Placental Vasculogenesis and Angiogenesis Related to GDM and the Possible Affect on the Placenta and the Fetus Outcome

Abstract

Placentas from gestational diabetes mellitus (GDM) are Patterns of fetoplacental angiogenesis of GDM often
hypervascularized. Placenta is a mirror that reflects the well-being of the fetus and continuously undergoes
a change in weight, structure, shape and function in order to support the well-being of the fetus.
Aim of Study: In this work we attempted to identify villous vascular and morphological changes in a group
of term placentae from mothers with GDM complicating pregnancy.
Objective: To analysis on the possible gross morphological changes and Patterns of fetoplacental
angiogenesis of GDM.
Materials and Method: The study was observational, analytical and cross sectional. The patients under this
study were selected from the Obstetric of AL-Emam AL-sadiq in the Babylon province. A total of eighty
samples were collected from women completed weeks of gestation. Among them, 40 samples were from
mothers having GDM, 40 belonged to normal pregnancy (control group). The placentas were examined
to measure their weight, diameter, thickness, cotyledons number, Insertion of umbilical cord, Vascular
pattern and Fasting blood glucose were determined by enzymatic method using Envoy® 500 reagents .Beta
chorionic gonadotrophin, progesterone and estradiol were determined using chemilumiscence immunoassay
technique on MAGLUMI 600 analyzer.
Results: In this study, the GDM group showed significantly higher values for the variables of the weight,
thickness,diameter, number of cotyledons, Patterns of fetoplacental angiogenesis of GDM and placentas
hypervascularized as compared to normal group. Consequences of GDM include increased risk of macrosomia
and birth complications in the infant. Fasting plasma glucose FBG, ?-HCG, P4, E2 were increased in the
gestational diabetic women.
Conclusion: From the findings of this study, placental variations in diabetic and normal mothers during
pregnancy. The variations in placental weight, thickness, diameter and fetoplacental angiogenesis found
in gestational diabetic mother may be a long term compensatory mechanism, aiming to secure a sufficient
nutrient supply to support the growth of the foetus. So, postnatal examination of the placenta can yield
information that may be important for immediate and late management of the mother and neonate. Fasting
plasma glucose FBG, ?-HCG, P4, E2 were increased in GDM group was aimed at assessing placental
peptides and maternal factors as potential predictors of the development of gestational diabetes among
pregnant women. GDM appears to effect the microvascular remodeling at angiogenesis. So gestational
diabetes mellitus (GDM) need to be identified early in pregnancy and managed to maintain a normal
vasculature and prevent neonatal mortality and morbidity if rapid intervention is completed.