Abstract
Objective:To evaluate the effects of diet control and Metformin on placental morphology in gestational diabetes mellitus (GDM).Methods:After written informed consent 62 GDMs were enrolled. According to WHO criteria, 30 cases of GDMs with blood sugar level <130 mg/dl, were assigned Group B (2000-2500Kcal/day and 30 minute walk thrice weekly were kept on diet control and 32 cases of GDM with blood sugar level >130 mg/dl, assigned Group C were kept on diet with tablet Metformin,(500mg TDS) Finally 25 normal pregnant females were kept in Group A as control. After delivery placentae were preserved and evaluated for morphology.Results:Heavy placentae with abundant villous immaturity, chorangiosis and syncytial knots in group B and fibrinoid necrosis and calcification in group C were seen. In group B versus A placental and cord width while in Group C versus A only cord width in gross morphology showed significant results. In group B versus A villous immaturity, chorangiosis, infarction and syncytial knots in light microscopy were present; similarly in B versus C placental width, chorangiosis and syncytial knots showed significant results, while in C versus A results were non-significant.Conclusion:Metformin produced beneficial effects on placental morphology being comparable to normal control in contrast to diet group.
Highlights
Gestational diabetes is glucose intolerance identified in the second trimester of pregnancy
Thirty-two gestational diabetes mellitus (GDM) patients in Group C were with RBS more than 130 mg/dl received tablet Metformin 500mg along with strict diet control therapy (
HbAIC evaluated at 36 weeks of pregnancy has shown significant decrease in group C as compared to group B. (Table-IV)
Summary
Gestational diabetes is glucose intolerance identified in the second trimester of pregnancy. This occurs mainly due to the diabetogenic effects of placental hormones and is associated with certain critical fetal and maternal consequences.[1] The worldwide prevalence of GDM is 3-9% whereas in our population prevalence is 3-3.45% but the outcomes are much worse due to lack of knowledge and medical care facilities.[2]. Placenta is involved in the nutritional supply of the maturing fetus. It is a discoid shaped structure covered with membranes and microscopically composed of multiple villi containing minute blood vessels and mesenchymal supportive tissue. Change in the maternal atmosphere influences the physiology and structure of this central organ.3The
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