Arizawa M, Nakayama M, Kidoguchi K
Department of Pathology, Osaka Medical Center.
Nihon Sanka Fujinka Gakkai Zasshi. 1991 Jun;43(6):595-602.
Strict clinical management of a diabetic mother who is pregnant reduces the risk of neonatal complications. It also reduces the frequency of fetal macrosomia. Diabetic mothers have a heavier placenta than mothers who are not diabetic. Light microscopic placental changes associated with diabetes include villous immaturity and dysmaturity. We have examined the placentas of 27 diabetic mothers whose maternal hemoglobin A1c (HbA1C) levels were measured throughout pregnancy. None of these placentas had a trimmed weight in excess of 600 grams. Eighteen of 27 specimens had immature villi. Four had dysmature villi. Three placentas had fibromuscular sclerosis within the villi. Five had cholangiosis and there was one cholangioma. Villous immaturity was present in 16 of 18 mothers whose HbA1C was more than 5.6% of the total hemoglobin. We found villous immaturity in 2 of 5, within 5.1-5.5% HbA1C. There was no villous immaturity in four cases whose HbA1C was less than 5.0% total hemoglobin. Our findings indicate that maternal hyperglycemia during pregnancy is associated with placental immaturity and dysmaturity.
对妊娠糖尿病母亲进行严格的临床管理可降低新生儿并发症的风险。这也会降低巨大儿的发生率。糖尿病母亲的胎盘比非糖尿病母亲的胎盘更重。与糖尿病相关的胎盘光镜下改变包括绒毛不成熟和发育异常。我们检查了27名糖尿病母亲的胎盘，这些母亲在整个孕期都测量了糖化血红蛋白（HbA1C）水平。这些胎盘中没有一个的修整后重量超过600克。27个标本中有18个有不成熟的绒毛。4个有发育异常的绒毛。3个胎盘的绒毛内有纤维肌性硬化。5个有胆管增生，还有1个胆管瘤。HbA1C占总血红蛋白超过5.6%的18名母亲中，有16名存在绒毛不成熟。在HbA1C为5.1 - 5.5%的5名母亲中，有2名发现绒毛不成熟。在HbA1C占总血红蛋白小于5.0%的4例中没有绒毛不成熟的情况。我们的研究结果表明，孕期母亲高血糖与胎盘不成熟和发育异常有关。
