It is known that pre-eclampsia affects the structure of the umbilical cord including changes in diameter and wall thickness. In this work, the morphological changes of umbilical cords associated with pre-eclampsia were investigated using scanning electron microscopy (SEM) and atomic force microscopy (AFM). The SEM images showed the overall structural changes in the umbilical cord, and the AFM imaged the surface of the cord in the nanometer range. The amount of Wharton's jelly was reduced in the cords of pre-eclampsia patients and it was holed along the boundary. Compared to a normal pregnancy, the surface of a pre-eclampsia cord was relatively smooth. In all components (Wharton's jelly, veins, and arteries), the values for surface roughness, Sa (average value of the roughness), Sq (root mean square), and Sz (peak to peak value), were smaller than those of the control (P < 0.05). Especially, the values for Sa of veins were ~fourfold less than those of the controls (P < 0.05). In pre-eclamptic cords, the amount of elastin in veins was increased while that of the artery was decreased.
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