Arshad Rabia, Kanpurwala Muhammad Adnan, Karim Nasim, Hassan Jahan Ara
Dr. Rabia Arshad, MBBS, M. Phil. Assistant Professor and Head of Pharmacology Department, Altamash Institute of Dental Medicine, 2-R Sunset Boulevard, DHA, Karachi, Pakistan.
Dr. Muhammad Adnan Kanpurwala, MBBS, M. Phil. Associate Professor, Physiology Department, Karachi Institute of Medical Sciences, Karachi, Pakistan.
Pak J Med Sci. 2016 Nov-Dec;32(6):1522-1527. doi: 10.12669/pjms.326.10872.
To evaluate the effects of diet control and Metformin on placental morphology in gestational diabetes mellitus (GDM).
After written informed consent 62 GDMs were enrolled. According to WHO criteria, 30 cases of GDMs with blood sugar level <130 mg/dl, were assigned Group B (2000-2500Kcal/day and 30 minute walk thrice weekly were kept on diet control and 32 cases of GDM with blood sugar level >130 mg/dl, assigned Group C were kept on diet with tablet Metformin,(500mg TDS) Finally 25 normal pregnant females were kept in Group A as control. After delivery placentae were preserved and evaluated for morphology.
Heavy placentae with abundant villous immaturity, chorangiosis and syncytial knots in group B and fibrinoid necrosis and calcification in group C were seen. In group B versus A placental and cord width while in Group C versus A only cord width in gross morphology showed significant results. In group B versus A villous immaturity, chorangiosis, infarction and syncytial knots in light microscopy were present; similarly in B versus C placental width, chorangiosis and syncytial knots showed significant results, while in C versus A results were non-significant.
Metformin produced beneficial effects on placental morphology being comparable to normal control in contrast to diet group.
评估饮食控制和二甲双胍对妊娠期糖尿病（GDM）胎盘形态的影响。
在获得书面知情同意后，纳入62例妊娠期糖尿病患者。根据世界卫生组织标准，将30例血糖水平<130mg/dl的妊娠期糖尿病患者分配到B组（每天2000 - 2500千卡热量，每周三次30分钟步行，进行饮食控制），32例血糖水平>130mg/dl的妊娠期糖尿病患者分配到C组，给予二甲双胍片（500mg，每日三次）。最后，将25名正常孕妇作为A组作为对照。分娩后保留胎盘并评估其形态。
B组可见胎盘厚重，绒毛大量不成熟、绒毛间血管增多和合体结节，C组可见纤维素样坏死和钙化。在大体形态上，B组与A组相比胎盘和脐带宽度有差异，而C组与A组相比仅脐带宽度有显著差异。在光学显微镜下，B组与A组相比存在绒毛不成熟、绒毛间血管增多、梗死和合体结节；同样，B组与C组相比胎盘宽度、绒毛间血管增多和合体结节有显著差异，而C组与A组相比差异不显著。
与饮食组相比，二甲双胍对胎盘形态产生有益影响，与正常对照组相当。
