Introdução: O Diabetes Mellitus Gestacional (DMG) é uma doença de caráter metabólico definida pela hiperglicemia e por complicações associadas, diagnosticadas pela primeira vez durante a gestação. O critério laboratorial para o diagnóstico de DMG, compreende o achado de dois valores de glicemia acima de dois desvios padrão da média. Essa comorbidade acomete em torno de 4,5% das gestantes no Brasil e em torno de 3% no mundo. O DMG implica em danos para a mãe e para o feto, pois provoca alterações histopatológicas, morfológicas e metabólicas em diversos órgãos, incluindo a placenta. Objetivos: Revisar as principais lesões histopatológicas placentárias associadas ao DMG em gestantes sem outras comorbidades, analisando suas frequências a partir dos artigos selecionados. Materiais e métodos: Revisão em inglês pelo PubMed, utilizando as palavras-chave: “gestacional diabetes”, “placenta” e “histopathology”. Foram analisados artigos entre os anos 2000-2022, e selecionados 37 artigos relevantes para formular uma revisão sobre os principais achados histopatológicos na placenta de gestantes portadoras de DMG. Resultados: Dentre as lesões mais frequentes relatadas em gestantes portadoras de DMG sem nenhuma outra comorbidade (como obesidade, hipertensão, pre-eclampsia, ISTs, etc) existente durante toda a gravidez, destacaram-se os seguintes achados: Imaturidade vilosa (15 artigos), Necrose Fibrinoide (14), Edema viloso (11), e Corioangiose (10), espessamento da membrana basal do sinciciotrofoblasto (5 ), depósito de glicogênio ( 5), espessamento vascular (4), presença de eritrócitos fetais nucleados (4) e aumento da presença de macrófagos (4). Conclusão: A placenta “diabética” apresenta diversas alterações histológicas como consequência dos valores glicêmicos elevados, implicando em lesões microscópicas não somente como resultado direto da DMG, mas também alterações compensatórias que atuam para contrapor hipóxia e inflamação local, os efeitos da má-nutrição materna e fetal, assim como de outros insultos específicos decorrentes da resistência a insulina transitória, característica do DMG . Tais alterações podem contribuir para o agravamento de um fenótipo fetal alterado comumente associado ao DMG e predispor este neonato a doenças cardiometabólicas durante a vida adulta.
Publicado
2022-03-09
Como Citar
Silva, G. A. de O. ., Barroso, E. S. T. ., & Bloise, E. . (2022). ANÁLISE NARRATIVA DAS ALTERAÇÕES HISTOPATOLÓGICAS PLACENTÁRIAS ASSOCIADAS AO DIABETES MELLITUS GESTACIONAL. Revista Multidisciplinar Em Saúde, 2(4), 32. https://doi.org/10.51161/rems/3215
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SubmissionSearch._getMergedKeywordResults(Object:Journal, Array[4], , null, null, 500, 1) % line 194, file: SubmissionSearch.inc.php
SubmissionSearch._getMergedPhraseResults(Object:Journal, Array[4], null, null, null, 500, 1) % line 146, file: SubmissionSearch.inc.php
SubmissionSearch._getMergedKeywordResults(Object:Journal, Array[3], null, null, null, 500, 1) % line 132, file: SubmissionSearch.inc.php
SubmissionSearch._getMergedArray(Object:Journal, Array[1], null, null) % line 263, file: SubmissionSearch.inc.php
SubmissionSearch.retrieveResults(Object:Request, Object:Journal, Array[1], null, null, null, Object:DBResultRange, Array[1]) % line 92, file: RecommendBySimilarityPlugin.inc.php
RecommendBySimilarityPlugin.callbackTemplateArticlePageFooter(Templates::Article::Footer::PageFooter, Array[3]) % line 107, file: HookRegistry.inc.php
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Dispatcher.dispatch(Object:Request) % line 281, file: PKPApplication.inc.php
PKPApplication.execute() % line 68, file: index.php
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