Abstract
Background: Forensic Pathology remains a mainstay in diagnosing all forms of fetal death including stillborn and it is an indispensable tool in the process of evaluating the underlying cause of death. Diabetes mellitus (DM) being a common clinical condition with hyperglycemic
state, it has a major impact on the growing fetus during gestation causing several morbidities including still birth. Histopathological evaluation of the systemic organs yields adequate information of the etiopathogenesis for the cause of death thereby aiding clinicians to proceed with further management and counselling to the parents
Methodology: The study was conducted between 2012 to 2020 covering 25 cases. The cases were categorized into 2 groups like Diabetes in Pregnancy (Type 1 & Type 2 DM) and Gestational Diabetes Mellitus (GDM). Complete clinical data including diabetic profile were
documented. Routine fetal autopsy procedure was performed and the major systemic organs involved in metabolism like Liver, kidney, pancreas and lungs were weighed and analyzed for histomorphological changes.
Results: The study analyzed 25 cases which showed 5 cases each in Type 1 & Type 2 DM and 10 cases in GDM. Renal changes in fetuses were prominent in GDM compared to other groups. Histomorphological changes in the form degenerative features in liver, pancreas and lungs
were more in common in GDM
Conclusion: Gestational Diabetes mellitus stays as a rampant condition leading to major cause for still birth compared to Type 1 & 2 DM. It had been evident that GDM is not an homogenous set of disease and a subset of conditions especially pre-existing but left undiagnosed could be a potential risk for growing fetal malformations with subsequent organ failure and stillbirth
Keywords: Fetal autopsy; Diabetes mellitus; Histomorphology; Still birth.