title: Clinical and ultrasound features of placental maturation in pre-gestational diabetic pregnancy.
abstract: BACKGROUND
  Pre-gestational diabetes (PGDM) is a significant cause of neonatal morbidity and mortality. Delayed villous maturation (DVM) is a placental diagnosis with increased risk of perinatal mortality.
  
  
  OBJECTIVE
  This study aimed to prospectively look at the incidence of DVM in a PGDM population compared to non-diabetic controls. Additionally, we analysed antenatal ultrasound and clinical markers for DVM in the diabetic population.
  
  
  METHODS
  This is a prospective study.
  
  
  METHODS
  Placentae of women with non-diabetic and PGDM pregnancies underwent detailed blinded histo-pathological examination.
  
  
  METHODS
  Clinical data, including birth weight, peri-natal outcome, and, in PGDM group, glycaemic control and ultrasound findings, were obtained.
  
  
  RESULTS
  77 non-diabetic women and 74 PGDM women consented to the study. The incidence of DVM in the PGDM group was higher than in the non-diabetic group (21/74 (28.4%) vs. 11/77 (14.3%) p=0.02; RR 1.98). In the PGDM group clinical and ultrasound markers were compared between the DVM group (n=21) and the non-DVM group (n=53). There was no difference in perinatal outcome nor glycaemic control between these two groups.
  
  
  CONCLUSIONS
  DVM, a placental finding with an increased risk of perinatal mortality, is increased in PGDM population compared to non-diabetic controls. No association was found with maternal glycaemic control. The presence of placental DVM was not associated with antenatal ultrasound parameters nor clinical perinatal outcome.
authors: UCD Obstetrics and Gynaecology, School of Medicine and Medical Science, University College Dublin, National Maternity Hospital, Ireland.
authors: Mary F
authors: MF
authors: Higgins
authors: Noirin M
authors: NM
authors: Russell
authors: Eoghan E
authors: EE
authors: Mooney
authors: Fionnuala M
authors: FM
authors: McAuliffe
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D010920:Placenta / Q000000981:diagnostic imaging / Q000503:physiopathology; D010922:Placenta Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000473:pathology; D010929:Placentation; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000175:diagnosis; D011446:Prospective Studies; D014463:Ultrasonography