Morphological and Histopathological Features of Placenta in Women with Gestational Diabetes Mellitus and Its Association with Perinatal Outcome

Abstract

Background: Placenta, a unique vascular organ, acts as a barrier between maternal and fetal circulation, protecting the fetus from adverse effects of maternal diseases. Gestational diabetes mellitus (GDM) alters the placental function leading to histological and morphological changes in placenta. Hyperglycemia affects placental development leading to adverse maternal and perinatal outcomes. Aim: To understand the morphological and histopathological variations of the placenta in GDM pregnancies and its association with the perinatal outcome. Materials and methods: A hospital-based cross-sectional study was conducted in women with singleton pregnancy between 37 and 40 weeks of gestation with GDM (Cases) and compared with women without GDM (Control). The morphological and histopathological features of the placenta were studied, and the associated perinatal outcome was analyzed. Results: In cases, most of the women had babies with birth weight of 3.51-4 kg (57.1%) and was statistically significant (p = 0.001). The mean placental weight among cases and controls was 719.57 ± 110. 8 gm and 380.71 ± 50.59 gm, respectively. Placental histopathological changes (calcification of the placenta, fibrinoid necrosis of villi and immature villous) were noted in cases and were statistically significant (p = 0.001). Abnormal perinatal outcomes were observed in cases with an oval-shaped placenta (64.7%), increased cord thickness (68.4%), fibrinoid necrosis of villi (50%), syncytial knots (61.9%), and immature villous (54.5%). Conclusion: Gestational diabetes mellitus causes an alteration in morphological and histological features of the placenta resulting in adverse perinatal outcomes. Early diagnosis, treatment, and glycemic control aid in reducing perinatal morbidity and mortality.