title: Structural, functional and circulatory placental changes associated with impaired glucose metabolism.
abstract: OBJECTIVE
  To investigate associations between structural, functional and circulatory placental changes in pregnancies complicated by impaired glucose metabolism.
  
  
  METHODS
  Umbilical artery (UA) blood flow resistance was measured by Doppler velocimetry in 21 gravidae with diabetes/impaired glucose tolerance (IGT) and 10 healthy gravidae. Umbilical and placental vessel segments were incubated for determination of prostacyclin and thromboxane synthesis, and tissues histologically examined. Non-parametric statistical tests at a two-tailed P<0.05 were used.
  
  
  RESULTS
  Placental lesions were more common in diabetes/IGT and, although not being an uniform finding, in general associated with a higher vascular synthesis of thromboxane and/or lower prostacyclin/thromboxane synthesis ratio. As an exception, ischemic villitis was associated with a higher ratio and higher UA flow resistance.
  
  
  CONCLUSIONS
  Placental lesions are associated with an altered vascular prostanoid synthesis in diabetes/IGT, but not until structural signs of ischemia develop is a rise of UA blood flow resistance detected.
authors.affiliation: Department of Obstetrics and Gynecology, Malmö University Hospital, Lund University, Malmö, Sweden. pia.saldeen@telia.com
authors.forename: Pia
authors.initials: P
authors.lastname: Saldeen
authors.forename: Per
authors.initials: P
authors.lastname: Olofsson
authors.forename: Ricardo N
authors.initials: RN
authors.lastname: Laurini
mesh_terms: D015121:6-Ketoprostaglandin F1 alpha / Q000096:biosynthesis; D003924:Diabetes Mellitus, Type 2 / Q000473:pathology / Q000503:physiopathology*; D016640:Diabetes, Gestational / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D018149:Glucose Intolerance / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D007238:Infarction; D007511:Ischemia / Q000473:pathology / Q000503:physiopathology; D010920:Placenta / Q000098:blood supply*; D010922:Placenta Diseases / Q000473:pathology / Q000503:physiopathology*; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000473:pathology / Q000503:physiopathology*; D013927:Thrombosis / Q000503:physiopathology; D013929:Thromboxane B2 / Q000096:biosynthesis; D014469:Umbilical Arteries / Q000503:physiopathology; D014655:Vascular Resistance
chemical_list: D013929:Thromboxane B2; D015121:6-Ketoprostaglandin F1 alpha