Effect of Gestational Diabetes Mellitus on Gross Morphology of Placenta: A Comparative Study

Abstract

Background: The fetus, placenta and mother constitute a triad of contributors to pregnancy outcome. When pregnancy is complicated by a medical problem like, diabetes mellitus which affects maternal health, architecture and functions of the placenta may even jeopardize the fetal normalcy. The placenta being the bridge between maternal and fetal activities, considered as a window through which maternal dysfunctions and their impacts on fetal well being can be understood. Aim: The aim was to study gross morphology of placentae of women with gestational diabetes mellitus and to compare the results with normal pregnancies. Methods: It was an observational study. After due approval from institutional ethics committee, 40 placentae from pregnant women clinically diagnosed with gestational diabetes mellitus and 40 placentae from uncomplicated normal pregnant women were collected from labour room and operation theatre of department of obstetrics and gynaecology of government medical college hospital in Jaipur (Rajasthan). Confirmed gestational diabetic cases were selected purposively while controls were taken sequentially. Gross morphological features of each placenta were recorded. The statistical methods used were unpaired 't' test and chi square test. Results: The results showed that weight, diameter, surface area, central thickness and number of cotyledons of placentae from diabetic mothers were significantly more than placentae from normal uncomplicated pregnancies, while no significant differences were observed in shape and site of umbilical cord insertion. Conclusion: The gross morphology of placentae with gestational diabetes mellitus significantly differs from normal pregnancies which may be associated with alteration in physiological functioning of placenta and ultimately fetal outcome.

Gross and Histological Alteration in the Placenta in Gestational Diabetes - A Comparative Study

“…Saini et al, in 2015, studied 40 control and 40 diabetic placentae and observed that the mean central thickness in the control group was 1.96 cm and, in the GDM group, it was 2.12 cm. 4 These findings showed similarity to our study. Elsennavy, in 2016, studied 30 control and 30 GDM placentae and found out that the control group showed a mean central thickness of 2.43 cm, and the GDM group showed a central thickness of 2.67cm 3 .…”

Study of correlation between placental morphology and adverse perinatal outcome in different conditions affecting pregnancy

“…The weight gain in placentae of diabetic mothers may be attributed to macrosomia and compensatory hyperplasia 6 . This macrosmiamay be attributed to fetal hyperinsulenemia in response to hyperglycaemia in fetuses of diabetic mothers (Queenan JT) 9 .…”

The Effect of Gestational Diabetes Mellitus on the Chorionic Villi of Human Placenta Among Saudi Arabian Mothers: A Quantitative and Comparative Study

“…At the beginning of the third week of intrauterine life, the placenta starts to accommodate the embryo [ 2 ]. Therefore, pregnancy becomes a diabetogenic condition that reflects physiological variations by causing insulin resistance to accommodate the embryo’s demand [ 5 ]. Meanwhile, in the healthy physiology of pregnancy, glucose tolerance decreases in the last trimester despite having plasma levels of insulin increase [ 5 ].…”