Abstract

Gestational diabetes mellitus (GDM) is defined as diabetes with onset or first recognition during gestation. It is a common complication of pregnancy that has become more prevalent over the past few decades. Abnormalities in fetal growth, including increased incidence of both large and small for gestational-age babies, suggest placental dysfunction. The diabetic metabolic situation causes hyperglycemia, hypoglycemia, hyperinsulinemia, and oxidative stress in the mother and the fetus. These alterations trigger a sequence of changes in the development of the vessels in the placenta. Consequently, the fetus is affected by this lack of supply of necessary substances or overstimulated by pathological factors with a significant risk for abnormal development. Aim and objective: To observe & study the various gross morphological changes in the placentas of diabetic mothers and their comparison with normal-term placentas. Method and material: The total number of specimens studied in the present study was 80, 40 placentas were from the mothers with uncomplicated/normal pregnancy which were taken as a control group, and 40 placentas from the mother with either gestational or overt diabetes which were taken as a study group. The specimens were collected from the NCMCH, Panipat for 1 year and the study was conducted in the Department Of Obstetrics and Gynecology. Result: The presence of degenerative lesions such as fibrinoid necrosis and vascular lesions like cholangitis was apparent, mainly in the diabetes group. Villous immaturity and the presence of NFRBC as an indication of chronic fetal hypoxia were significantly increased in the placentas of women with diabetes compared with the control group. The fetal/placental weight ratio was significantly lower in the diabetic group. Conclusion: Histological abnormalities were observed more frequently in the diabetic placentas compared to the controls. These findings support the hypothesis that impaired placental function is one of the main reasons for the increased frequency of fetal complications in diabetic pregnancies.

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