Histopathological Changes of Umbilical Cord Blood Vessels in Diabetic Pregnancies

Abstract

Histopatological changes of umbilical cord (UC) functions due to diabetes mellitus (DM) are resulting in fetal
hyperinsulinemia, which in turn stimulates hematopoiesis and fetal erythema. This may increase metabolic rate and
oxygen requirements in the response of several factors such as hyperglycemia, ketoacidosis and vascular diseases.
The study aimed to evaluate the histopatological changes of UC blood vessels in diabetic pregnant women.
A cross- sectional, analytical study was designed. A total of 75 UC samples were collected from Aljala Maternity
Hospital, Tripoli-Libya, from March to December 2017. Out of them 25 were from non - complicated pregnancies,
25 were pre-gestational diabetes mellitus (PGDM group) and 25 were gestational diabetes mellitus (GDM group).
Segments of UC were taken at 5 cm from fetal, central and placental attachments for each group. All tissue
segments were stained by special stains and examined under light microscope.
The mean weight of UC was larger in PGDM than GDM and control groups respectively. The tissue segments of
PGDM in comparison to GDM showed widely edematous spaced smooth muscle cells, more increased amount of
collagen and elastic fibers, glycogen, proteoglycans (PGs) and glycosaminoglycan (GAGs) molecules, mostly in
central segments. Hugely dilated and discordant umbilical arteries were observed in fetal segments of GDM.
Histopatological changes revealed that diabetic pregnancy had a higher effects on PGDM than GDM.