Decreased Placental Perfusion Assessed by Three-dimensional Power Doppler Ultrasound in Pregnancies with Gestational Diabetes Mellitus

The incidence of gestational diabetes mellitus (GDM) was 5-8% of all pregnancies worldwide. 1 Subclinical inflammation with vascular dysfunction caused by insulin resistance characterizes GDM. 2 An abnormal endothelial function was noted in nonobese pregnancies complicated by GDM, in relation to the inflammatory status. 2 Maternal hyperglycemia and vascular endothelial growth factors (VEGFs) have a direct influence on the growth, maintenance, and function of fetoplacental vessels, and the expressions of VEGF-A and VEGFR-2 messenger RNAs and protein reduces in placentas affected by GDM. On the fetal side, vasculopathy such as significant villous fibrinoid necrosis, chorangiosis, fibromuscular sclerosis, and villous edema were evident. The question raised here is whether placental perfusion is altered in GDM pregnancies.