The study on morphology of placenta in gestational diabetes mellitus

Abstract

Introduction: Gestational diabetes mellitus (GDM) refers to glucose intolerance with onset or first recognition during pregnancy. Its raising and varied prevalence in India makes it significant to study its effect on placenta for an effective euglycemic control. Aim: To study the morphologic changes in placenta of GDM and its occurrence of onset in relation to maternal age and parity order. Materials and Methods: The material for the present prospective study consisted of placenta from cases diagnosed as GDM received from the department of obstetrics and gynecology. The study was done for a period of one year from June 2014 to May 2015. Results: A total of 80 placenta were analysed. 40 cases diagnosed as GDM were the Study group and remaining 40 was the control group the morphologic findings in GDM were found statistically significant. In the gross findings 37 (92.5%) GDM placenta weighed >500gm, the mean number of cotyledons was 21.08 and the mean size was 473.8cm3. The umbilical coed insertion was commonly eccentric. Various histopathological lesions identified were chorangiosis in 30(75%), increased syncytial knots in 29 (72.5%), villous edema in 28 (70%) cases, trophoblast basement membrane thickening in 24(60%), villous stromal fibrosis in 24(60%), fibrin deposition in 22(55%), and fibrinoid necrosis in 10(25%) cases. PAS stain for trophoblast basement membrane thickening and PTAH for fibrin deposition were positive. Majority of GDM cases were in the maternal age group of (25-30) years and were multiparous. Conclusion: GDM causes significant morphologic changes consistent with dysmaturity and immaturity of the trophoblast tissue demanding an effective glycemic control. Keywords: Gestational Diabetes Mellitus, Placenta, Histopathology.