Gestational diabetes mellitus having a great effect on the structure of the umbilical cord vessels can affect the hemodynamic in these vessels and bring variations in the anastomotic pattern of umbilical arteries and mode of umbilical cord insertion. Hyrtl's anastomotic pattern and its correlation to cord insertion has so far not been studied in umbilical cords of GDM mothers. Hence, a study on Hyrtl's anastomosis in GDM and normal pregnancy helps to understand the anatomy exhibited by the different groups and to add to the already existing quantum of knowledge. 59 GDM and 52 normal umbilical cords attached to placenta were procured from the operation theatre and labour room, department of Obstetrics and Gynaecology of PK Das Institute of Medical Sciences and Research, Palakkad. Our study reveals that the characteristics of Hyrtl's anastomosis differ in the umbilical cords of GDM mother from that of normal mothers by adopting anastomosis by branching pattern and there do not exists a correlation between the Hyrtl's anastomosis and cord insertion in both groups.Morphological study of Hyrtl's anastomosis in gestational diabetes mellitus and its relation to umbilical cord insertion.

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The placenta is an essential component for maintaining pregnancy and the proper development of the fetus. Among the complications of pregnancy hypertensive disorders ranks first worldwide for maternal mortality and morbidity. Throughout gestation, placenta undergoes a lot of changes in its morphology and morphometric parameters. The aim of the present study to examine the effect of maternal parameters such as age, parity, height, pre-gestational weight, BMI and a gestational week on placental morphology and morphometric parameters. 80 pregnant women aged between18-40, parity1 - 4, gestational age between 37weeks-40weeks, who attended the antenatal clinic of the hospital and delivered by either vaginal route or caesarean section were included. Placental and maternal parameters were assessed using standard methods. In the present study pre-gestational weight shows a significant positive correlation with the thickness in both groups and significant negative correlation with the placental diameter in the normal placenta Height of the mother also shows a statistically significant negative correlation with the number of maternal cotyledons. Positive as well as negative correlation exists among variables. Longitudinal studies in more samples are required, and results cannot be generalized. Examination placental parameters and its correlation with the maternal parameters will help to manage future pregnancies, fetal outcome and maternal health.