A Morphological Study of Placenta in Normal and Diabetic Pregnancies and Its Foetal Implications
Keywords:
Placentae, Normal pregnancy, Gestational diabetes mellitus, Morphology, Foetus
Abstract
Background: The placenta is a foeto-maternal organ that separates the maternal and foetal circulations and plays a key metabolic role in pregnancy. Placental changes are directly proportional to the disease duration and its severity. In addition foetal outcome is also adversely influenced by pathological changes in placenta. . In the present study the focus is to bring out placental changes specifically associated with diabetes Methods: The placentae for the study were obtained from the in- patients of department of Obstetrics and Gynaecology, Sree Gokulam Medical College and Research Foundation, Venjaramoodu. 100 placentae were collected for the study. Among these 50 placentae were from mothers with uneventful antenatal period comprising the normal group and 50 placentae from mothers with GDM classified as GDM group. A descriptive study was done to assess the morphology of placentae in Gestational diabetes mellitus and to compare the same with that of normal pregnancies. The parameters included both gross and microscopy. Result: The morphometric parameters and gross observations like hematoma and calcification were increased in GDM. Microscopic findings like Syncytial knots, fibrinoid necrosis, Cytotrophoblastic proliferation, basement membrane thickening, obliterative endarteritis, Villous vascularity and villous stromal fibrosis (p<0.001) were significantly increased in GDM group. Significant percentage of placentae with more than 5% of immature villi was seen in GDM group. The birth weight of babies was increased in GDM group mothers compared to normal group Conclusion: Â Diabetes in pregnancy has a profound impact on both the placenta and the foetus. Both the villous and stromal parameters are altered by the high glycemic level.References
1. Damjanov I, Linder J. Anderson’s Pathology, 10th Edition, Elsevier.
2. Robboy S J et.al. Robboy's Pathology of the Female Reproductive Tract. 2nd Edition, Elsevier.
3. Marilza V C, Rudge, Cesar P, Debora C, Yuri K, Gustavo N, CibeleVC. Histopathological placental lesions in mild gestational hyperglycemic and diabetic women. Diabetology & Metabolic Syndrome. 2011.
4. Tewari V, Tewari A, Bhardwaj N. Histological and histochemical changes in placenta of diabetic pregnant females and its comparision with normal placenta. Asian Pacific Journal of Tropical Disease. 2011.
5. Fox H. Ageing of placenta. Arch Dis Child Foetal Neonatal. 1997; 77: 171-175.
6. Daskalakis G, Marinopoulos S, Krielesi V, Papapanagiotou A, Papantoniou N, Esogitis S. Placental pathology in women with gestational diabetes. Acta Obstetricia et Gynecologica. 2008; 87: 403-407.
7. Saha S, Biswas S, Mitra D, Adhikari A, Saha C. Histologic and morphometric study of human placenta in gestational diabetes mellitus. IJAE.2014; 1(119):
1-9.
8. Verma R, Mishra S, Kaul J. Cellular Changes in the Placenta in Pregnancies Complicated with Diabetes. Int. J. Morphol.2010; 28(1):259-264.
9. Bandana D, Dutta D, Chakraborthy D S, Nath P. Placental morphology in hypertensive disorders of pregnancy and its correlation with foetal outcome. Journal of Obstet and Gynecol India. 1996; 46(1):40-46 .
10. Tewari V, Tewari A, Bhardwaj N. Histological and histochemical changes in placenta of diabetic pregnant females and its comparision with normal placenta. Asian Pacific Journal of Tropical Disease. 2011.
11. Shams F, Rafique M, Samoo NA, Irfan R. Fibrinoid Necrosis and Hyalinization Observed in Normal, Diabetic and Hypertensive Placentae. Journal of the College of Physicians and Surgeons. 2012; Vol. 22 (12): 769-772.
12. Majumdar S, Dasgupta H, Bhattacharya K, Bhattacharya A. A Study of Placenta In Normal and Hypertensive Pregnancies. J Anat Soc India.2005;54(2):1-9.
13. Maternal diseases complicating pregnancy: diabetes, tumors, preeclampsia, lupus anticoagulant. In: Benirschke K, Kaufmann P (eds). Pathology of the Human Placenta, 3rd edn. New York: Springer; 1995: 476-536.
14. Khaskhelli LB, Memon S, Goswami P, Bano S. Change in Normal Morphology of Placenta and Its Possible Effects on Foetal Outcome in Diabetic Mothers as Compared to Non-Diabetic Mothers. JLUMHS. January-April 2013; 1(12).
2. Robboy S J et.al. Robboy's Pathology of the Female Reproductive Tract. 2nd Edition, Elsevier.
3. Marilza V C, Rudge, Cesar P, Debora C, Yuri K, Gustavo N, CibeleVC. Histopathological placental lesions in mild gestational hyperglycemic and diabetic women. Diabetology & Metabolic Syndrome. 2011.
4. Tewari V, Tewari A, Bhardwaj N. Histological and histochemical changes in placenta of diabetic pregnant females and its comparision with normal placenta. Asian Pacific Journal of Tropical Disease. 2011.
5. Fox H. Ageing of placenta. Arch Dis Child Foetal Neonatal. 1997; 77: 171-175.
6. Daskalakis G, Marinopoulos S, Krielesi V, Papapanagiotou A, Papantoniou N, Esogitis S. Placental pathology in women with gestational diabetes. Acta Obstetricia et Gynecologica. 2008; 87: 403-407.
7. Saha S, Biswas S, Mitra D, Adhikari A, Saha C. Histologic and morphometric study of human placenta in gestational diabetes mellitus. IJAE.2014; 1(119):
1-9.
8. Verma R, Mishra S, Kaul J. Cellular Changes in the Placenta in Pregnancies Complicated with Diabetes. Int. J. Morphol.2010; 28(1):259-264.
9. Bandana D, Dutta D, Chakraborthy D S, Nath P. Placental morphology in hypertensive disorders of pregnancy and its correlation with foetal outcome. Journal of Obstet and Gynecol India. 1996; 46(1):40-46 .
10. Tewari V, Tewari A, Bhardwaj N. Histological and histochemical changes in placenta of diabetic pregnant females and its comparision with normal placenta. Asian Pacific Journal of Tropical Disease. 2011.
11. Shams F, Rafique M, Samoo NA, Irfan R. Fibrinoid Necrosis and Hyalinization Observed in Normal, Diabetic and Hypertensive Placentae. Journal of the College of Physicians and Surgeons. 2012; Vol. 22 (12): 769-772.
12. Majumdar S, Dasgupta H, Bhattacharya K, Bhattacharya A. A Study of Placenta In Normal and Hypertensive Pregnancies. J Anat Soc India.2005;54(2):1-9.
13. Maternal diseases complicating pregnancy: diabetes, tumors, preeclampsia, lupus anticoagulant. In: Benirschke K, Kaufmann P (eds). Pathology of the Human Placenta, 3rd edn. New York: Springer; 1995: 476-536.
14. Khaskhelli LB, Memon S, Goswami P, Bano S. Change in Normal Morphology of Placenta and Its Possible Effects on Foetal Outcome in Diabetic Mothers as Compared to Non-Diabetic Mothers. JLUMHS. January-April 2013; 1(12).
Published
2019-02-26
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