AI Summary & Key Takeaways
AI InsightWhen multiple cord entanglement is seen during obstetric examination, umbilical artery discordance must be remembered and investigated, and also maternal-fetal condition should be considered.
📌 3 Key Takeaways
Abstract
Objective: The present study aimed to examine the histopathologi- cal 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, histopatholog- ical findings of the placenta and obstetric outcomes were retrospective- ly examined in 50 cases. The cases were divided into two groups by the number of cord entanglement (single-multiple) and their histopatho- logical findings and neonatal Apgar scores were assessed. Results: Out of 50 cases, 38 (76%) had single and 12 (24%) had mul- tiple 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 differ- ence was detected (p=0.037). Out of 50 cases, placental hypoxia find- ing 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 preg- nancy 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.
Özet
Amaç: Çal›flmam›zda tek veya çoklu umbilikal kord dolanmas› olan olgularda umbilikal arter uyumsuzlu¤una yönelik histopatolojik ta- n›y› ve gebelik sonuçlar›n› incelemeyi amaçlad›k. Yöntem: Umbilikal kordun vasküler yap›s›, plasentan›n histopato- lojik bulgular› ve obstetrik sonuçlar 50 olguda retrospektif olarak incelendi. Olgular kordon dolanmas› say›s›na (tek-çoklu) göre iki gruba ayr›ld› ve olgular›n histopatolojik bulgular› ve neonatal Ap- gar skorlar› de¤erlendirildi. Bulgular: Elli olgunun 38’inde (%76) tek ve 12’sinde (%24) çoklu kordon dolanmas› mevcuttu. 50 olgunun ortalama gestasyonel yafl› 39.16±1.06 ve neonatal Apgar skorlar› 1. dakika için 8.7±0.58, 5. da- kika için 9.64±0.56 idi. Gestasyonel yafl (p=0.79), 1. dakika Apgar skoru (p=0.832) ve 5. dakika Apgar skoru (p=0.656) bak›m›ndan tek- li ve çoklu kordon dolanmas› gruplar›nda istatistiksel olarak anlaml› fark yoktu. Histopatolojik muayenede 1. ve 2. umbilikal arterlerin ça- p› tek kordon dolanmas› grubunda s›ras›yla 0.11±0.12, 0.09±0.05 μm (p=0.756) ve çoklu kordon dolanmas› grubunda ise s›ras›yla 0.13±0.14, 0.06±0.02 μm (p=0.131) olarak bulundu. Umbilikal arter- yal çaplar gruba göre karfl›laflt›r›ld›¤›nda, umbilikal arter 2’nin çap› tek kordon dolanmas› grubunda 0.09±0.05 μm ve çoklu kordon do- lanmas› grubunda 0.06±0.02 μm olarak bulundu ve istatistiksel olarak anlaml› fark vard› (p=0.037). Elli olgunun 10’unda (2 çoklu, 8 tek) plasental hipoksi bulgusu sadece koranjiozis olarak tespit edildi. Sonuç: Çoklu umbilikal kord dolanmas› olan olgularda umbilikal arter uyumsuzlu¤u tespit ettik, fakat olgular›n herhangi birinde kötü gebelik sonucu gözlemlemedik. Obstetrik muayenede çoklu kordon dolanmas› görülmesi halinde, umbilikal arter uyumsuzlu- ¤u hat›rlanarak araflt›r›lmal› ve ayr›ca maternal-fetal durum dikka- te al›nmal›d›r.