MORPHOLOGICAL AND HISTOLOGICAL ALTERATIONS OF THE PLACENTA IN PREGNANCIES COMPLICATED BY DIABETES MELLITUS
Keywords:
diabetes mellitus, placenta, morphological changes, chorangiosis, villous immaturity, maternal-fetal interface, hypoxia, trophoblastic basement membrane.Abstract
This study investigates the profound morphological and histological alterations in the human placenta associated with maternal diabetes mellitus, encompassing both gestational (GDM) and pre-gestational diabetes. As the critical interface between mother and fetus, the placenta undergoes significant structural adaptations in response to the hyperglycemic and hypoxic environment characteristic of diabetic pregnancies. Through macroscopic, histological, and morphometric analyses of placentas obtained post-delivery, we compared the pathological changes in diabetic groups against healthy controls. The findings highlight severe structural anomalies, including placentomegaly, villous immaturity, chorangiosis, thickening of the trophoblastic basement membrane, and increased fibrinoid necrosis. This study underscores the direct correlation between maternal glycemic control and placental structural integrity, emphasizing how these morphological shifts contribute to adverse fetal outcomes such as macrosomia and chronic fetal hypoxia.
References
1. Desoye, G., & Hauguel-de Mouzon, S. (2007). The human placenta in gestational diabetes mellitus: the insulin and cytokine network. Diabetes Care, 30(Supplement 2), S120-S126.
2. Fox, H. (1997). Pathology of the Placenta (2nd ed.). W.B. Saunders. (A foundational text for normal and abnormal placental morphology).
3. Evers, I. M., Nikkels, P. G., Sikkema, J. M., & Visser, G. H. (2003). Placental pathology in women with type 1 diabetes and in a control group with normal and large-for-gestational-age infants. Placenta, 24(8-9), 819-825.
4. Huynh, J., Dawson, D., Roberts, D., & Bentley-Lewis, R. (2015). A systematic review of placental pathology in maternal diabetes mellitus. Placenta, 36(2), 101-114.
5. Benirschke, K., Burton, G. J., & Baergen, R. N. (2012). Pathology of the Human Placenta (6th ed.). Springer.
