Biomedicine

Abstract

Introduction and Aim: Hyrtl’s anastomosis is the only connection between the two umbilical arteries, which helps in equalizing the blood pressure in the umbilical arteries supplying to the different territories of the placenta. The aim was to study the morphological and structural pattern of Hyrtl’s anastomosis in normal, pregnancy-induced hypertension (PIH) and small for gestational age (SGA) umbilical cords.
Materials and Methods: This study included 150 term placentas with the umbilical cord, divided into three groups. Group I (Normal), Group II (Pregnancy Induced Hypertension), and Group III (Small for Gestational Age).
Results: Hyrtl’s anastomosis could be identified in 138 cases. In 69 cases, the anastomosis noted was a transverse type, oblique in 40, fenestrated in 23, and fused in 6 cases. Hyrtl’s anastomosis was absent in ten cases and the single umbilical artery was observed in two cases. A significant increase in the incidence of a transverse type of Hyrtl’s anastomosis was noted in PIH groups. The percentage of oblique type was more in normal and SGA groups as and when compared to PIH groups. There was a statistically significant increase in the length of Hyrtl’s anastomosis in the normal groups when compared to PIH groups, both in the transverse and oblique type. A histologically significant difference in the tunica media of the umbilical arteries and Hyrtl’s anastomosis was noted in PIH groups.
Conclusion: Hyrtl’s anastomosis in PIH groups showed varied histomorphological anatomy when compared to normal groups