A Case of COVID-19 Pregnancy Complicated with Hydrops Fetalis and Intrauterine Death

Popescu, Daniela-Eugenia; Cioca, Andreea; Muresan, Camelia; Navolan, Dan; Gui, Arina; Pop, Ovidiu Laurean; Marcovici, Tamara; Ilie, Constantin; Craina, Marius; Boia, Marioara

doi:10.3390/medicina57070667

Cited by 19 publications

(17 citation statements)

References 23 publications

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“…Indeed, third trimester’s pregnant women placentas received in our laboratory showed subnormal placental examination while they presented severe symptoms with respiratory distress requiring emergency fetal extraction. On the other hand, second trimester’s or third trimester’s maternal infections have been reported several times with IUFD despite mild maternal COVID-19 symptoms [ 13 , 24 , 25 , 26 , 27 ]. This makes clinical monitoring difficult and raises the question of ultrasound monitoring.…”

Section: Discussionmentioning

confidence: 99%

Severe placental lesions due to maternal SARS-CoV-2 infection associated to intrauterine fetal death

et al. 2022

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SARS-CoV-2 infection can cause severe placental lesions leading rapidly to intra uterine fetal death (IUFD). From August 2020 to September 2021, in the pathology Department of Toulouse Oncopole, we analyzed 50 placentas from COVID-19 positive unvaccinated mothers. The purpose of our study is to describe the clinicopathological characteristics of these placental damages and to understand the pathophysiology. Ten of them (20%) showed placental lesions with positive immunohistochemistry for SARS-CoV-2 in villous trophoblast. In five cases (10%), we observed massive placental damage associating trophoblastic necrosis, fibrinous deposits, intervillositis as well as extensive hemorrhagic changes due to SARS-CoV-2 infection probably responsible of IUFD by functional placental insufficiency. In five other cases, we found similar placental lesions but with a focal distribution that did not lead to IUFD but live birth. These lesions are independent of maternal clinical severity of COVID-19 infection since they occur despite mild maternal symptoms and are therefore difficult to predict. In our cases, they occurred 1 to 3 weeks after positive SARS-CoV-2 maternal RT-PCR testing and were observed in 2nd and 3rd trimesters of pregnancies. When these lesions are focal, they do not lead to IUFD and can be involved in intra-uterine growth restriction. Our findings, together with recent observations, suggest that future pregnancy guidance should include stricter pandemic precautions such as screening for a wider array of COVID-19 symptoms, enhanced ultrasound monitoring as well as newborn medical surveillance.

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Section: Discussionmentioning

confidence: 99%

Severe placental lesions due to maternal SARS-CoV-2 infection associated to intrauterine fetal death

et al. 2022

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“…In another study, a link has been found between COVID-19 and the risk of pre-term and cesarean deliveries [ 10 ]. The cases of vertical transmission of the virus [ 11 ], which could lead to hydrops fetalis and death of the fetus have also been reported [ 12 ]. Children are more susceptible to asymptomatic infections; however, they are carriers of SARS-COV-2, transmitting the virus to others, including pregnant women [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

The Approach of Pregnant Women to Vaccination Based on a COVID-19 Systematic Review

et al. 2021

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Background and Objectives: Pregnant women are more likely to develop a more severe course of COVID-19 than their non-pregnant peers. There are many arguments for the safety and efficacy of COVID-19 vaccines in pregnant women. The aim of this study is to conduct a systematic review concerning the approach of pregnant women towards vaccination against COVID-19, with particular regard to determinants of vaccination acceptance. Materials and Methods: Articles were reviewed in which the aim was to evaluate—via a survey or questionnaire—the acceptance and decision to undergo vaccination against COVID-19. The articles were subjected to review according to recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA). Results: In various studies, the percentage of pregnant women accepting the COVID-19 vaccine was between 29.7% and 77.4%. The strongest factors co-existing with the acceptance of the COVID-19 vaccination in pregnancy were trust in the importance and effectiveness of the vaccine, explicit communication about the safety of COVID-19 vaccines for pregnant women, acceptance of other vaccinations such as those for influenza, belief in the importance of vaccines/mass vaccination in one’s own country, anxiety about COVID-19, trust in public health agencies/health science, as well as compliance to mask guidelines. The remaining factors were older age, higher education, and socioeconomic status. Conclusions: This review allowed us to show that geographic factors (Asian, South American countries) and pandemic factors (different threats and risks from infection) significantly influence the acceptance of vaccines. The most significant factors affecting acceptance are those related to public awareness of the risk of infection, vaccine safety, and the way in which reliable information about the need and safety of vaccines is provided. Professional and reliable patient information by obstetricians and qualified medical personnel would significantly increase the level of confidence in vaccination against COVID-19.

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“…There are also reports indicating vertical transmission with regard to the virus [14]. This can lead to fetal oedema or even death [15]. Among those more prone to asymptomatic infections, we may include children, who further transmit the virus to pregnant women [16,17].…”

Section: Introductionmentioning

confidence: 99%

Approach of Pregnant Women from Poland and the Ukraine to COVID-19 Vaccination—The Role of Medical Consultation

Januszek

Siwiec

Januszek³

et al. 2022

Vaccines

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There are many arguments for the safety and efficacy of COVID-19 vaccines in pregnancy. The aim of this study is to describe the level of vaccination acceptance, to find the factors that most influence the decision to vaccinate, and to describe the scale of changes in vaccination acceptance influenced by medical information on the safety, efficacy, and benefits of vaccination among pregnant women. A total of 300 patients completed the questionnaire, including 150 in Poland and 150 in the Ukraine. The level of vaccination acceptance was assessed before and after medical consultation. There were 53 (35.3%) patients with the intention to get vaccinated in Poland and 25 (16.7%) in the Ukraine. After consultation with a physician, this increased to 109 (72.6%) in Poland and 69 (46%) in the Ukraine. The main factors influencing the acceptance of vaccinations were the fear of harming the foetus (OR-0.119, CI-0.039–0.324 p < 0.001), complications in pregnancy (OR-0.073 CI-0.023–0.197 p < 0.001), and limitations in the vaccination programme (OR-0.026 CI-0.001–0.207 p < 0.001). Medical information about the safety, effectiveness and benefits of vaccinations among pregnant women, provided during a medical visit, may increase the acceptance of vaccinations by 105.6%, as among Polish patients, and by 176%, as among pregnant women from the Ukraine.

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A Case of COVID-19 Pregnancy Complicated with Hydrops Fetalis and Intrauterine Death

Cited by 19 publications

References 23 publications

Severe placental lesions due to maternal SARS-CoV-2 infection associated to intrauterine fetal death

Severe placental lesions due to maternal SARS-CoV-2 infection associated to intrauterine fetal death

The Approach of Pregnant Women to Vaccination Based on a COVID-19 Systematic Review

Approach of Pregnant Women from Poland and the Ukraine to COVID-19 Vaccination—The Role of Medical Consultation

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