DIABETES MELLITUS AND A THICK PLACENTA

• In diabetic gestations, 60% of placentas have villi that do not correspond to the gestational age (1).
• One half of the villi are excessively immature while the other half show accelerated maturation (2).
• Villous edema and a large amount of fibrinoid villous necrosis is common.
• These findings are less marked in gestational diabetics, however there is considerable overlap.
• Good control of the hyperglycemia state does not appear to prevent the development of placental abnormalities (1).

ULTRASOUND

• Placentomegaly (most common cause in one series) (1).
• Placentas may reach 8-9cm.
• Echotexture tends to be homogeneous.
• Basilar plate and septal calcifications tend to be less common in diabetic patients (3).

REFERENCES

1. Harris RD, Cho C, Wells WA. Sonography of the placenta with emphasis on pathological correlation. Seminars in Ultrasound, CT, and MRI 1996;17(1):66-89.
2. Fox H. Pathology of the placenta. In: Bennington JL (ed): Major problems in pathology. Philadelphia, Saunders, 1978,pp 1-37.
3. Benirschke K, Kaufmann P. Pathology of the human placenta. New York, Springer - Verlag, 1990.