[Uteroplacental blood flow in maternal diabetes mellitus]

Various uteroplacental blood flow disorders, their diagnosis, and correction, especially if the maternal obstetric history is burdened by endocrinopathy, still remain an urgent obstetric problem.

To study blood flow in the vessel-red blood cell segment and to search for changes in both the vessels of the villous tree of the placenta and uterus and the properties of blood corpuscles, by using modern microscopy methods (scanning probe microscopy, atomic force microscopy).

For macroscopic and microscopic examinations, fragments of the placenta, umbilical cord, and uterus were taken; venous blood samples were collected from patients without endocrinopathy, with gestational diabetes mellitus (GDM) or type 1 and type 2 diabetes mellitus (DM) prior to delivery. The data were statistically processed using both parametric (Student's t-test) and nonparametric (Fisher's exact test) methods.

The authors found that microangiopathy and other metabolic changes in diabetes mellitus could lead to villous stromal sclerosis, the appearance of intermediate villi, changes in blood vessel shape, relief tortuosity, depth, and area, endothelial cell destruction, stasis, and thrombosis. In these endocrinopathies, there were also changes in maternal red blood cells: their polymorphism was observed and geometric parameters and deformability were impaired. In this case, cell shape impairment correlated with the severity of the above described vascular complications.

The use of modern microscopy methods makes it possible to diagnose uteroplacental blood flow changes even in early pregnancy and to prevent the progression of uteroplacental blood flow disorders and placental insufficiency.