PP012. Abnormal vascular umbilical cord morphology in vascular-related pregnancy complications

Abstract

Background: Preeclampsia (PE), foetal growth restriction (FGR) and preterm birth (PTB) are associated with an increased risk on the development of cardiovascular disease in offspring. Abnormal programming of the embryonic and extra-embryonic vasculature may be involved. The umbilical cord could be a good model for studying foetal vascular development.

Objectives: We examined the morphology of the umbilical cord vasculature in complicated (PE, FGR, PTB) and uncomplicated pregnancies.

Methods: In a case-control study, we included 105 patients consisting of PE (n=31), FGR (n=26), PTB (n=24) and controls (n=24). Macroscopic measurements were performed and tissue samples were formalin-fixed within 1 hour after birth, for microscopic analysis of digitised paraffin sections.

Results: The macroscopic evaluation showed shorter umbilical cords in PE than in controls. Microscopic measurements revealed a smaller total cord area in all complicated pregnancies compared to controls. The artery wall area was smaller in PE and IUGR, and a smaller vein wall area was present in PE only, compared to controls. The percentage of elastic fibres in the vein was lower in PE and IUGR than in controls (Table 1).

Conclusion: Our study demonstrates umbilical cord vascular abnormalities in PE, FGR and PTB, suggesting early vascular damage. Future studies should focus on similar structural changes in foetal vasculature and associations with cardiovascular disease in later life.