title: Severe pre-eclampsia complicated by HELLP syndrome alterations in the structure of the umbilical cord (morphometric and immunohistochemical study).
abstract: The aim of this study was to evaluate the morphometric and immunohistochemistry in umbilical cords from patients with severe pre-eclampsia with and without haemolysis, elevated liver enzymes and low platelets (HELLP) syndrome. The patient and control groups were similar according to baseline obstetric characteristics. White blood cell count in patients with HELLP syndrome and the control group was significantly increased among patients with HELLP syndrome (p< 0.001). Morphometric examination and endothelial core length were significantly different between the groups. In the umbilical cord cross-section of the HELLP group, endothelial cell degeneration in the vessel wall and basement membrane thickening were observed. In the muscle layer of blood vessels, the following disorders were found: increased collagen fibres in the muscle cell, hyperplasia and separation of muscle fibres as well as edema in the intermediate connective tissue. Immunohistochemical analysis showed that endothelial cells, basal membrane and fibroblast cells in the HELLP group expressed high levels of CD44. Vessel wall and amniotic epithelial basement membrane thickening were observed in the HELLP group. Matrix metalloproteinase 9 (MMP9) was expressed. Fibroblast and smooth muscle cells were fusiform and showed a positive reaction to immunohistochemical staining ofα-actin smooth muscle.
authors.affiliation: Department of Obstetrics and Gynecology, Diyarbakır Maternity and Child Health Hospital , Diyarbakır , Turkey.
authors.forename: Deniz
authors.initials: D
authors.lastname: Balsak
authors.affiliation: Department of Obstetrics and Gynecology, Diyarbakır Maternity and Child Health Hospital , Diyarbakır , Turkey.
authors.forename: Cihan
authors.initials: C
authors.lastname: Togrul
authors.affiliation: Department of Histology and Embryology, Dicle University, School of Medicine , Diyarbakır , Turkey.
authors.forename: Cenap
authors.initials: C
authors.lastname: Ekinci
authors.affiliation: Department of Obstetrics and Gynecology, Memorial Hospital , Diyarbakır , Turkey.
authors.forename: Yunus
authors.initials: Y
authors.lastname: Cavus
authors.affiliation: Department of Obstetrics and Gynecology, Diyarbakır Maternity and Child Health Hospital , Diyarbakır , Turkey.
authors.forename: Ali Emre
authors.initials: AE
authors.lastname: Tahaoglu
authors.affiliation: Department of Histology and Embryology, Dicle University, School of Medicine , Diyarbakır , Turkey.
authors.forename: Engin
authors.initials: E
authors.lastname: Deveci
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Dicle University , Diyarbakır , Turkey.
authors.forename: Talip
authors.initials: T
authors.lastname: Gül
authors.affiliation: Department of Histology and Embryology, Dicle University, School of Medicine , Diyarbakır , Turkey.
authors.forename: Evren
authors.initials: E
authors.lastname: Karaman
authors.affiliation: Department of Biochemistry, Faculty of Medicine, Dicle University , Diyarbakır , Turkey.
authors.forename: Aysun
authors.initials: A
authors.lastname: Ekinci
authors.affiliation: Department of Obstetrics and Gynecology, Diyarbakır Education Research Hospital , Diyarbakır , Turkey.
authors.forename: Nafi
authors.initials: N
authors.lastname: Sakar
keywords: CD44; HELLP syndrome; MMP9; umbilical cord; α-smooth actin