Histomorphometrical Analysis of the Umbilical Cord and Placenta in Human Fetuses with Macrosomia

Abstract

Objective: To evaluate the histomorphometrical changes in the umbilical cords and placenta associated with excessive fetal growth.

Study Design: Comparative cross-sectional study
Place and Duration of Study: This study was conducted at the College Science, University of Baghdad, Baghdad, Iraq from 1st September 2025 to 28th February 2026.

Methods: A total of 160 Iraqi pregnant women at 3rd trimester of pregnancy with their neonates under vaginal or caesarean delivery were enrolled.

Results: No significant differences (P≥0.05) observed in maternal age between groups, the mean maternal age with normal fetus weight was 24.21±20.5 years, women carrying macrosomic fetus was 25.11±18.5 years. The pregnant with macrosomic fetus showed significantly (p≤0.01) shorter gestational age and higher maternal and neonatal weights 32.10±1.2, 94±3.2 kg, 4.8±2.5 kg than control group 36.1±1.5, 80±10.5 kg, 2.5±0.4 kg respectively. The macroscopic examination showed significant differences in placental and umbilical cords between groups(P≤ 0.05) the placental weight and length were lower in the macrosomic infants (319.5±10.03g, 16.43±1.04 cm) while in the non-macrosomic infants (509.17±11.42 g,19.15±2.05 cm)while umbilical cords length and diameter were significantly increased (72±0.06, 55±3.05 cm) compared to control 3.44±2.15, 1.82±0.06cm) .The morphometric analysis demonstrated reduced placenta surface area 190±20.5cm, diameter 15.33±10.5cm2, and the placental thickness 1.32±1.5 cm compared to the non-macrosomic infants 210.2±18.5 cm, 18.3±1.4 cm2 , 1.72±1.2 cm respectively. The placental villiin macrosomic infants appeared increased surface area and villous diameter (1.38 ± 0.1 mm2,, 0.14 ± 0.02mm) while blood vessel diameter was reduced in the macrosomic infants 0.03 ± 0.02 mm.

Conclusion: Placental morphometrical index is associated with fetal macrosomia and understanding gestational complications.