Histopathological Changes in the Placenta of Pregnant Women with Gestational Diabetes Mellitus and Fetal Outcome Miami Abdul Hassan Ali* FICOG, Eaman Marouf Muhammad** FICOG ABOG, Sarah Salim Hasan** MBChB, Thaeer Jawad Kadem** FIBMS
Background: Proper fetal growth depends on proper development and function of the placenta. Gestational diabetes mellitus (GDM) lead to an abnormal placental development and affect its function.
Objective: To study histopathological changes in the placenta of pregnant women with GDM and to compare these changes with that of women of normal pregnancy.
Methods: This was a case-control study carried out at Al-Yarmouk Teaching Hospital, department of obstetrics and gynecology between January 1st 2016 and January 1st 2017. The study included 120 pregnant women, 60 with gestational diabetes mellitus (study group), and 60 women with normal pregnancy (control group), the placental tissues of all pregnant women were examined both grossly and histologically after delivery. The fetal outcomes were noted.
Results: Gross examination of the diabetic placenta showed increased weight, diameter, number of cotyledons, p value (<0.001). Microscopic examination of the diabetic placenta showed the following changes: villous edema, villous fibrin (focal and perivillous) and increased syncytial knotting, p value (<0.001). Fetal outcome include increased birth weight, macrosomia, p value (<0.001), and low Apgar score at 1 minute, p value (0.043) and low Apgar score at 5 minutes, p value (0.022).
Conclusion: Gestational diabetes mellitus lead to changes both grossly and histologically in the placenta and may affect its function and consequently fetal growth and development.
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