(32) Analyzing Placental Vasculature at term in Gestational Diabetes Mellitus (GDM)

Abstract Authors: Truman Poteat¹ , Omonseigho O. Talton² , Danny J. Schust³ , Laura C. Schulz<sup>1

1. Department of Obstetrics and Gynecology, University of Missouri, Columbia, MO
2. Department of Biology, University of Detroit Mercy, Detroit, MI
3. Department of Obstetrics & Gynecology, Duke University, Durham, NC</sup>


Abstract Text: Gestational Diabetes (GDM) is one of the most common pregnancy complications and has longterm health implications for both mother and child. Prior research has observed abnormalities in the placental vasculature, including dense vasculature, syncytial knots and fibrin deposition, dilated blood vessels, and irregular foci in GDM placentas, but analysis of these abnormalities has largely been qualitative in nature. Our study proceeded with the goal of completing quantitative analysis of placental vascular density between healthy pregnancies and those complicated by GDM. Pregnant patients were invited to participate in the larger study at the time of a first trimester ultrasound scan, which was used to analyze placental blood flow. GDM status was determined through routine testing at 24-28 weeks gestation. Additionally, full thickness samples were collected from delivered human placentas midway between the cord insertion point and edge. Of these placentas, 23 were available for analysis from GDM pregnancies, and 51 controls were selected from pregnancies not complicated by GDM. Samples were sectioned and stained with hematoxylin & eosin and 15 images were captured from each section. Five of these were randomly selected for analysis with ImageJ. In each of the images, individual villi were manually outlined, and blood vessels were counted by an operator blinded to GDM diagnosis. Total villous area (p=0.6723), mean individual villous area (p = 0.8257), total number of blood vessels (p = 0.5836), average number of blood vessels per villus (p > 0.9999), and average blood vessel per villous area (p = 0.7039) were all strikingly similar between placentas from control and GDM pregnancies. These results suggest that GDM does not impact vascular density. However, it is possible that a 2D analysis may not be sufficient to identify differences that do exist, and accuracy is limited by subjective operator selections. Going forward, we plan to complete a 3D morphological analysis of the same placentas to compare these methods. This work was supported by NIH R03HD105831 and R25GM064120.