Abstract

IMPACT OF CONCURRENT DIABETES AND SICKLE CELL ANAEMIA ON FULL-TERM PLACENTA IN CHHATTISGARH REGION

Author(s): Praveen Kumar Kurrey1, Praveen Kumar Banjare2, Karuna Sonwani3, Vijay Kurrey4, Sangeeta Khare5, Vinod Koshley6

BACKGROUND
The placenta is a fetomaternal organ with important metabolic, endocrine and immunologic functions besides being responsible for nutrition, respiration and excretion for the foetus. It is the most accurate record of infant's prenatal experience. Placental examination reflects prenatal factors and postnatal foetal outcomes.
MATERIALS AND METHODS
In the present study, 150 full-term placentas were studied morphologically in which 50 placentae were collected from normal mothers, 50 were from mothers with diabetes and 50 were from mothers with sickle cell disease. Placentae were examined for shape, weight, volume with surface area, number of cotyledons and attachment of umbilical cord.
RESULTS
Cotyledon count was significantly higher in placentas of diabetic cases. The most common shape of the placenta was discoidal in both normal cases (68%) and in mothers with diabetes (48%). The triangular shape of placenta was significantly higher in cases of diabetes (16%) in comparison to normal placentas (4%). Irregular shape was found in only 6% of normal placenta, while it was 10% in cases of diabetic cases, which was significantly higher. Attachment of umbilical cord was found most commonly as central in normal cases (32%), while as eccentric in diabetic cases (34%). Marginal attachment of umbilical cord was found significantly higher in cases of diabetes (30%) in comparison to normal placenta (16%). The weight of placenta was significantly higher in cases of diabetes (mean 545.64 gm) in comparison to normal subjects (mean 468.88 gm). The mean volume of placenta was also significantly higher in cases of diabetes (mean 700.20 mL) in comparison to normal subjects (mean 576.44 mL). The placental surface area was also affected by diabetes and it was found higher 22 (mean 318.82 cm) than normal subjects (mean 273.12 cm).
CONCLUSION
The present study indicated that diabetes and sickling adversely affects gross placental parameters. This might be the probable reason behind worst foetal outcome in mothers with diabetes and sickling. Placental examination reflects prenatal factors and postnatal foetal outcomes.