Abstract Background: Gestational diabetes mellitus (GDM) induces both morphological and histomorphometric alterations in the placenta that can impact fetoplacental exchange and pregnancy outcomes. Understanding these structural and histological changes is crucial for identifying pathological mechanisms and potential clinical implications. Materials and Methods: This cross-sectional study analyzed 200 placental samples, including 100 from GDM-complicated pregnancies and 100 from normoglycemic controls. Morphological parameters such as Hyrtl’s anastomosis diameter, cotyledon number, and cotyledon length were measured. Histological assessments included villi maturity, syncytial knot formation, and intervillous space using hematoxylin and eosin staining. Periodic Acid–Schiff (PAS) staining was used to evaluate villous basement membrane thickness and glycogen deposition. Results: Placentas from GDM pregnancies showed a significantly increased diameter of Hyrtl’s anastomosis, higher cotyledon count, and greater cotyledon length compared with controls ( P < 0.001). Histologically, GDM placentas exhibited more mature villi, larger syncytial knots, and reduced intervillous space ( P < 0.001). PAS staining revealed marked thickening of the villous basement membrane and increased glycogen deposition, indicating altered glucose metabolic adaptation. Conclusion: GDM profoundly affects placental vascular architecture and histology, contributing to disrupted fetoplacental exchange and adverse perinatal outcomes. Placental morphometric assessment holds clinical relevance for risk stratification in GDM pregnancies. Future studies should evaluate the long-term consequences of these changes on offspring health and explore interventions to reduce adverse effects.
Bethu et al. (Sun,) studied this question.
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