Correlation Between Placental Histomorphology and Umbilical Cord Coiling Index in Preeclampsia

Authors

  • Cyrus Kimanthi Department of Human Anatomy. University of Nairobi, Kenya.
  • Moses Obimbo Department of Human Anatomy. University of Nairobi, Kenya.
  • Kirsteen Awori Department of Human Anatomy. University of Nairobi, Kenya.
  • Mohamed Otieno Department of Human Anatomy. University of Nairobi, Kenya.
  • Talha Chaudhry Department of Human Anatomy. University of Nairobi, Kenya.

DOI:

https://doi.org/10.5195/ijms.2022.1738

Keywords:

Placenta, Pre-Eclampsia, Umbilical Cord, Maternal Health, Meconium

Abstract

BACKGROUND

Preeclampsia is a common hypertensive disorder of pregnancy and one of the leading causes of maternal health complications and death globally. Both preeclampsia and abnormal umbilical coiling have been reported to alter the structure of the placenta significantly. Cases of preeclampsia and either of the two abnormal coiling states; hypercoiling or hypocoiling, occurring in the same pregnancy have been documented. The type of abnormal coiling associated with preeclampsia varies in different populations. The extent of changes in the placenta in preeclampsia coupled with either of the two is unknown. The current study aimed at determining which of the coiling state significantly alters the structure of the placentae of mothers with preeclampsia and therefore, predisposes them to more adverse perinatal outcomes.

 

METHODs

An unmatched case-control study was carried out in Kenyatta National Hospital labor ward and maternity theatre. Seventy (70) placentae from mothers with diagnosis of preeclampsia (cases) and mothers without complicated pregnancy (controls) were collected. The length of the cord and the number of coils was measured to calculate the coiling index. A gross placental examination was carried out followed by biopsy and tissue processing for light microscopy. Slides were photographed and several histological features analyzed in the terminal villi. Data from this study was input into SPSS (Version 21.0) where mean values, standard deviations, and frequency tables were obtained. Appropriate parametric and non-parametric tests were used where needed. A P-value of <0.05 was considered statistically significant.

 

RESULTS

In the current study, the mean umbilical cord coiling index (UCI) in cases and controls was 0.40 ± 0.18 and 0.22 ± 0.08 coils/cm respectively. Cases had a significantly greater UCI than controls (P = < 0.001). All placentae in the case hypocoiled subdivision had infarctions and were meconium stained. The mean placental weight was 519 g and 578 g respectively in cases and controls and the difference was found to be significant (p = 0.031). In cases and controls, the gross placental volume was 542 cm3 and 638 cm3, respectively. There was a significant difference in placental volume between cases and controls, and between subdivisions (p = < 0.001 and 0.028 respectively). The case hypocoiled subdivision had the highest absolute volume of villous stroma, fibrin deposition, syncytial knots and the lowest fetal capillary surface area.

 

CONCLUSION

Hypocoiling was associated with alteration of the structure of the placenta in preeclampsia more than it was observed in hypercoiling. Early detection of hypocoiling using ultrasound in pregnancies complicated with preeclampsia may help clinicians in identification of cases that warrant close antenatal and intrapartum monitoring thus reducing adverse perinatal outcomes.

 

Metrics

Metrics Loading ...

Downloads

Published

2022-12-31

How to Cite

Kimanthi, C., Obimbo, M., Awori, K., Otieno, M., & Chaudhry, T. (2022). Correlation Between Placental Histomorphology and Umbilical Cord Coiling Index in Preeclampsia. International Journal of Medical Students, 10, S190. https://doi.org/10.5195/ijms.2022.1738

Issue

Vol 10 (2022): Supplement 1

Section

Abstracts of the WCMSR

Categories

License

Copyright (c) 2022 Cyrus Kimanthi, Moses Obimbo, Kirsteen Awori, Mohamed Otieno, Talha Chaudhry

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

  1. The Author retains copyright in the Work, where the term “Work” shall include all digital objects that may result in subsequent electronic publication or distribution.
  2. Upon acceptance of the Work, the author shall grant to the Publisher the right of first publication of the Work.
  3. The Author shall grant to the Publisher and its agents the nonexclusive perpetual right and license to publish, archive, and make accessible the Work in whole or in part in all forms of media now or hereafter known under a Creative Commons Attribution 4.0 International License or its equivalent, which, for the avoidance of doubt, allows others to copy, distribute, and transmit the Work under the following conditions:
    1. Attribution—other users must attribute the Work in the manner specified by the author as indicated on the journal Web site; with the understanding that the above condition can be waived with permission from the Author and that where the Work or any of its elements is in the public domain under applicable law, that status is in no way affected by the license.
    2. The Author is able to enter into separate, additional contractual arrangements for the nonexclusive distribution of the journal's published version of the Work (e.g., post it to an institutional repository or publish it in a book), as long as there is provided in the document an acknowledgment of its initial publication in this journal.
    3. Authors are permitted and encouraged to post online a prepublication manuscript (but not the Publisher’s final formatted PDF version of the Work) in institutional repositories or on their Websites prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. Any such posting made before acceptance and publication of the Work shall be updated upon publication to include a reference to the Publisher-assigned DOI (Digital Object Identifier) and a link to the online abstract for the final published Work in the Journal.
    4. Upon Publisher’s request, the Author agrees to furnish promptly to Publisher, at the Author’s own expense, written evidence of the permissions, licenses, and consents for use of third-party material included within the Work, except as determined by Publisher to be covered by the principles of Fair Use.
    5. The Author represents and warrants that:
      1. the Work is the Author’s original work;
      2. the Author has not transferred, and will not transfer, exclusive rights in the Work to any third party;
      3. the Work is not pending review or under consideration by another publisher;
      4. the Work has not previously been published;
      5. the Work contains no misrepresentation or infringement of the Work or property of other authors or third parties; and
      6. the Work contains no libel, invasion of privacy, or other unlawful matter.
    6. The Author agrees to indemnify and hold Publisher harmless from the Author’s breach of the representations and warranties contained in Paragraph 6 above, as well as any claim or proceeding relating to Publisher’s use and publication of any content contained in the Work, including third-party content.

Enforcement of copyright

The IJMS takes the protection of copyright very seriously.

If the IJMS discovers that you have used its copyright materials in contravention of the license above, the IJMS may bring legal proceedings against you seeking reparation and an injunction to stop you using those materials. You could also be ordered to pay legal costs.

If you become aware of any use of the IJMS' copyright materials that contravenes or may contravene the license above, please report this by email to contact@ijms.org

 

Infringing material

If you become aware of any material on the website that you believe infringes your or any other person's copyright, please report this by email to contact@ijms.org