Dengue infection in pregnancy and its impact on the placenta

Abstract

A histopathological and immunohistochemical study was conducted in placental tissues and retained products of conception from 24 patients with confirmed dengue infection during pregnancy. The immunohistochemical assay was positive for dengue virus in 19 placental and three ovular remnants analyzed. The light microscopic findings were signs of hypoxia, choriodeciduitis, deciduitis and intervillositis and the viral antigens were found in cytoplasmic of the trophoblast, villous stroma and decidua. Our results suggest that immunohistochemistry could be used as a laboratory confirmation method for dengue in pregnant women, especially in endemic areas when embedded material is the only material available.

Epigenetic and transgenerational mechanisms in infection-mediated neurodevelopmental disorders

“…The placenta plays a key role in maternal–fetal interactions and expresses a variety of factors important for the homeostatic response to infectious agents. 42 Maternal infections also typically disrupt the circulation and architecture of the placenta, 27 , 43 , 44 as shown by studies in rodents and humans, which in turn can induce placental insufficiency and reduce the delivery of oxygen and essential nutrients to the developing offspring ( Figure 1 ).…”

Self limiting fetal bradycardia associated with maternal evidence of dengue and chikungunya virus co-infection: a case report

“…9 Another Interestingly, there is evidence of histopathological changes of fetal hypoxia in the placenta of newborn with dengue infected mothers. 10 However, there is no evidence of infection of the human syntiotrophoblastic tissue by the chikungunya virus per se. 11 Promphan et al, have reported sinus node dysfunction following dengue infection in a 13-year boy who developed bradycardia and hypotension.…”

Arboviruses and pregnancy: maternal, fetal, and neonatal effects

“…Indeed, histopathological analyses of placenta collected at delivery from Dengue virus -infected mothers have evidenced hypoxic lesions with villous stroma edema, infarcted and pre-infarcted areas in 19/24 cases, including 8 from mothers who did not report overt shock syndrome. 72 This is also the most likely scenario accounting for fetal losses in severe Crimean-Congo hemorrhagic fever, although not proven. Placental arbovirus infection can induce placental dysfunction, with subsequent adverse fetal outcome.…”

“…29 Brazilian data suggest that maternal sickle cell disease, a genetic trait highly prevalent in Latin America and Africa, might increase dengueassociated risk of fetal loss. 72 Whether serotype has an impact on fetal loss remains unknown. Perinatal Dengue virus transmission is also reported in case of maternal symptoms occurring 10 days around delivery, yet its actual incidence is unknown.…”

“…Indeed, the same histopathological studies also evidenced chorio-deciduitis and villitis; immunostaining evidenced viral antigens in the decidual cells trophoblasts and villous stroma cells in 22/24 cases that overlapped with histological lesions in 10. 72 Placental arbovirus infection can also lead to antepartum MTCT, which can either be asymptomatic, lead to fetal death, and/or to developmental defects (teratogenicity). MTCT associated with fetal death has been poorly studied in human, and is only documented for Zika virus and Japanese encephalitis virus, but largely reported in other mammals for many arboviruses, like Venezuelan equine encephalitis virus in mice and mares, Western equine encephalitis virus in rhesus macaques, Ross river virus in mice, Japanese encephalitis virus in swine and West Nile virus in mice or Rift valley fever virus in ruminants.…”