Meng Qian, Shao Li, Luo Xiucui, Mu Yingping, Xu Wen, Gao Chao, Gao Li, Liu Jiayin, Cui Yugui
Department of Obstetrics, Lianyungang Maternity and Child Health Care Hospital, Lianyungang 222000, China ; The State Key Laboratory of Reproductive Medicine, Center of Clinical Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, China.
The State Key Laboratory of Reproductive Medicine, Center of Clinical Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, China.
Obstet Gynecol Int. 2015;2015:283124. doi: 10.1155/2015/283124. Epub 2015 Aug 24.
Objectives. Gestational diabetes mellitus (GDM) leads to an abnormal placental environment which may cause some structural alterations of placenta and affect placental development and function. In this study, the ultrastructural appearances of term placentas from women with GDM and normal pregnancy were meticulously compared. Materials and Methods. The placenta tissues of term birth from 10 women with GDM and 10 women with normal pregnancy were applied with the signed informed consent. The morphology of fetomaternal interface of placenta was examined using light microscopy (LM) and transmission electron microscopy (TEM). Results. On LM, the following morphological changes in villous tissues were found in the GDM placentas when compared with the control placentas: edematous stroma, apparent increase in the number of syncytial knots, and perivillous fibrin deposition. On TEM, the distinct ultrastructural alterations indicating the degeneration of terminal villi were found in the GDM placentas as follows: thickening of the basal membrane (BM) of vasculosyncytial membrane (VSM) and the VSM itself, significantly fewer or even absent syncytiotrophoblastic microvilli, swollen or completely destroyed mitochondria and endoplasmic reticulum, and syncytiotrophoblasts with multiple vacuoles. Conclusion. Ultrastructural differences exist between GDM and control placentas. The differences of placenta ultrastructure are likely responsible for the impairment of placental barrier and function in GDM.
目的。妊娠期糖尿病(GDM)会导致胎盘环境异常,这可能会引起胎盘的一些结构改变,并影响胎盘的发育和功能。在本研究中,对患有GDM的女性和正常妊娠女性足月胎盘的超微结构进行了细致比较。
材料与方法。经签署知情同意书后,获取了10例患有GDM的女性和10例正常妊娠女性的足月分娩胎盘组织。使用光学显微镜(LM)和透射电子显微镜(TEM)检查胎盘母胎界面的形态。
结果。在光学显微镜下,与对照胎盘相比,GDM胎盘的绒毛组织出现了以下形态学变化:间质水肿、合体结节数量明显增加以及绒毛周围纤维蛋白沉积。在透射电子显微镜下,GDM胎盘出现了表明终末绒毛退变的明显超微结构改变:血管合体膜(VSM)的基底膜(BM)和VSM本身增厚,合体滋养层微绒毛明显减少甚至缺失,线粒体和内质网肿胀或完全破坏,以及出现多个空泡的合体滋养层细胞。
结论。GDM胎盘与对照胎盘之间存在超微结构差异。胎盘超微结构的差异可能是导致GDM胎盘屏障和功能受损的原因。