International Journal of Clinical Obstetrics and Gynaecology

Background and Objectives: Gestational diabetes mellitus is a common metabolic condition that happens during pregnancy and raises the risk of problems for both the mother and the baby. Structural and circulatory alterations in the placenta are some of the most important factors that lead to bad outcomes. This study sought to conduct a pathological examination of placental anomalies in pregnancies complicated by gestational diabetes mellitus and to link these findings with clinical characteristics.
Material and Methods: A prospective observational study was undertaken with 40 pregnant women diagnosed with gestational diabetes mellitus (GDM) at the Department of Obstretics and Gynacology, Madha Medical College, Kundrathur Main Road, Kovur, Chennai, Tamil Nadu, India. The duration of the study was from August 2019 to July 2020. Placental specimens were obtained right after birth and looked at with both the naked eye and a microscope to see whether there were any changes in structure, blood vessels, or inflammation. Maternal clinical data (age, gestational age, glycemic control) and fetal outcomes (birth weight, Apgar score) were documented. The placental results were classified and juxtaposed with recognized normal histological characteristics. We used SPSS version XX for statistical analysis, and p<0.05 was considered significant.
Results: Macroscopically, placentas from GDM pregnancies exhibited elevated weight in 22 (55%) instances and thicker umbilical cords in 10 (25%) instances. Microscopic examination demonstrated villous immaturity in 15 (37.5%), heightened vascularity in 18 (45%), fibrinoid necrosis in 8 (20%), and chorangiosis in 12 (30%) instances. Maternal hyperglycemia and inadequate glycemic control were significantly correlated with elevated placental weight and vascular anomalies (p<0.05). Ten (25%) of the babies had macrosomia, and four (10%) had poor Apgar scores (less than 7 at 5 minutes).
Conclusion: Pregnancies complicated by gestational diabetes mellitus (GDM) demonstrate unique placental abnormalities, such as elevated weight, villous immaturity, and vascular alterations, which are associated with maternal glycemic management and unfavorable infant outcomes. Histopathological examination of the placenta offers significant insights into the pathophysiology of gestational diabetes mellitus (GDM) and may assist in forecasting newborn hazards.