Histomorphometric Analysis of Umbilical Cord Blood Vessel Thickness amongst Normal and Intrauterine Growth-restricted Newborns

Introduction: The umbilical cord (UC), comprising one vein and two arteries embedded in Wharton’s jelly, is critical for foetal-maternal exchange. Structural alterations in the UC have been associated with adverse foetal outcomes such as intrauterine growth restriction (IUGR). Histomorphometric studies indicate reduced vessel thickness and cross-sectional area in IUGR cords, suggesting compromised foetal circulation. This study aimed to analyse and compare the wall thickness of umbilical vessels in IUGR and normal newborns. Materials and Methods: This observational case series included 125 IUGR and 125 normal UC samples collected immediately postdelivery. A 5 cm UC segment was fixed in 10% formalin, sectioned (3 μm) and stained with haematoxylin and eosin. Vessel wall thickness (umbilical vein [UV], umbilical arteries [UA1], UA2) was measured using Imagej software under 40×. Statistical analysis was performed using SPSS and Stata, with significance set at P < 0.05. Results: Mean wall thickness in normal newborns was significantly higher: UV (370.53 ± 139.49 μm), UA1 (624.16 ± 136.88 μm) and UA2 (615.87 ± 128.66 μm), compared to IUGR: UV (234.89 ± 89.74 μm), UA1 (359.18 ± 78.56 μm) and UA2 (349.51 ± 83.34 μm). The differences were statistically highly significant ( P < 0.0001). Conclusion: The present study demonstrates significantly reduced vessel wall thickness in IUGR UC, which may serve as a histological marker for foetal growth restriction. These findings underscore the potential of umbilical vessel histomorphometry in early diagnosis and management of IUGR, advocating for future interdisciplinary research to explore therapeutic implications.