Clinical Association of Delayed Villous Maturation in Gestational Diabetes Mellitus Pregnancy: A Prospective Study

Delayed Villous Maturation (DVM) is a histological hallmark in Gestational Diabetes Mellitus (GDM) pregnancies commonly observed after 36 weeks of gestation. It is associated with perinatal morbidity and mortality. Our study aims to assess DVM in the term placentas of GDM pregnancies and its association with its perinatal outcomes compared to normal pregnancies.

A total of 120 term placentae from GDM and normal pregnancies were collected from the Obstetrics and Gynaecology Department for one year and subjected to histopathological examination to evaluate DVM and its association with placental morphology and perinatal outcomes.

The current study found statistically significant increased presence of DVM in GDM placentas and its association with placental weight, diameter, maternal weight, glycated haemoglobin and foetal weight. The present study also observed presence of DVM with chorangiosis in a GDM placenta.

The present study has found a statistically significant association of DVM in GDM pregnancies with its perinatal outcomes compared to normal pregnancies. There is no antenatal ultrasound marker to detect placental DVM and adverse foetal outcomes caused due to it. Since there is risk of reoccurrence of DVM and type 2 diabetes in future pregnancies, identification of DVM in GDM pregnancies and its clinical association with foetal outcomes should be considered clinically important. This may explain the cause of intrauterine foetal deaths and adverse neonatal outcomes in the current pregnancy and indicating a need for comprehensive maternal care in future pregnancies to prevent perinatal outcomes by implementing Rescue by birth.