Histological changes in placental syncytiotrophoblasts of poorly controlled gestational diabetic patients.

It seems reasonable to expect that biochemical changes occurring in the pregnant woman with diabetes should be reflected in the placenta structure. However, it has not been possible to correlate placental morphology with glycemic control in a comparison between those with long life 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 diabetic patients. Using specific staining techniques and direct light microscopy we qualitatively studied these placentae and compared them with the normal placentae. We found fibrin thrombi, villous oedema, hyperplasia and thickening of basement membrane in the placentae of poorly controlled gestational diabetic mothers. Direct microscopy revealed that these various changes in syncytiotrophoblast structure were marked in the poorly controlled gestational placenta compared with overt diabetics, and could have been due to the presence of histochemical compounds e.g. general carbohydrates and lipids. These studies may indicate that 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 structural changes in the placental cells.