Histological changes in the amniotic membrane structure of gestational diabetic women’s’ in comparison with pregestational diabetic and non-diabetic women
Article Sidebar
Main Article Content
Abstract
The main objective of this study was to compare the demographic characteristics and histological changes in the amniotic membrane (AM) of gestational diabetes mellitus (GDM), pregestational diabetes mellitus (PGDM), and non-diabetic women. A total of thirty AM samples (n = 10 for each group) were obtained from full-term pregnant women without any complications. These samples were processed for paraffin blocks, sectioned, and stained with H&E. The results of demographic characteristics showed the mean maternal age of the PGDM and GDM groups was significantly higher compared with the control. Neonatal weight decreased significantly in the PGDM group, but both diabetic groups showed no significant differences between them in terms of maternal age and neonatal weight. A random blood sugar (RBS) test and WBC count showed a highly significant increase in GDM and a significant increase in PGDM. The highest significant value of RBC was recorded for PGDM. The thickness of the epithelial layer plus the basement membrane (BM) was significantly increased due to the PGDM. while the compact layer plus the fibroblast layer and the total thickness of AM showed a significant increase in GDM. The nucleus diameter of AM epithelial cells was significantly decreased in diabetic groups. The histological examination revealed that both diabetic groups caused several changes and damage in AM, including: hypertrophy and hyperplasia in epithelial cells associated with the formation of the vacuole between them; degeneration of some of these cells that pinched off from the lining epithelium; breakdown of the compact and fibroblast layers and caused damage to the stromal collagen fibril; epithelial cells and their nuclei became elongated and resembled columnar epithelium; and the basement membrane appeared thicker in comparison to the control group. In conclusion, GDM and PGDM induced various alterations and damage to the AM, which in turn delayed embryonic development and the delivery.
Article Details
References
- Algaba-Chueca F., Maymó-Masip E., Ejarque M., Ballesteros M., Llauradó G., López C., Guarque A., Serena C., Martínez-Guasch L., Gutiérrez C., Bosch R., Vendrell1 J., Megía A., and Fernández-Veledo S. (2020). Gestational diabetes impacts fetal precursor cell responses with potential consequences for offspring. Stem Cells Transl Med. 9:351–363.
- Alo Khudir, A.B. (2017). Histological evaluation of the placenta in type 2 diabetes mellitus. Master of Science thesis. University of Duhok, College of Medicine.
- AL-Yahya1 A.A.I. and Makhlouf M.M.M. (2013). Characterization of the human amniotic membrane: histological, immunohistochemical and ultrastructural studies. Life Science Journal. 10(4): 3701-3710.
- Ambrósio, C.E., Orlandin, J.R., Oliveira, V.C., Motta, L.C.B., Pinto, P.A.F., Pereira, V.M., Padoveze, L.R., Karam, R.G. and de Oliveira Pinheiro, A., (2019). Potential application of aminiotic stem cells in veterinary medicine. Animal Reproduction, 16(1):24-30.
- Benirschke K, Kaufmann P, and Baergen RN. (2006). Pathology of the human placenta. 6th ed. Berlin-Germany, 150-155.
- Bortolon, L.N.M., Triz, L. de P.L., Faustino, B. de S., de Sá, L.B.C., Rocha, D.R.T.W. andArbex, A.K. (2016). Gestational Diabetes Mellitus: New Diagnostic criteria. Open Journal of Endocrine and Metabolic Diseases. 6: 13-19.
- Collier A, Abraham EC, Armstrong J, Godwin J, Monteath K, and Lindsay R. (2017). Reported prevalence of gestational diabetes in Scotland: the relationship with obesity, age, socioeconomic status, smoking and macrosomia, and how many are we missing? J Diabetes Investig. 8 (2):161- 167.
- Cunningham F. (2001). William’s obstetrics. Slock, London.
- Drury, R., and Wallington, E.A. (1980): Carleton's Histological technique. 5th ed. Oxford University Press. Oxford, New York, Toronto.
- Duncan, D.B. (1955). Multiple range and multiple F tests. Biometrics. 11: 1-42.
- Ferenczy, P. A. V. H., and Souza, L. B. D. (2020). Comparison of the preparation and preservation techniques of amniotic membrane used in the treatment of ocular surface diseases. Revista Brasileira de Oftalmologia, 79, 71-80.
- Hao Y., Ma D.H., Hwang D.G., Kim W.S. and Zhang F. (2000). Identification of antiangiogenic and antiinflammatory proteins in human amniotic membrane. Cornea 19: 348–352.diseases. Revista Brasileira de Oftalmologia, 79, 71-80.
- Hanson MA, andGluckman PD. (2014). Early developmental conditioning of later health and disease: physiology or pathophysiology? Physiol Rev. 94:1027-1076.
- Hilmy, N., Yusof, N., and Nather, A. A. (Eds.). (2017). Human amniotic membrane: basic science and clinical application. World Scientific.
- Ilancheran S., Michalska A., Peh G., Wallace E.M., Pera M., and Manuelpillai U. (2007). Stem cells derived from human fetal membranes display multilineage differentiation potential. Biology of Reproduction, 77(3): 577–588.
- Joshy G., and Simmons D. (2006). Epidemiology of diabetes in New Zealand: revisittoa changing landscape. New Zealand Medical Journal 119. 2:7.
- Manuel Va´zquez Blanco, Hilda Ruda Vega, Roberto A. Guerri-Guttenber, Rodolfo Giuliano, Daniel R. Grana, Francisco Azzato, and Jose´ Milei. (2011). Histopathology and histomorphometry of umbilical cord blood vessels. Findings in normal and high-risk pregnancies Artery Research, 5(2):50–57.
- Mamede, A. C., Carvalho, M. J., Abrantes, A. M., Laranjo, M., Maia, C. J., and Botelho, M. F. (2012). Amniotic membrane: from structure and functions to clinical applications. Cell and Tissue Research, 349, 447-458.
- Mitanchez D, Yzydorczyk C, Siddeek B, Boubred F, Benahmed M, and Simeoni U. (2015). The offspring of the diabetic mother—short- and longterm implications. Best Pract Res Clin Obstet Gynaecol.2 9: 256-269.
- Nergiz, Y., Deveci, E., Sak, M.E., Evsen, M.S., Ekinci, C., Nergiz, S., Unal, B.K. and Seker, U., (2019). Histological of changes in the amniotic membrane and placenta villous basal lamina in complicated pregnancies. Int. J. of Health Serv. Res. and Policy, 4(2):124-130.
- Niknejad, H.; Peirovi, H.; Jorjani, M.; Ahmadiani, A.; Ghanavi, J.; and Seifalian, A. M. (2008). Properties of the amniotic membrane for potential use in tissue engineering. European Cells and Materials, vol. 15, pp. 88–99.
- Pappa K. I., and Anagnou N. P. (2009). Novel sources of fetal stem cells: where do they fit on the developmental continuum? Regenerative Medicine, 4(3): 423–433.
- Salem M., Abd El-Gawwad Sh. M., Mahmou E.S., & Elyamany H. Y. (2019). Histological study of human umbilical cord in Diabetic pregnant females. The Egyptian Journal of Histology. 42 (4). 874-887.
- Sippel K. C., Ma J. J., and Foster C. S. (2001). Amniotic membrane surgery. Curr. Opin. Ophthalmol., 12(4):269-281.
- Song, C., Lyu, Y., Li, C., Liu, P., Li, J., Ma, R. C., and Yang, X. J. O. R. (2018). Long‐term risk of diabetes in women at varying durations after gestational diabetes: a systematic review and meta‐analysis with more than 2 million women. Obesity reviews, 19(3), 421-429.
- SPSS (2019). Statistical Package for Social Sciences, Ver. 26, Use’s guide, IBM publications, USA.
- Takeichi, M. (1990). Cadherins: a molecular family important in selective cell-cell adhesion. Annu. Rev. Biochem., 59:237-252.
- Toda A., Okabe M., Yoshida T., and Nikaido T. (2007). The potential of amniotic membrane/amnion-derived cells for regeneration of various tissues. J Pharmacol Sci 105:215–228.
- Toğrul, C., Görkem, Ü., Coşkun, B., Nergisli Kaşlı, C.K., Güngör, T. and Deveci, E., (2017). Histopathological and immunohistochemical changes in the amniotic membrane of gestational diabetic mothers. Int. J. Morphol. 35(1):184-188.
- Weli, S.J. (2021). Description effect of diabetes in women in appearance of histological changes in the placenta. Master of Science Thesis. Diyala University, College of Science.
- Zhang, Y., Zhang, Y., Zhao, L., Shang, Y., He, D. and Chen, J., (2021). Distribution of complete blood count constituents in gestational diabetes mellitus. Medicine, 100:23 (e26301).