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母体高血糖对胎盘毛细血管分布的影响。

Influence of maternal hyperglycemia on placental capillary distribution.

机构信息

Department of Gynecology and Obstetrics, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho, Botucatu, SP, Brazil.

Faculdade Ceres - Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP, Brazil.

出版信息

Einstein (Sao Paulo). 2024 Nov 4;22:eAO0583. doi: 10.31744/einstein_journal/2024AO0583. eCollection 2024.

Abstract

OBJECTIVE

This study was conducted to investigate the distribution of placental villous vessels in pregnant women with different degrees of hyperglycemia.

METHODS

A cross-sectional study was performed using placental samples from 30 pregnant women without diabetes (n=10), with gestational diabetes mellitus (n=10), and with previous diabetes (type 1 and type 2 diabetes; n=10). Maternal glycemic control was evaluated using the glycemic mean and glycated hemoglobin levels. Placental samples were obtained during elective cesarean sections and processed for villous vessel analysis using immunohistochemistry for Von Willebrand factor. Vessels within 10μm of the villus margin were classified as peripheral, and vessels at a distance greater than 10μm were classified as central. The number, area, and perimeter of all vessels were evaluated, and the relationship between vessel area and total area of placental villus was calculated.

RESULTS

Pregnant women with gestational diabetes mellitus and those with previous diabetes had higher glycated hemoglobin levels. The number of vessels was reduced in the villi of the previous Diabetes Group owing to peripheral reduction. Additionally, the area, perimeter, and percentage of peripheral blood were lower in the previous Diabetes Group than in the Non-Diabetic Group.

CONCLUSION

Maternal glycemic levels can modify placental capillary distribution.

摘要

目的

本研究旨在探讨不同程度高血糖孕妇胎盘绒毛血管的分布情况。

方法

采用横断面研究方法,收集 30 例孕妇胎盘样本,其中无糖尿病(n=10)、妊娠期糖尿病(n=10)和既往糖尿病(1 型和 2 型糖尿病,n=10)。采用血糖均值和糖化血红蛋白水平评估母体血糖控制情况。胎盘样本取自择期剖宫产,采用 Von Willebrand 因子免疫组织化学法对绒毛血管进行分析。将距绒毛边缘 10μm 以内的血管归类为周边血管,距绒毛边缘 10μm 以上的血管归类为中央血管。评估所有血管的数量、面积和周长,并计算血管面积与胎盘绒毛总面积的关系。

结果

患有妊娠期糖尿病和既往糖尿病的孕妇糖化血红蛋白水平较高。由于周边血管减少,既往糖尿病组绒毛中的血管数量减少。此外,既往糖尿病组的血管面积、周长和外周血比例均低于非糖尿病组。

结论

母体血糖水平可改变胎盘毛细血管的分布。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f746/11634342/1f4532048c9c/2317-6385-eins-22-eAO0583-gf05.jpg

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