scholarly journals Gross and Histomorphologic Study of the Umbilical Cord in Pre-gestational Diabetes Mellitus and Gestational Diabetes Mellitus

2015 ◽  
Vol 12 (1) ◽  
pp. 25-29 ◽  
Author(s):  
Md Rafiqul Alam ◽  
Md Abdul Momen ◽  
Anjuman Ara Sultana ◽  
SM Nurul Hassan

Objective: The umbilical cord is fetal organ and contains two arteries and one vein covered by connective tissue called Wharton’s jelly. Gestational diabetes mellitus (GDM) is a common metabolic disorder, the importance of which includes possible fetal and maternal complications. As the umbilical cord is the communicating channel between the fetus and the placenta, any pathological change in the umbilical cord may cause harm to the fetus. For this reason, some gross morphological and microscopic features of umbilical cord were analyzed in case of pre-gestational and gestational diabetes mellitus. Materials and Methods: A cross-sectional, analytical and observational type of study was carried out in the Department of Anatomy, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka between July 2004 and December 2005. Total 60 umbilical cords with placentae were collected within 34 to 40 weeks of gestation from BSMMU and BIRDEM. Among these, twenty were from mothers not suffering from diabetes (Control group), twenty had pre-gestational diabetes mellitus (PDM group) and twenty were suffering from gestational diabetes mellitus (GDM group). Number of umbilical vessels were observed on the cut surface of umbilical cord later confirmed by histological examination. Presence or absence of true or false knots were noted. The umbilical cord cross sectional area, vessel areas and their luminal area were estimated. The ANOVA post-hoc option was used for statistical analyses of results. Results: Among the gross and histomorphological variables of the umbilical cord, there was no significant difference between the three groups. DOI: http://dx.doi.org/10.3329/bja.v12i1.22615 Bangladesh Journal of Anatomy, January 2014, Vol. 12 No. 1 pp 25-29

2020 ◽  
Vol 16 (8) ◽  
pp. 895-899 ◽  
Author(s):  
Shahin Safian ◽  
Farzaneh Esna-Ashari ◽  
Shiva Borzouei

Aims: Investigation thyroid dysfunction and autoimmunity in pregnant women with gestational diabetes mellitus. Background: This article was written to evaluate the thyroid function and anti-thyroid peroxidase (anti- TPO) antibodies in pregnant women with gestational diabetes mellitus (GDM). Method: A total of 252 women with GDM and 252 healthy pregnant women were enrolled. Thyroid tests, including TSH, FreeT3, Free T4, and anti-TPO were performed for all women at 24–28 weeks of gestation. Data analysis was then carried out using SPSS ver. 22. Result: There was a significant difference between the experimental group (38.4%) and the control group (14.06%) in terms of the prevalence of subclinical hypothyroidism (p= 0.016). The frequency of anti-TPO was higher in the experimental group than the control group and positive anti-TPO was observed in 18.6% of women with GDM and 10.3% of healthy pregnant women (P= 0.008). Conclusion: Thyroid disorders are observed in pregnant women with GDM more frequently than healthy individuals and it may be thus reasonable to perform thyroid tests routinely.


2020 ◽  
Author(s):  
Caiying Feng ◽  
Jie You ◽  
Guixia Chen ◽  
Hongli Su ◽  
Li Zhang ◽  
...  

Abstract Background Previous studies have discovered that zinc-α2-glycoprotein is related to insulin resistance and lipid metabolism. The aim of the study is to explore the change of serum zinc-α2-glycoprotein(ZAG) and its related factors in gestational diabetes mellitus(GDM). Methods Eighty newly diagnosed GDM patients were enrolled in study group, and 80 normal pregnant women were selected as control group. The differences of baseline data between the two groups were compared, and the change of serum ZAG level and its relationship with related indexes was analyzed. Results Compared to control group, the level of serum ZAG in the study group decreased [(43.94 ± 14.51)mg/L vs. (62.57 ± 19.05)mg/L, P < 0.001]. Pearson correlation (or Spearman correlation) analysis showed that serum ZAG level was negatively correlated with FPG, FINS, HOMA-IR and TG (P < 0.05) and positively correlated with HDL(P < 0.05). Multiple linear regression showed that HDL, FINS, HOMA-IR were independent factors of serum ZAG(P < 0.001). Conclusion The level of serum ZAG in patients with gestational diabetes mellitus decreased, and HDL, FINS and HOMA-IR are the influencing factors in study group. Trial registration: The study registered in the Chinese Clinical Trial Registry(Chi CTR2000028811).


2017 ◽  
Vol 16 (2) ◽  
pp. 55-62
Author(s):  
Rinku Joshi ◽  
Rosy Malla ◽  
Madhur Dev Bhattarai ◽  
Dhan Bahadur Shrestha

Introduction: Diabetes has become a significant health problem all over the world and its prevalence is increasing rapidly, including in Nepal. Prevalence of gestational diabetes mellitus (GDM) is directly related to the prevalence of type 2 diabetes. Women who areoverweight or obese before they become pregnant are more at risk of GDM irrespective of other factors.Though the risk of developing GDM in shown to be higher in overweight or obese women, there are very few studies done to show such observation in the urban population of Nepal.Methods: This was a hospital based cross-sectional prospective study conducted among the women attending ante partum clinic, in a tertiary level hospital, located at Lalitpur for one-year duration in 2009. All overweight (pre-pregnancy body mass index (BMI)>23) urban women at 24-28 weeks of gestation were enrolled.Fasting blood glucose, screening 50-g oral glucose challenge test(OGTT) and 2-hr OGTT following overnight fastingwas done as per need based on their test results and GDM was diagnosed based on standard guidelines.Results: Out of 256 women majority of women had BMI >25 kg/m2 (n=180),and 151(59%) were multiparous and 105 (41%) were primiparas. Positive screening test was obtained in 51 women (19.9%).The incidence of GDM by ADA and WHO criteria was 10 (3.9%) and 16 (6.3%) respectively. There was statistically non-significant difference in the rate of positive screening test and BMI (p=0.09). The abnormal screening test between primiparous and multiparous was significant (p=0.01).Conclusion: This study showed a high pre-pregnancy BMI and the incidence of GDMamong the patients enrolled. The rate of positive screening test is also higher than the previous studies so, GDM is a growing issue and must be well addressed.


2021 ◽  
Vol 8 ◽  
Author(s):  
Mohd Razif Mohd Idris ◽  
Fazlina Nordin ◽  
Zaleha Abdullah Mahdy ◽  
S. Fadilah Abd Wahid

Background: The in utero environment has many factors that can support cell differentiation. Cytokines, chemokines and growth factors play big roles in haematopoietic mechanisms. Some diseases like gestational diabetes mellitus (GDM) might affect the environment and haematopoietic stem cell (HSC) quality. The aim of this study is to investigate the adverse effects of GDM on umbilical cord blood (UCB) HSC in terms of differentiation potency including the UCB parameters used for banking and transplantation purposes.Methods: UCB-HSC was collected from 42 GDM and 38 normal pregnancies. UCB-HSC was isolated and further enriched using immuno-magnetic separation beads (MACS). The UCB-HSC were cultured in methylcellulose media to investigate the differentiation potency. The level of erythropoietin (EPO) and insulin in the UCB plasma was measured using enzyme linked immunoassay (ELISA) technique.Result: The UCB parameters; volume, total nucleated count (TNC) and total CD34+ cells were significantly reduced in the GDM group compared to the control group. The number of HSC progenitors' colonies were significantly reduced in the GDM group except for progenitor BFU-E, which was significantly increased (GDM = 94.19 ± 6.21, Control = 73.61 ± 2.73, p = 0.010). This data was associated with higher EPO level in GDM group. However, the insulin level in the GDM group was comparable to the Control group.Conclusion: Our results suggest that the changes in the in utero environment due to abnormalities during pregnancy such as GDM might affect the differentiation potency of UCB-HSC. These findings can be considered as an additional parameter for the inclusion and exclusion criteria for UCB banking, particularly for mothers with GDM.


2020 ◽  
Author(s):  
Mohd Razif Mohd Idris ◽  
Fazlina Nordin ◽  
Zaleha Abdullah Mahdy ◽  
S Fadilah Abd Wahid

Abstract Background The in utero environment has many factors that can support cell differentiation. Cytokines, chemokines, and growth factors play big roles in haematopoietic mechanisms. Some diseases like gestational diabetes mellitus (GDM) might affect the environment and quality of haematopoietic stem cell (HSC). This study aims to investigate the adverse effects of GDM on umbilical cord blood (UCB) HSC regarding its differentiation potency, including the UCB parameters used for banking and transplantation purposes. Methods UCB-HSC was collected from 42 GDM and 38 normal pregnancies. UCB-HSC was isolated and further enriched using immuno-magnetic separation beads (MACS). The UCB-HSC were cultured in methylcellulose media to investigate the differentiation potency. The level of erythropoietin (EPO) and insulin in the UCB plasma was measured using enzyme-linked immunoassay (ELISA) technique. Results The UCB parameters, i.e., volume, total nucleated count (TNC), and total CD34+ cells, were significantly reduced in the GDM group compared to the control group. The number of HSC progenitor colonies was significantly reduced in the GDM group, except for progenitor BFU-E, which was significantly increased (GDM = 94.19 ± 6.21, Control = 73.61 ± 2.73, p = 0.010). This data was associated with a higher EPO level in the GDM group. However, the insulin level in the GDM group was comparable to the control group. Conclusion Our results suggest that the changes in the in utero environment due to abnormalities during pregnancy, such as GDM might affect the differentiation potency of UCB-HSC. These findings can be considered as an additional parameter for the inclusion and exclusion criteria for UCB banking, particularly for mothers with GDM.


2019 ◽  
Vol 47 (9) ◽  
pp. 941-946 ◽  
Author(s):  
Tim Hetkamp ◽  
Kerstin Hammer ◽  
Mareike Möllers ◽  
Helen A. Köster ◽  
Maria K. Falkenberg ◽  
...  

Abstract Background The aim of this study was to compare the adrenal gland size of fetuses of women with gestational diabetes mellitus (GDM) with that of healthy control fetuses. Methods This prospective cross-sectional study included measurements of the adrenal gland size of 62 GDM fetuses (GDM group) and 370 normal controls (control group) between the 19th and 41st week of gestation. A standardized transversal plane was used to measure the total width and the medulla width. The cortex width and an adrenal gland ratio (total width/medulla width) were calculated from these data. Adrenal gland size measurements were adjusted to the week of gestation and compared between the two groups in a multivariable linear regression analysis. A variance decomposition metric was used to compare the relative importance of predictors of the different adrenal gland size measurements. Results For all the investigated parameters of the adrenal gland size, increased values were found in the case of GDM (P < 0.05), while adjusting for the week of gestation. GDM seems to have a greater impact on the size of the cortex than on the size of the medulla. Conclusion The fetal adrenal gland is enlarged in pregnancy complicated by GDM. The width of the cortex seems to be particularly affected.


1970 ◽  
Vol 9 (1) ◽  
pp. 21-25 ◽  
Author(s):  
Sanjoy Kumar Chakraborty ◽  
BM Ali Yousuf ◽  
Laila Anjuman Banu ◽  
Khondker Manzare Shamim

Objective: Clinically the adverse effects of the diabetes on the out come of pregnancy are well established. The present study was designed to look for the impacts of gestational diabetes on the gross and histomorphological features of the umbilical cord. Type of study: A descriptive study having analytical components. Place and period of study: Department of Anatomy, Chittagong Medical College, Chittagong, from May 2006 to April 2007. Materials: Total fifty (50) umbilical cords with the placenta were collected within 36th to 40th weeks of gestation from Chittagong Medical College hospital and Memon maternity hospital of Chittagong City Corporation. Out of them 25 cords were from non diabetic pregnant mother (Control group) and 25 cords from mothers with gestational diabetes mellitus (GDM group). Method: After proper fixation with 10% formalin the diameter of the umbilical cord were measured with a vernier calipers in millimeters. Circumference, Cross-Sectional Area (CSA) of the umbilical cord and CSA of the Wharton’s jelly were measured by computerized micrometric method in millimeters and sq. millimeters respectively. Number of the umbilical vessels were examined and counted on the cut surface of the umbilical cord, later confirmed by histological examination. Presence or absence of the true knots were noted. Result: Among the gross morphological variables of the umbilical cord, the mean diameter was significantly larger in the GDM group than in the Control group (P< 0.05). Though the mean circumference, mean CSA of the umbilical cord and mean CSA of the Wharton's jelly were found to be higher in the GDM group than in the Control group, but the difference did not reach to the significant level. All the cords of the GDM group, the umbilical cord contained two arteries and one vein, whereas, two cords of the Control group, the umbilical cord had three arteries and one vein and one cord contain four arteries and one vein. No true knots were found in any groups. Pearson’s correlation test revealed significant positive correlation in both GDM and Control groups between mean diameter and circumference of the umbilical cord (r = 0.881, P = 0.000 & r = 0.689, P = 0.000) and between CSA of the umbilical cord and Wharton's jelly (r = 0.988, P = 0.000 & r = 0.990, P = 0.000). Key words: Umbilical cord; Gross and Histomorphology; GDM. DOI: http://dx.doi.org/ 10.3329/bja.v9i1.8143 Bangladesh Journal of Anatomy January 2011, Vol. 9 No. 1 pp 21-25


2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Malgorzata Walentowicz-Sadlecka ◽  
Piotr Domaracki ◽  
Pawel Sadlecki ◽  
Joanna Siodmiak ◽  
Marek Grabiec ◽  
...  

Background. Placental soluble fms-like tyrosine kinase-1 (sFlt-1), an antagonist of vascular endothelial growth factor, is considered an etiological factor of endothelial damage in pregnancy pathologies. An increase in the sFlt-1 level is associated with alterations of endothelial integrity. In contrast, vitamin D exerts a protective effect and low concentrations of 25(OH)D may have an adverse effect on common complications of pregnancy, such as gestational hypertension (GH), preeclampsia (PE), and gestational diabetes mellitus (GDM). The aim of this study was to analyze the levels of sFlt-1 in Polish women with physiological pregnancies and pregnancies complicated by GH, PE, and GDM. Moreover, we analyzed relationships between the maternal serum sFlt-1 level and the sFlt-1 to 25(OH)D ratio and the risk of GH and PE. Material and Methods. The study included 171 women with complicated pregnancies; among them are 45 with GH, 23 with PE, and 103 with GDM. The control group was comprised of 36 women with physiological pregnancies. Concentrations of sFl-1 and 25(OH)D were measured before delivery, with commercially available immunoassays. Results. Women with GH differed significantly from the controls in terms of their serum sFlt-1 levels (5797 pg/ml vs. 3531 pg/ml, p=0.0014). Moreover, a significant difference in sFlt-1 concentrations was found between women with PE and those with physiological pregnancies (6074 pg/ml vs. 3531 pg/ml, p<0.0001). GDM did not exert a statistically significant effect on serum sFlt-1 levels. Both logistic regression and ROC analysis demonstrated that elevated concentration of sFlt-1 was associated with greater risk of GH (AUC=0.70, p=0.0001) and PE (AUC=0.82, p<0.0001). Also, the sFlt-1 to 25(OH)D ratio, with the cutoff values of 652 (AUC=0.74, p<0.0001) and 653 (AUC=0.88, p<0.0001), respectively, was identified as a significant predictor of GH and PE. Conclusions. Determination of the sFlt-1/25(OH)D ratio might provide additional important information and, thus, be helpful in the identification of patients with PE and GH, facilitating their qualification for intensive treatment and improving the neonatal outcomes.


2014 ◽  
Vol 32 (2) ◽  
pp. 178-186 ◽  
Author(s):  
Fernanda Barros S. Resende ◽  
Heleni Aires Clemente ◽  
Dalila Fernandes Bezerra ◽  
Evellyn Câmara Grilo ◽  
Larisse Rayanne M. de Melo ◽  
...  

OBJECTIVE: To evaluate and compare the levels of α-tocopherol in colostrum and in the serum of healthy and diabetic mothers.METHODS: This cross-sectional study enrolled 51 volunteer mothers, 20 with the diagnosis of gestational diabetes mellitus and 31 without associated diseases. Serum and colostrum samples were collected in fasting in the immediate postpartum period and α-tocopherol was analyzed by high performance liquid chromatography (HPLC). In order to define the nutritional status of vitamin E, the cutoff point for the serum (697.7µg/dL) was adopted. Student's t-test for independent variables compared the average concentrations of α-tocopherol in the serum and in the colostrum between control and gestational diabetes mellitus groups. Pearson's correlation was used to assess the relationship between the concentration of α-tocopherol in serum and colostrum for both groups. Differences were considered significant when p<0.05.RESULTS: The α-tocopherol concentration in colostrum was 1,483.1±533.8µg/dL for Control Group and 1,368.8±681.8µg/dL for diabetic women, without differences between groups (p=0.50). However, α-tocopherol concentration in the serum was 1,059.5±372.7µg/dL in the Control Group and 1,391.4±531.5µg/dL in the diabetic one (p<0.01). No correlation was found between the concentration of α-tocopherol in the serum and in the colostrum for control and diabetic groups.CONCLUSIONS: The groups had adequate nutritional status of vitamin E. Gestational diabetes was not associated with changes in α-tocopherol concentration in colostrum.


2020 ◽  
Vol 9 (8) ◽  
pp. 2587
Author(s):  
Tomasz Gęca ◽  
Maciej Kwiatek ◽  
Arkadiusz Krzyżanowski ◽  
Anna Kwaśniewska

Background: Gestational diabetes mellitus (GDM) is the most common metabolic disorder in pregnant women, defined as any degree of glucose intolerance with onset or first detected during pregnancy. Explanation of its pathogenesis is extremely important due to the possibility of preventing serious maternal and fetal complications. The aim of the study was to evaluate the concentrations of two molecules: C1q/tumor necrosis factor-related protein-3 (CTRP-3) and pigment epithelium-derived factor (PEDF) which may possibly participate in GDM development. To our knowledge, this is the first study in pregnant women with GDM evaluating CTRP-3 level. Methods: Serum CTRP-3 and PEDF concentration and clinical characteristics were detected in 172 pregnant women. These women were divided into two groups: normal glucose tolerance group (NGT, n = 54) and gestational diabetes mellitus group (GDM, n = 118). This second group was further divided into two subgroups depending on the treatment used: GDM 1—diet only (n = 75) and GDM 2—insulin treatment (n = 43). Results: Our study did not reveal any statistically significant difference between the concentration of PEDF in the control and GDM group. In our study there was a significantly higher concentration of CTRP-3 evaluated in the peripheral blood serum in patients with gestational diabetes (GDM) compared to those in the control group (8.84 vs. 4.79 ng/mL). Significantly higher values of CTRP-3 were observed in both the diet-treated subgroup and the group with insulin therapy when compared to control group (8.40 and 10.96, respectively vs. 4.79 ng/mL). Conclusion: PEDF concentration does not change in GDM, whereas an increased level of CTRP-3 may point to the key role of this adipokine in the development of GDM.


Sign in / Sign up

Export Citation Format

Share Document