Influence of the Anastomosis of the Umbilical Arteries (Hyrtl's) on the Morphometry and Efficiency of the Placenta

Liliana Salazar; Mara S. Gómez; Yhoiss S. Muñoz & María Carolina Pustovrh

Summary

Hyrtl's anastomosis (HA), a single vessel, with wide anatomical variability, communicates the umbilical arteries, near the insertion of the umbilical cord in human placentas. The objective of this study was to determine if there is a relationship between the morphometric characteristics of the placenta and the presence of the anastomosis and to analyze if this influences the placental efficiency. Descriptive study. We analyzed 60 placentas from mothers who agreed to participate in the study, single pregnancy, term (between 37.0 and 41.6 weeks), aged between 18 and 37 years with at least four visits to prenatal control, without comorbidities. The placental characteristics of weight, diameters and thickness were taken fresh. Once fixed with 10 % formaldehyde, the anastomosis was located, classified, and photographed by dissection. The weight of the placenta was 494.4 ± 87.1 g, the central thickness corresponded to 1.7 ± 0.4 cm, the MD 19.9 ± 2.0 cm and Dm 18.4 ±1.7 cm: The predominant cord insertion was eccentric, with 65 % and the discoid or oval shape with 60 %. In 51 placentas the presence of anastomosis was found (85 %). In the group of placentas with AH presence, a lower placental weight was found when compared to the group that did not present AH, the rest of the morphometric characteristics of the placenta, including the type of umbilical cord insertion, were not related to the anastomosis. Placental efficiency expressed as the neonatal weight/placental weight ratio showed significant differences in the group with presence of anastomosis, with higher values compared to the group without anastomosis. The presence of HA contributes positively to placental efficiency. However, the increase in placental weight may be a compensatory effect of the placenta and does not always indicate a greater functional efficiency of the organ.

KEY WORDS: Hyrtl's anastomosis; Umbilical arteries; Fetal/placental weight ratio(F/P).

How to cite this article

SALAZAR, L.; GÓMEZ, M. S.; MUÑOZ, Y. S. & PUSTOVRH, M. C. Influence of the anastomosis of the umbilical arteries (Hyrtl's) on the morphometry and efficiency of the placenta. Int. J. Morphol., 40(6):1530-1535, 2022.

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