CLINICOPATHOLOGICAL COMPARISON OF HISTOPATHOLOGY OF PLACENTAE IN GESTATIONAL DIABETES MELLITUS COMPARED WITH THAT OF UNCOMPLICATED PREGNANCY AND PERINATAL OUTCOME IN GDM MOTHERS IN DIFFERENT INTERVENTIONS IN PREGNANCY
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Keywords
Clinicopathological Comparison, Histopathology, Placentae, Gestational Diabetes Mellitus, Perinatal Outcome
Abstract
Background: This Study Was Conducted To Study The Histopathology Of Placenta Complicated With Gdm With Placenta With Normal Pregnancy And To Compare The Perinatal Outcome In Gdm Cases With Different Treatment Types Of Interventions.
Methods: This Was A Hospital-Based Prospective Case Control And Observational Study That Took Place From January 2020 To August 2021 In The Department Of Obstetrics And Gynaecology And Department Of Pathology, Scb Mch, Cuttack, Orissa. The Study Involved 50 Antenatal Mothers Who Were Diagnosed As Gdm In Opd And Labour Room. The Study Was Approved By The Institutional Ethics Committee, And The Participants Provided Written Informed Consent.
Results: The Prevalence Of Gdm (P-Value < 0.002) Strongly Correlated With Increasing Age (Mean Age 29.38±3.09 Years, 86%, >25 Yrs.). Every Morphological Characteristic, Including The Number Of Cotyledons (Mean No. 18.72), Central Thickness (Mean 3.06 Cm), And Placental Weight (Mean Weight 646.58 G) (P-Value < 0.001), Was Statistically Significant. Maternal Decidual Vasculopathy (80%), Fibrinoid Necrosis Of Vessels (86%), Villous Edema (80%), Calcification (68%), Thickened Basement Membrane (100%), Syncytial Knot Formation (10%), And Villous Immaturity (84%), Chorangiosis (82%), Villous Fibrosis (82%), Intervillous And Perivillous Fibrin Deposits (82%), Were All Statistically Significant Histopathological Features. The Mode Of Delivery Did Not Differ Statistically Significantly Between The Groups (Lscs 46%, P-Value = 0.309). The Mean Birth Weight Of 3.50 Kg Demonstrated Statistical Significance, Nonetheless. Macrosomia (42%) And Hypocalcemia (40%) Were Reported To Be The Two Most Common Unfavorable Fetal Outcomes In Newborns With Gdm. Of The Patients With Gdm, 68% Followed A Diet Plan, 22% Received Insulin Along With A Diet Plan, And 10% Had Not Received Any Treatment At All. Both Macrosomia And Hypoglycemia Demonstrated Statistical Significance In All The Gdm Therapy Groups.
Conclusion: Gdm Is More Common In Increasing Maternal Age. All Morphological Characters Like Weight Of Placenta, Central Thickness, Number In Cotyledons Except Diameter Of Placenta Are Increased In Gdm Which Is Statistically Significant. All The Histopathological Changes Are Also Statistically Significant. Perinatal Outcome In Unfavorable In Gdm Mothers Who Did Not Receive Any Therapy
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Dr. Punyatoya Punyashree Sethy
Senior Resident, Department Of Obstetrics And Gynaecology, Shri Jagannath Medical College, Puri, Odisha, India
Dr. Subhra Ghosh
Professor And Hod, Department Of Obstetrics And Gynaecology, Shri Jagannath Medical College, Puri, Odisha, India
Dr. Saumya Nanda
Associate Professor, Department Of Obstetrics And Gynaecology, Shri Jagannath Medical College, Puri, Odisha, India
Dr. Mahija Sahu
Professor & Hod, Department Of Obstetrics And Gynaecology, Mkcg Medical College, Berhampur, Odisha, India.