Placental pathology in women with gestational diabetes.
BACKGROUND
The aim of this study was to investigate pathologic differences of the placenta in pregnancies complicated by gestational diabetes compared to non-diabetic pregnancies.


METHODS
Forty singleton pregnancies complicated by gestational diabetes were recruited and compared to 40 consecutive normal pregnancies. A pathologist, blinded to all clinical data, reviewed all histological samples of the placentas. The histological assessment was carried out with regard to the following aspects: fetal vessel thrombosis, villous immaturity, chorangiosis, presence of nucleated fetal red blood cells (NFRBCs), ischemia, infarction, presence of hydropic or avascular villi, lymphohistiocytic villitis and villous fibrinoid necrosis.


RESULTS
The presence of degenerative lesions such as fibrinoid necrosis and vascular lesions like chorangiosis was apparent, mainly in the diabetes group. Villous immaturity and the presence of NFRBC as an indication of chronic fetal hypoxia were significantly increased in the placentas of women with diabetes compared with the control group. Fetal/placental weight ratio was significantly lower in the diabetic group.


CONCLUSIONS
Histological abnormalities were observed more frequently in the diabetic placentas compared to the controls. These findings support the hypothesis that impaired placental function is one of the main reasons for the increased frequency of fetal complications in diabetic pregnancies.
Daskalakis
George
G
First Department of Obstetrics and Gynecology, Athens University, Athens, Greece. gdaskalakis@yahoo.com
Marinopoulos
Spyros
S
Krielesi
Vasiliki
V
Papapanagiotou
Angeliki
A
Papantoniou
Nikolaos
N
Mesogitis
Spyros
S
Antsaklis
Aris
A
D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D016640:Diabetes, Gestational / Q000097:blood / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D020567:Fetal Weight / Q000502:physiology; D006442:Glycated Hemoglobin; D006801:Humans; D010920:Placenta / Q000473:pathology*; D021041:Placental Circulation / Q000502:physiology; D011247:Pregnancy
D001786:Blood Glucose; D006442:Glycated Hemoglobin