Placental dysfunction and stillbirth in gestational diabetes mellitus

Abstract

Introduction the risk of developing gestational diabetes mellitus increases with increasing bmI, obese women being three times more likely to develop gestational diabetes than normal weight females. gestational diabetes increases the risk of foetal macrosomia and stillbirths. obesity, and gestational diabetes are states of insulin resistance with diverse abnormalities in endothelial function, haemostasis, vascular inflammation, oxidative stress, glycation of proteins and cellular processes that underpin atherosclerosis and impaired function of the micro-circulation. all of these features can lead to abnormalities in placental function leading to increased foetal morbidity and stillbirth. We describe two cases of gestational diabetes with resultant stillbirth, with particular reference to the placental pathology and discuss those placental abnormalities that contributed to foetal mortality.