Morphological and Micrometrical Changes of the Placental Terminal Villi in Normal and Pregnancies Complicated With Gestational Diabetes Mellitus

Abstract

Incidence of gestational diabetes mellitus (GDM) is escalating in Indian women amounting to 10% of the total pregnancies mainly due to the diet, obesity and sedentary life style. Placenta is a crucial organ of intrauterine life. The functional units of the placenta such as chorionic villi, foetal blood vessels, and the syncytial knots are altered histologically in gestational diabetic condition. The present study is undertaken to observe the morphological and micrometrical changes of the GDM and normal placenta. MATERIAL AND METHODS Total number of 96 placentas, out of which 48 are GDM and 48 from control were procured for the present study. The placentas were collected from our General Hospital, Nellore, AP. Morphology and micrometry of the placentas were studied. RESULTS The shape of placenta was similar in both groups, but the weight in GDM (537.27±131.97 g), diameter (168.2±13.23 mm) and thickness (29.9±3.45 mm) were significantly (P<0.005) increased when compared to control. The mean number (9.01±2.25 mm 3) and diameter (0.08±0.03 mm) of the terminal villi and number of foetal blood vessels (21.76±8.52 mm 3) were found to be increased in GDM, but the diameter of the blood vessel (0.04±0.02 mm) was decreased and highly significant (P<0.001). The syncytial knots and fibrinoid necrosis were also observed in GDM when compared to the normal placenta. CONCLUSION The placentas from GDM were observed with significant morphological and histological changes as compared to controls, which may alter the perinatal outcome resulting in macrosomia, congenital malformations and intrauterine growth retardation.