Morphology histomorphometry and leptin expression of human umbilical cords in normal and gestational diabetes mellitus pregnancies managed with diet and drug

Abstract

Epidemic of obesity and diabetes are increasing at an unprecedented newlinerate all over the world and there is a simultaneous increase in the prevalence newlineof GDM. An early detection of specific risks, through screening and newlinemonitoring, would allow early commencement of preventive measures, newlineappropriate antenatal care and optimal level of surveillance. It would also newlineallow recruitment of high risk populations to trials of interventions enabling the newlinedevelopment of better therapeutic strategies leading to favorable clinical newlineoutcomes. newlineUmbilical cord being the only lifeline between the mother and the newlinedeveloping foetus, miniscule changes within the cord can have an adverse newlineimpact on the foetus. There is a need to assess several factors influencing newlineGDM and the structural changes within the cord that could be a direct impact newlineof this disorder. Early detection of such changes and a thorough newlineunderstanding of the cord morphology, through radiological studies, could newlineenhance the effectiveness of the intra uterine therapeutic options like surgery newlineand cord transfusion, paving the way for an improved maternal and child newlinehealth. Comparison of structural changes in the umbilical cords of GDM newlinemanaged with diet and drug would provide adequate knowledge to the newlineobstetricians and gynaecologists to take a logical decision upon the newlinemanagement aspect. It is reported that leptin appears to play a role in the pathophysiology of newlineGDM with the levels in both the cord and maternal blood found to be elevated newlinein pregnant women with GDM. Leptin might also serve as marker of GDM newlineseverity and drugs targeting their pro inflammatory effects may open up a new newlineadjuvant therapeutic approach in GDM. This study attempts to explore the newlineexpression of leptin in the umbilical cords of GDM and normal mothers, newlinethrough suitable immuno- histochemical methods newlinein conclusion morphological and histomorphometrical newlinedifferences between normal and GDM would facilitate an early antenatal newlinedetection of the disease and proper management. newline newline