Fibrin deposition in pregnancy

Stalker, Amy

doi:10.1136/jcp.29.suppl_10.70

Cited by 16 publications

(3 citation statements)

References 29 publications

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“…Based on the current COVID-related knowledge, the coagulopathies in patients with SARS-CoV-2 infections are attributed to a combination of different factors rather than one single mechanism [ 1 , 2 , 32 ]. Regarding the fibrin deposits in the intervillous space of the placentas from SASRS-CoV-2-positive mothers with fetal distress, there may be a decrease in local fibrinolysis similar to what is seen in preeclampsia [ 33 , 34 ]. Perivillous fibrin deposition may be triggered by an activation of immune cells and circulating pro-inflammatory cytokines [ 20 ] and potentially microparticles [ 32 ] from the mother as well as by the hypoxic alteration of the villous trophoblast [ 33 , 35 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

Placental pathology in sudden intrauterine death (SIUD) in SARS-CoV-2-positive oligosymptomatic women

Horn

Krücken

Hiller

et al. 2022

Arch Gynecol Obstet

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Background Pregnant women are also susceptible to SARS-CoV-2. Although an infection of the placenta may be rare, pregnancy may occasionally be affected by intrauterine failure. The knowledge of placental morphology on sudden intrauterine demise is still limited. Methods Fetal and placental tissue of two cases of sudden intrauterine death in the second trimester were analysed morphologically and by immunohistochemistry. One case was evaluated by RT-PCR. Results Both mothers were tested positive for the Alpha variant of SARS-CoV-2 but were oligosymptomatic for COVID-19. Unexpected sudden intrauterine death (SIUD) occurred at 15 + 2 and 27 + 3 weeks of gestation. One fetus demonstrated an intrauterine growth restriction. No malformations nor inflammatory changes were observed in either fetus on autopsy. In contrast to the placentas, the fetal tissue was negative for SARS-CoV-2 on immunohistochemical and RT-PCR analyses. Macroscopically, the placentas showed an increased consistency with a white, reticular cutting surface covering about 95% of the whole placenta. Only very focal histiocytic chronic intervillositis was noted histologically. Massive perivillous fibrin deposits with extensive necroses of the villous trophoblast were present in more than 90% of the placental tissue. Immunohistochemical staining was strong and diffusely positive for SARS-CoV-2 in the villous trophoblast and rarely within the villous stromal cells. Placental SARS-CoV-2 infection was confirmed by RT-PCR. Conclusion Sudden intrauterine death may occur in mothers who are oligosymptomatic for COVID-19. Acute placental failure is responsible for SIUD, demonstrated by massive perivillous fibrin deposits and extensive necroses of the villous trophoblast with SARS-CoV-2-positivity based on immunohistochemical staining and RT-PCR. Detailed histopathological examination of placental and fetal tissue is mandatory to verify SARS-CoV-2 and to evaluate the pathogenesis and functionality of this disease.

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Section: Discussionmentioning

confidence: 99%

Placental pathology in sudden intrauterine death (SIUD) in SARS-CoV-2-positive oligosymptomatic women

Horn

Krücken

Hiller

et al. 2022

Arch Gynecol Obstet

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“…When this tissue suffers damage, coagulation can occur. In some instances, if this process is exacerbated, fibrin derived from fibrinogen leads to thrombosis, necrosis, and placental infarcts [ 81 , 82 , 83 ]. It has also been reported that fibrin deposition between the chorionic villi can promote apoptosis in the syncytiotrophoblast layer, structurally discontinuing this protective barrier [ 84 ].…”

Section: Histopathological Changes In the Placenta Caused By Viral In...mentioning

confidence: 99%

Collateral Damage in the Placenta during Viral Infection in Pregnancy: A Possible Mechanism for Vertical Transmission and an Adverse Pregnancy Outcome

Cruz-Holguín,

González-García,

Velázquez-Cervantes

et al. 2024

Diseases

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In mammals, the placenta is a connection between a mother and a new developing organism. This tissue has a protective function against some microorganisms, transports nutrients, and exchanges gases and excretory substances between the mother and the fetus. Placental tissue is mainly composed of chorionic villi functional units called trophoblasts (cytotrophoblasts, the syncytiotrophoblast, and extravillous trophoblasts). However, some viruses have developed mechanisms that help them invade the placenta, causing various conditions such as necrosis, poor perfusion, and membrane rupture which, in turn, can impact the development of the fetus and put the mother’s health at risk. In this study, we collected the most relevant information about viral infection during pregnancy which can affect both the mother and the fetus, leading to an increase in the probability of vertical transmission. Knowing these mechanisms could be relevant for new research in the maternal–fetal context and may provide options for new therapeutic targets and biomarkers in fetal prognosis.

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“…Chronic inflammatory responses to these antigens are believed to induce recurrent depositions of fibrin within microvessels and interstitial spaces [Brakman, 1967;Wells, 1973;Rodman, 1973;Colvin et al, 1973], However, the presence of fibrin per se within such spaces has been difficult to visualize because of various technical limitations of avail able methods [Lendrum et al, 1962: Stalker, 1976. Nontheless, reports indicating that anticoagulant and fibrinolytic agents may reduce the indu ration and duration of various inflammatory lesions suggest that a con tinuous presence of fibrin for prolonged periods may be an important determinant of lesion chronicity [ Wiseman and Chang, 1968;Edwards and Rickies, 1978].…”

Section: Introductionmentioning

confidence: 99%

Evidence of Impaired Anterior Segment Fibrinolytic Activity in Chronic Uveitis

et al. 1982

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Purified homologous fibrinogen (2.4–9.4 mg) was injected intracamerally in cat eyes at approximate six months intervals for up to 30 months in order to assess, in vivo, the long-term impact of chronic uveitis on anterior segment fibrinolytic capability. Normal and acutely inflamed eyes responded with slow clotting, small clot formation and rapid lysis (2–3 days). Chronically inflamed eyes showed rapid clotting, larger clots and much slower lysis, with BCG-induced uveitis much slower than endotoxin-induced uveitis. Suppression of plasminogen activator levels within aqueous humor of chronically inflamed eyes was indicated, using modified fibrin plate methods. The normal balance between fibrinolysis and fibrinogenesis within tissues bounding the anterior chamber is apparently tilted in favor of the latter function when inflammation is prolonged.

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Fibrin deposition in pregnancy

Cited by 16 publications

References 29 publications

Placental pathology in sudden intrauterine death (SIUD) in SARS-CoV-2-positive oligosymptomatic women

Placental pathology in sudden intrauterine death (SIUD) in SARS-CoV-2-positive oligosymptomatic women

Collateral Damage in the Placenta during Viral Infection in Pregnancy: A Possible Mechanism for Vertical Transmission and an Adverse Pregnancy Outcome

Evidence of Impaired Anterior Segment Fibrinolytic Activity in Chronic Uveitis

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