Placental histopathological lesions in correlation with neonatal outcome in preeclampsia with and without severe features

Weiner, Eran; Feldstein, Ohad; Tamayev, Liliya; Grinstein, Ehud; Barber, Elad; Bar, Jacob; Schreiber, Letizia; Kovo, Michal

doi:10.1016/j.preghy.2018.02.001

Cited by 41 publications

(23 citation statements)

References 42 publications

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“…[23][24][25][26] Maternal hypertensive disorders, including gestational hypertension and preeclampsia, are the major risk factors for MVM. 27,28 Surprisingly, only 1 of the patients in our study was hypertensive. The patients in this study differed from typical MVM patients in other ways.…”

Section: Discussionmentioning

confidence: 56%

Placental Pathology in COVID-19

Shanes

Mithal

Otero

et al. 2020

American Journal of Clinical Pathology

553

551

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Objectives To describe histopathologic findings in the placentas of women with coronavirus disease 2019 (COVID-19) during pregnancy. Methods Pregnant women with COVID-19 delivering between March 18, 2020, and May 5, 2020, were identified. Placentas were examined and compared to historical controls and women with placental evaluation for a history of melanoma. Results Sixteen placentas from patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were examined (15 with live birth in the third trimester, 1 delivered in the second trimester after intrauterine fetal demise). Compared to controls, third trimester placentas were significantly more likely to show at least one feature of maternal vascular malperfusion (MVM), particularly abnormal or injured maternal vessels, and intervillous thrombi. Rates of acute and chronic inflammation were not increased. The placenta from the patient with intrauterine fetal demise showed villous edema and a retroplacental hematoma. Conclusions Relative to controls, COVID-19 placentas show increased prevalence of decidual arteriopathy and other features of MVM, a pattern of placental injury reflecting abnormalities in oxygenation within the intervillous space associated with adverse perinatal outcomes. Only 1 COVID-19 patient was hypertensive despite the association of MVM with hypertensive disorders and preeclampsia. These changes may reflect a systemic inflammatory or hypercoagulable state influencing placental physiology.

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Section: Discussionmentioning

confidence: 56%

Placental Pathology in COVID-19

Shanes

Mithal

Otero

et al. 2020

American Journal of Clinical Pathology

553

551

View full text Add to dashboard Cite

show abstract

“…Another study with 16 placentas from patients with SARS-CoV-2 were examined and the most significant finding is an increase in the rate of features of maternal vascular malperfusion (MVM), most prominently decidual arteriopathy including atherosis, fibrinoid necrosis, and mural hypertrophy of membrane arterioles ( 45 ). Maternal hypertensive disorders, including gestational hypertension and preeclampsia, are the major risk factors for MVM ( 46 ), although only 1 of the patients was hypertensive in this study. Notwithstanding, SARS-CoV-2 is a virus that is expected to induce inflammation, it is relevant that neither acute inflammatory pathology (AIP) nor chronic inflammatory pathology (CIP) were increased in COVID-19 patients relative to the controls.…”

Section: Viral Infection and Pregnancymentioning

confidence: 59%

Pregnancy, Viral Infection, and COVID-19

et al. 2020

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Pregnancy comprises a unique immunological condition, to allow fetal development and to protect the host from pathogenic infections. Viral infections during pregnancy can disrupt immunological tolerance and may generate deleterious effects on the fetus. Despite these possible links between pregnancy and infection-induced morbidity, it is unclear how pregnancy interferes with maternal response to some viral pathogens. In this context, the novel coronavirus (SARS-CoV-2) can induce the coronavirus diseases-2019 (COVID-19) in pregnant women. The potential risk of vertical transmission is unclear, babies born from COVID-19-positive mothers seems to have no serious clinical symptoms, the possible mechanisms are discussed, which highlights that checking the children's outcome and more research is warranted. In this review, we investigate the reports concerning viral infections and COVID-19 during pregnancy, to establish a correlation and possible implications of COVID-19 during pregnancy and neonatal's health.

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“…20–23 Maternal hypertensive disorders, including gestational hypertension and preeclampsia, are the major risk factors for MVM. 24,25…”

Section: Discussionmentioning

confidence: 99%

Placental pathology in COVID-19

Shanes

Mithal

Otero

et al. 2020

Preprint

112

117

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Objectives: To describe histopathologic findings in the placentas of women with COVID-19 during pregnancy. Methods: Pregnant women with COVID-19 delivering between March 18, 2020 and May 5, 2020 were identified. Placentas were examined and compared to historical controls and women with placental evaluation for a history of melanoma. Results: 16 placentas from patients with SARS-CoV-2 were examined (15 with live birth in the 3rd trimester 1 delivered in the 2nd trimester after intrauterine fetal demise). Compared to controls, third trimester placentas were significantly more likely to show at least one feature of maternal vascular malperfusion (MVM), including abnormal or injured maternal vessels, as well as delayed villous maturation, chorangiosis, and intervillous thrombi. Rates of acute and chronic inflammation were not increased. The placenta from the patient with intrauterine fetal demise showed villous edema and a retroplacental hematoma. Conclusions: Relative to controls, COVID-19 placentas show increased prevalence of features of maternal vascular malperfusion (MVM), a pattern of placental injury reflecting abnormalities in oxygenation within the intervillous space associated with adverse perinatal outcomes. Only 1 COVID-19 patient was hypertensive despite the association of MVM with hypertensive disorders and preeclampsia. These changes may reflect a systemic inflammatory or hypercoagulable state influencing placental physiology.

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Placental histopathological lesions in correlation with neonatal outcome in preeclampsia with and without severe features

Cited by 41 publications

References 42 publications

Placental Pathology in COVID-19

Placental Pathology in COVID-19

Pregnancy, Viral Infection, and COVID-19

Placental pathology in COVID-19

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