Research
Histopathological placental lesions in mild gestational hyperglycemic and diabetic women
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* Corresponding author: Marilza VC Rudge marilzarudge@ig.com.br
1 Department of Gynecology and Obstetrics, Botucatu Medical School, Univ Estadual Paulista_Unesp, São Paulo State, Brazil
2 Department of Pathology, Federal School of Medical Sciences of Porto Alegre, Brazil
Diabetology & Metabolic Syndrome 2011, 3:19 doi:10.1186/1758-5996-3-19
Published: 10 August 2011Abstract
Objective
To investigate and compare the incidence of histopathological placental lesions in mild gestational hyperglycemia, gestational diabetes and overt diabetes at term and preterm gestation.
Research design and methods
One-hundred-and-thirty-one placental samples were collected from Diabetes mellitus (DM) positive screened patients. Two diagnostic tests, glycemic profile and 100 g oral glucose tolerance test (OGTT) in parallel identified 4 groups normoglycemic, mild gestational hyperglycemia (MGH), gestational DM (GDM) or overt DM (DM). Placental tissue specimens and sections from 4 groups were obtained by uniform random sampling and stained with hematoxylin-eosin.
Results
Placentas from MGH group presented 17 types of histopathological change and higher rates of syncytial nodes and endarteritis. GDM placentas presented only nine types of histopathological change, high rates of dysmaturity, low rates of calcification and no syncytial nodes. Overt DM placentas showed 22 types of histopathological change, 21 of which were present in the preterm period. There were histopathological similarities between MGH and DM placentas, but the former exhibited a higher incidence of endarteritis, which has been described as a "post-mortem" phenomenon.
Conclusion
Our results confirmed that the distinct placental changes associated with DM and MGH depend on gestational period during which the diabetic insult occurs. It may reasonably be inferred that subclinical maternal hyperglycemia during pregnancy, as showed in MGH group, is responsible for increased placental endarteritis, a postmortem lesion in the live fetus.