Histopathological changes of the umbilical cord in gestational diabetes mellitus, preeclampsia, HELLP syndrome and normal pregnancies

Histopathological changes of the umbilical cord in gestational diabetes mellitus, preeclampsia, HELLP syndrome and normal pregnancies. Introduction and objective: Preeclampsia, HELLP syndrome and gestational diabetes are quite common complication in pregnanc. In this study,ıt is aimed to compare the thickness and structure of the basal lamia by comparing preeclampsia, HELLP syndrome and gestational diabetes with the endothelial differences ,vascular wall structure and mast cell densities of normal pregnant women' umbilical cord through making morphometric measurements to see if there is any difference between them. Material and method: In the study, sanples were taken from postpartium umbilical cords of normal pregnant women, preeclampsia, gestational diabetes and pregnant women diagnosed with HELLP syndrome. Umblical cord samples taken during maternity, followed by routine paraffin through fixing 10% neutral formalin. In this performed as totally sixty facts through taking fifteen umbilical cords from each of four groups, Hematoxyline-eosin, Masson trichrom, periodic acid Schiff, and toluidine blue stain were applied on to the serial histological sections obtained from paraffin blocks. The obtained preparations were evaluated with Zeiss Imager 2 Microscope by taking micrographs. Morphometric measurements were statistically analyzed with SPSS software. Results: In cases of gestational diabetes due to increased collagen production, thickening and excessive narrowing of the lumen and differentiation of Wharton jely were observed on the umbilical artery. Differentiations are observed in the Vacuolization of smooth muscle cells and muscle fibers that make up the Media while camber and damage are observed in endothelial. The most significant structural changes of preeclamptic pregnancies are obtained as the thickening and the endothelial injury. In the umbilical cord artery medial layer, due to the growth of collagen fiber. In HELLP cases due to the increase in media diffuse edema between muscle fibers and in collagen, the thickening of umbilical artery wall and the narrowing of luminal are seen as extremely significant. Another striking symptom with HELLP cases is the observing of intramuscular hemorrhages in the umbilical artery wall as an unattained case in preeclampsia and gestational diabetes. In most of the cases, differentiation in Wharton jelly, metaplasic changes in the amniotic epithelium and thickening of the basal lamina are found. The result of Morphometric measurements ,due to the increase of collagen thickening in the arterial wall ,and narrowing of the lumen with thickening in vein media are retained in each three groups of the gestational diabetes, preeclampsia and HELLP(p=0.000). Umbilical venous dilatation is seen significant only in gestational diabetes (p=0.005). Whereas, the umbilical cord and increase in the total circumference and diameter are found significant in gestational diabetes group (p=0.000). Its known that endotelial cell degeneration visible as a result of Preeclampsia, HELLP and Gestational diabetes mellitus. Furthermore, in our research, we have evaluated increase in umblical cord section area of gestational diabetes mellitus group in compare with the other groups. Additionally, microscobical vascular degenerations observed in our research. We suggest more researches needed to observe relations between fetal growth and umblical cord of Preeclampsia, HELLP, Gestational diabaetes mellitus patients. Keywords: Umbilical cord, preeclampsia, gestational diabetes mellitus, HELLP syndrome, Wharton jelly.