Gross Morphological Changes in Placenta of Women with Gestational Diabetes Mellitus and Pregnancy-Induced Hypertension Compared to Normal Pregnancies: A Review

Abstract

Background: The placenta is the blood vessel that connects the mother and fetus and the gross morphology of the placenta indicates the effects of maternal diseases like Gestational Diabetes Mellitus (GDM) and Pregnancy-Induced Hypertension (PIH). Placental weight, size, thickness, infarctions, calcification, and cord insertion abnormalities can impair the materno-fetal exchange, which plays a role in the poor perinatal outcomes.

Material and Methods: The systematic search involved PubMed, Scopus, Embase, and Cochrane Library and involved search using the following keywords: placenta, gestational diabetes mellitus, pregnancy-induced hypertension, gross morphology, infarction, calcification, and cord insertion up to 2024. Articles presenting gross morphological data in placentas in GDM, PIH and normal pregnancies were included and those with case reports, incomplete abstracts and articles with no morphological information were excluded. Significant parameters obtained were; placental weight, dimensions, thickness, presence of infarcts, calcification and cord of insertion type.

Conclusion: The use of gross morphological assessment of the placenta gives helpful information on the impact of maternal metabolic and vascular disorders. Observable variations in GDM and PIH indicate the adaptive and pathological reactions of the placenta, which is why the systematic postnatal examination is necessary as a complementary diagnostic tool.