Structural, functional and circulatory placental changes associated with impaired glucose metabolism.
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.
Saldeen
Pia
P
Department of Obstetrics and Gynecology, Malmö University Hospital, Lund University, Malmö, Sweden. pia.saldeen@telia.com
Olofsson
Per
P
Laurini
Ricardo N
RN
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
D013929:Thromboxane B2; D015121:6-Ketoprostaglandin F1 alpha