Histopathological changes in the placentas of pregnant women with Gestational Diabetes Mellitus

Süleyman Cemil Oğlak, M. Obut, F. Aşır, Emine Zeynep Yılmaz, Gökhan Bolluk, Elif Ağaçayak, Murat Akkuş
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Abstract

Objectives: Placental damage might be the primary underlying cause of the high rates of fetal adverse outcomes in cases with gestational diabetes mellitus (GDM). Histopathological changes were considered to be associated with GDM in the literature. However, there are also studies showing no changes in the placenta in some gestational diabetic women. The pathophysiology of these placental alterations remains elusive. Therefore, this study aimed to examine the histopathological changes in the placentas of patients with GDM and compare them with the placentas of the healthy control group. Material and methods: This experimental non-randomized case-control study was conducted with 40 GDM patients and 40 healthy pregnant women at Dicle University Faculty of Medicine between March 2023 and December 2023. Placental tissues obtained following cesarean delivery were subjected to routine tissue processing. Placental samples were stained with hematoxylin-eosin and examined histopathologically using a light microscope. Results: When histopathological findings were compared between the GDM and control groups, villous degeneration, congestion in blood vessels, fibrinoid accumulation, inflammation and intervillous hemorrhage were higher in the GDM group than in the control group (p<0.001). Conclusion: The intricate relationship between GDM and placental pathology underscores the profound impact of metabolic changes on placental structure and function throughout pregnancy. Understanding these pathological changes is crucial for elucidating the progression of GDM and its implications for maternal and fetal health, highlighting the importance of comprehensive placental analysis in managing pregnancies complicated by GDM. Keywords: Gestational diabetes, hematoxylin-eosin staining, histopathological examination
妊娠糖尿病孕妇胎盘的组织病理学变化
目的:胎盘损伤可能是导致妊娠期糖尿病(GDM)病例中胎儿不良结局发生率高的主要根本原因。文献认为组织病理学变化与 GDM 有关。然而,也有研究显示一些妊娠糖尿病妇女的胎盘并无变化。这些胎盘改变的病理生理学仍然难以捉摸。因此,本研究旨在检查 GDM 患者胎盘的组织病理学变化,并将其与健康对照组的胎盘进行比较。材料和方法本实验性非随机病例对照研究于2023年3月至2023年12月期间在迪克勒大学医学院对40名GDM患者和40名健康孕妇进行了研究。对剖宫产后获得的胎盘组织进行了常规组织处理。用苏木精-伊红对胎盘样本进行染色,并使用光学显微镜对其进行组织病理学检查。结果:比较 GDM 组和对照组的组织病理学结果,GDM 组的绒毛变性、血管充血、纤维素堆积、炎症和绒毛间出血均高于对照组(P<0.001)。结论GDM 与胎盘病理学之间错综复杂的关系凸显了整个孕期代谢变化对胎盘结构和功能的深远影响。了解这些病理变化对于阐明 GDM 的进展及其对母体和胎儿健康的影响至关重要,这也凸显了胎盘综合分析在管理 GDM 并发症妊娠中的重要性。关键词妊娠糖尿病 苏木精-伊红染色 组织病理学检查
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