Volume 6 • Issue 2 • 1000307
J Cytol Histol
ISSN: 2157-7099 JCH, an open access journal
Research Article Open Access
Treesh and Khair J Cytol Histol 2015, 6:2
DOI: 10.4172/2157-7099.1000307
Research Article Open Access
Histological Changes of the Human Placenta in Pregnancies Complicated with
Diabetes
Soad A. Treesh
1
* and Nadia S. Khair
2
1
Department of Histology and Medical Genetics, Faculty of Medicine, University of Tripoli, Libya
2
Department of Histology, Faculty of Medicine, Menoufa University, Egypt
*Corresponding author: Soad A. Treesh, Department of Histology and
Medical Genetics, Faculty of Medicine, University of Tripoli, Libya, Tel: 0021891
7596693; E-mail: sotaw11@yahoo.com
Received December 17, 2014; Accepted January 23, 2015; Published January
25, 2015
Citation: Treesh SA, Khair NS (2015) Histological Changes of the Human
Placenta in Pregnancies Complicated with Diabetes. J Cytol Histol 6: 307. doi:
10.4172/2157-7099.1000307
Copyright: © 2015 Treesh SA, et al. This is an open-access article distributed
under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the
original author and source are credited.
Abstract
Normal fetal growth and survival depends on proper development and function of the placenta. The diabetic
pregnancy is characterized by numerous disturbances in fetal growth and development. This study was done to
focus on the effects of gestational diabetes on the histology of the placenta to confrm the magnitude of damage
caused by diabetes to human placenta. Twenty Placentas of full term pregnancy were collected from Alzawia
hospital, Libya. We used histological, histochemical and CD34 imuno-histochemical stains in this study. In diabetic
pregnancy, placental weight is higher in comparison to normal pregnancy. Chorionic villi showed increased number
of fetal capillaries, stromal villous fbrosis, villous edema, thickness of basement membrane of syncytiotrophoblast,
glycogen deposits and strong positive reaction for CD34 in the wall of blood vessels in stem villus.
Keywords: Placenta; Diabetes; Histological; Histochemical; Imuno-
histochemical
Introduction
Te placenta is a complex organ of short life-span which is
responsible for the transfer of nutrients and waste products between
the fetal and maternal circulations. Te metabolic and endocrine
activities of the placenta are not clearly understood [1]. It is the most
important and vital organ of the intrauterine life, it must integrate
signals from the fetus and the mother in an efort to match fetal
demand with maternal nutrient supply [2]. So, it actually plays a crucial
role in fetal growth. Te main functional units of the placenta are the
chorionic villi, within them; fetal blood is separated from maternal
blood in the surrounding inter-villous space by vasculosyncytial
membranes overlying dilated fetal capillaries [3]. Histologically, a
term placenta shows large number of villi and syncytial knots. In these
knots, syntiotrophoblast nuclei are aggregated together in clusters
leaving zones of thin cytoplasm devoid of nuclei in between [4]. Te
difusion barrier between maternal and fetal circulation comprises of
fve layers trophoblast, trophoblasic basement membrane, and core
of supporting tissue, capillary endothelial basement membrane and
endothelium [5]. Diabetes mellitus is now a major health concern in
our society, according to the centers for disease control and prevention,
the crude incidence of diagnosed diabetes increased 124% from 3.3 per
1000 to 7.4 per 1000 [6]. Meanwhile other Studies suggest that, the
prevalence of diabetes mellitus (DM) among women of childbearing
age is increasing due to more sedentary life styles, changes in diet and
adolescent obesity [7]. Diabetes mellitus in pregnant women may be
categorize into clinical diabetes or pregestational diabetes (women
previously diagnosed with type I or type II diabetes) and gestational
diabetes (GDM) which is stated as any degree of glucose intolerance
with commencement or frst recognition during pregnancy. Abnormal
maternal glucose tolerance occurs in 3- 10% of pregnancies. Whatever,
any type of diabetes mellitus during pregnancy produces variety of
placental abnormalities [8]. Te nature and extent of these changes
depend on a number of factors, such as glucose level during the critical
periods in placental development [9]. Alterations in placental function
due to uncontrolled diabetes result in disturbances in fetal growth and
development, macrosomia, congenital malformations and intrauterine
growth retardation [10].
Aim of the present work is to investigate histological diferences
of the placenta in pregnancies complicated by gestational diabetes
compared to non-diabetic pregnancies and to increase our knowledge
about the histological, histochemical and immunohistochemical
changes in diabetic placenta, as very few studies have been done on
histochemical changes in placenta of a diabetic mother (pregestational).
Material and Methods
Sample
A total of twenty cases were studied, seven placentas from non-
diabetic mothers and thirteen placentas from diabetic mothers.Te
placentas of full term pregnancy were collected from Labor Room and
Gynecology operation theatre of Alzawia hospital, Libya.
Tissue preparation
All placentas, including those from the control group were treated
identically in a standardized manner. Immediately afer delivery, cords
were clamped to ensure that placentas are not drained of blood.
Two centimeter of tissue was taken from the center of each placenta
and fxed in 10% formalin for one week. Te tissue was dehydrated
and followed by embedding in parafn and 7 micron serial sections
were generated with the help of rotator microtome. Te tissue sections
were stained with hematoxylin and eosin (H&E), Periodic -Acid Schif
(PAS), Mallory’s trichrome, methyl green pyronin and Von Gieson
stains [11]. CD34 immunohistochemical stain was also done.
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ISSN: 2157-7099