusion Umbilical artery discordance was detected in cases with multiple umbilical cord entanglement. However, poor pregnancy outcome was not observed in any of the cases. When multiple cord entanglement is seen during obstetric examination, umbilical artery discordance must be remembered and investigated, and also maternal-fetal condition should be considered.