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Structural, functional and circulatory placental changes associated with impaired glucose metabolism
Pia Saldeen1, Per Olofsson, Ricardo N Laurini
1Department of Obstetrics and Gynecology, Malmö University Hospital, Lund University, Malmö, Sweden. pia.saldeen@telia.com
Objective:
To investigate associations between structural, functional and circulatory placental changes in pregnancies complicated by impaired glucose metabolism.
Design:
Umbilical artery (UA) blood flow resistance was measured by Doppler velocimetry in 21 gravidae with diabetes/impaired glucose tolerance (IGT) and 10 healthy gravidae. Umbilical and placental vessel segments were incubated for determination of prostacyclin and thromboxane synthesis, and tissues histologically examined. Non-parametric statistical tests at a two-tailed P<0.05 were used.
Results:
Placental lesions were more common in diabetes/IGT and, although not being an uniform finding, in general associated with a higher vascular synthesis of thromboxane and/or lower prostacyclin/thromboxane synthesis ratio. As an exception, ischemic villitis was associated with a higher ratio and higher UA flow resistance.
Conclusions:
Placental lesions are associated with an altered vascular prostanoid synthesis in diabetes/IGT, but not until structural signs of ischemia develop is a rise of UA blood flow resistance detected.