HISTOLOGICAL-CHANGES IN PLACENTAL SYNCYTIOTROPHOBLASTS OF POORLY CONTROLLED GESTATIONAL DIABETIC-PATIENTS

It seems reasonable to expect that biochemical changes occurring in th e pregnant woman with diabetes should be reflected in the placenta str ucture. However, it has not been possible to correlate placental morph ology with glycemic control in a comparison between those with long li fe diabetes and poorly controlled gestational diabetes. In the present study we have histologically studied the syncytiotrophoblast of human placentae from overt diabetic and poorly controlled gestational diabe tic patients. Using specific staining techniques and direct light micr oscopy we qualitatively studied these placentae and compared them with the normal placentae. We found fibrin thrombi, villous oedema, hyperp lasia and thickening of basement membrane in the placentae of poorly c ontrolled gestational diabetic mothers. Direct microscopy revealed tha t these various changes in syncytiotrophoblast structure were marked i n the poorly controlled gestational placenta compared with overt diabe tics, and could have been due to the presence of histochemical compoun ds e.g. general carbohydrates and lipids. These studies may indicate t hat poor control of diabetes during the gestation as indicated by high level HbAlc may result in the accummulation of carbohydrate compounds and fat droplets in the placental basement membrane, leading to struc tural changes in the placental cells.