Placental pathology in women with gestational diabetes
Placental pathology in women with gestational diabetes
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DOI：
10.1080/00016340801908783
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发表时间：
2008-01-01
影响因子：
4.3
通讯作者：
Antsaklis, Aris
中科院分区：
文献类型：
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作者：
Daskalakis, George;Marinopoulos, Spyros;Antsaklis, Aris
背景本研究的目的是探讨妊娠期糖尿病并发症与非糖尿病妊娠胎盘的病理差异。方法.招募了40例合并妊娠期糖尿病的单胎妊娠，并与40例连续正常妊娠进行比较。病理学家对所有临床数据不知情，审查了胎盘的所有组织学样本。对以下方面进行了组织学评估：胎儿血管血栓形成、绒毛不成熟、脉络膜血管病、有核胎儿红细胞（NFRBC）的存在、缺血、梗死、水肿或无血管绒毛的存在、淋巴组织细胞性绒毛炎和绒毛纤维素样坏死。结果退行性病变如纤维素样坏死和血管病变如脉络膜血管病的存在是明显的，主要是在糖尿病组。与对照组相比，糖尿病孕妇胎盘中绒毛不成熟和NFRBC的存在作为慢性胎儿缺氧的指征显著增加。糖尿病组的胎儿/胎盘重量比显着降低。结论与对照组相比，在糖尿病胎盘中观察到更频繁的组织学异常。这些发现支持了以下假设：胎盘功能受损是糖尿病妊娠中胎儿并发症发生频率增加的主要原因之一。
Background. The aim of this study was to investigate pathologic differences of the placenta in pregnancies complicated by gestational diabetes compared to non-diabetic pregnancies. Methods. Forty singleton pregnancies complicated by gestational diabetes were recruited and compared to 40 consecutive normal pregnancies. A pathologist, blinded to all clinical data, reviewed all histological samples of the placentas. The histological assessment was carried out with regard to the following aspects: fetal vessel thrombosis, villous immaturity, chorangiosis, presence of nucleated fetal red blood cells (NFRBCs), ischemia, infarction, presence of hydropic or avascular villi, lymphohistiocytic villitis and villous fibrinoid necrosis. Results. The presence of degenerative lesions such as fibrinoid necrosis and vascular lesions like chorangiosis 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. 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.