Gestational diabetes as one of the "great obstetrical syndromes" - The maternal, placental, and fetal dialog

Rinat Gabbay-Benziv, Ahmet A. Baschat

Research output: Contribution to journalArticle

Abstract

Gestational diabetes mellitus (GDM)-associated fetal and neonatal adverse outcome results from the metabolic milieu projected on the fetus via the placental interface. Therefore, it can be considered to be one of the great obstetrical syndromes. Placentas from GDM pregnancies differ from nondiabetic pregnancies by an increased placental to fetal ratio and by histological findings such as villous fibrinoid necrosis, villous immaturity, chorangiosis, and ischemic changes. While early onset diabetes is more associated with marked structural changes of the placenta, GDM that rises at late gestation is associated more with placental functional changes. These placental changes, causing increased intervillous diffusion distance of immature villi and placental size to perfusion mismatch, may predispose the fetus to chronic and acute changes in gas and nutrient exchange thus turning the placenta from being a "fetus protector" to a potential source of adverse outcome. Understanding placental changes and how they affect outcome is necessary in order to develop effective screening, prevention, and management approaches.

Original languageEnglish (US)
Pages (from-to)150-155
Number of pages6
JournalBest Practice and Research: Clinical Obstetrics and Gynaecology
Volume29
Issue number2
DOIs
StatePublished - Feb 1 2015
Externally publishedYes

Keywords

  • gestational diabetes
  • great obstetrical syndromes
  • placenta
  • roots of disease

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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