PURPOSE AND CONTEXT Umbilical cord abnormalities with clinical signs of cord compromise are frequently associated with fetal vascular malperfusion (FVM). Single umbilical artery (SUA) has been reported to be associated with high-grade FVM in fetal growth restriction but not in an unselected population; our study aimed to address this issue. METHODS Clinical and placental phenotypes of 55 consecutive placentas with SUA (Group 1) were compared with those of 655 placentas with 3-vessel umbilical cord (Group 2) from patients who were in the second half of their pregnancy. The placentas were histologically examined using hematoxylin and eosin (H&E) staining and CD 34 immunostaining. KEY RESULTS Several umbilical cord phenotypes and high-grade distal FVM, based on H&E staining and endothelial fragmentation by CD34 were significantly more common in Group 1, whereas decidual clusters of multinucleate trophoblasts were more common in Group 2. Notably, H&E staining or CD34 immunostaining evaluated separately showed that high-grade distal FVM was more common in Group 1 than in Group 2, but the difference was not statistically significant. CONCLUSIONS SUA predisposes to remote, advanced, and recent high-grade distal villous FVM, with a pathogenesis partly different from that of stasis-induced FVM, likely related to fetal anomalies associated with SUA.

中文翻译：

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单脐动脉脐带与高度远端胎儿血管灌注不良有关。

目的和背景 具有脐带受损临床症状的脐带异常通常与胎儿血管灌注不良 (FVM) 相关。据报道，单脐动脉 (SUA) 与胎儿生长受限的高级别 FVM 相关，但在未选择的人群中则不然；我们的研究旨在解决这个问题。方法 将 55 个连续 SUA 胎盘（第 1 组）的临床和胎盘表型与来自妊娠后半期患者的 655 个 3 血管脐带胎盘（第 2 组）的临床和胎盘表型进行比较。使用苏木精和伊红 (H&E) 染色和 CD 34 免疫染色对胎盘进行组织学检查。主要结果 基于 H&E 染色和 CD34 导致的内皮碎裂，多种脐带表型和高级远端 FVM 在第 1 组中明显更为常见，而多核滋养层蜕膜簇在第 2 组中更为常见。值得注意的是，H&E 染色或 CD34 免疫染色单独评估显示，高级别远端 FVM 在第 1 组中比第 2 组中更常见，但差异无统计学意义。结论 SUA 易发生远期、晚期和近期的高级别远端绒毛 FVM，其发病机制部分不同于停滞引起的 FVM，可能与 SUA 相关的胎儿异常有关。