Table 3.
Placental Histopathologic Abnormalities in Pregnancies Affected by Gestational Diabetes
| Authors, Year |
Ref | Study type | Population | Diabetes Diagnosis Criteria |
Blinding of pathologist to diabetes type? |
Glycemic control? | Placental structure/ abnormali ties under investigation |
Defined placental variables? |
Results | |
|---|---|---|---|---|---|---|---|---|---|---|
| GDM | Control | |||||||||
| Teasdale, 1981 |
(9) | Prospective | 5 | 5 | O' Sullivan and Mahan criteria |
Not specified | Good | Volume of intervillous space and fetal capillary bed; the number per unit area, surface densities and surface areas of the villi and their fetal capillaries; the number of syncytiovascular membranes per 100 peripheral villi |
Yes | - Significant increase of volumes and surface areas of parenchymal tissue components (intervillous space, trophoblast and fetal capillaries) in placentas of women with GDM. |
| Lao, 1997 | (40) | Retrospecti ve |
21 | 478 | WHO criteria |
Not specified | Not specified | Placental weight | Yes | - Placentas of women with GDM were significantly heavier. |
| Jirkovska, 2002 |
(41) | Prospective | 11 | 9 | Not specified | Not specified | Not specified | Vascular topography and branching |
Yes | - Basic arrangement of villous capillaries similar in both normal and diabetic placentas. - Proportion of simple forms of the capillary bed without redundant connections is significantly decreased and the mean number of redundant connections per villus increased in diabetic placentas compared to controls. |
| Taricco et al., 2003 |
(14) | Prospective | 132 | 143 | Carpenter -Coustan criteria |
No | Not specified | Placental weight | Yes | - Placentas of women with GDM had significantly higher placenta and lower fetus/placenta weight ratios. |
| Ashfaq, 2005 |
(42) | Prospective | 20 | 20 | Not specified |
Not specified | Not specified | Placental weight | Yes | - Placentas of women with GDM had significant increases in weight, central thickness and diameter of the placenta. |
| Daskalakis et al., 2007 |
(10) | Prospective | 40 | 40 | Carpenter -Coustan criteria |
Yes | Excellent to good | Lymphohistiocytic villitis, presence of nucleated red blood cells, ischemia, infarction, villous fibrinoid necrosis, villous immaturity, chorangiosis, hydropic villi, fetal vessel thrombosis, avascular villi |
Yes | - Placenta of women with GDM had increased incidence of fibrinoid necrosis and chorangiosis. - Placentas of women with GDM had increased incidence of villous immaturity and presence of nucleated fetal red blood cells. |
| Madazli et al., 2008 |
(43) | Prospective | 22 | 22 | 2001 ADA criteria |
Yes | Good | Villous immaturity, chorangiosis, lymphohistiocytic villi, villous fibrinoid necrosis, ischemia, infarction, the presence of nucleated red blood cells |
Yes | - Placentas of women with GDM had increased incidence of villous immaturity, chorangiosis and ischemia. - The incidence of fibrinoid necrosis, nucleated red blood cells counts, infarction and villitis increased in diabetic women but did not reach statistically significance. |