Placental Pathology in Covid-19 Positive Mothers: Preliminary Findings

Baergen, Rebecca N.; Heller, Debra S.

doi:10.1177/1093526620925569

Cited by 298 publications

(347 citation statements)

References 9 publications

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“…Increased intervillous brin deposition in relation to COVID-19 has also been observed by Shanes et al [4] and Baergen and Heller [5] in PCR-negative third trimester placentas. Moreover, this nding has been described in a small series of placentas delivered from pregnant women with severe acute respiratory syndrome caused by the SARS-COV virus during the 2003 epidemic [10].…”

Section: Discussion Main Ndings -Tendency Toward Thrombosis and Brin supporting

confidence: 70%

“…Concerning the fetal vasculature, frank fetal vascular malperfusion with mural thrombi in larger fetal vessels and/or focal avascular villi was seen in ten placentas in the study by Baergen and Heller [5] and in ve placentas in the series presented by Shanes et al [4]. We observed incipient mural thrombus formation in the fetal vessels of P1, however, a disorder in glucose metabolism as an underlying contributory factor could not be ruled out in this case of fetal macrosomia.…”

Section: Fetal Vascular Malperfusion (Fvm)mentioning

confidence: 46%

“…As of the time of this writing vertical SARS-COV-2 transmission remains controversial, while viral RNA has been detected in some placentas of COVID-19-affected mothers suggesting placental infection [1][2][3]. Emerging data on COVID-19-induced placental pathology are still limited [4,5]. We herein present in detail the placental pathology in two cases of pregnant women mildly affected with COVID-19 at term, and describe the pathological changes, including novel ndings not previously reported, along with their pathophysiological correlates.…”

Section: Introductionmentioning

confidence: 99%

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Further placental pathology in mild COVID-19 of term pregnancy with pathophysiological correlates

Konstantinidou¹,

Papaevangelou²,

Tsakris³

et al. 2020

Preprint

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Abstract Placental pathology related to SARS-COV-2 infection during pregnancy is under investigation, with emerging but still limited and variable data, mainly including changes of fetal and maternal vascular malperfusion. We observed novel pathological findings not previously reported in two term placentas delivered from women mildly affected with COVID-19, with a 2-day and 6-day interval between the onset of symptoms and delivery. The main changes involved the maternal more than the fetal components of the placenta and included a tendency toward thrombosis and fibrin formation, and mild maternal malperfusion. We further observed fibrin degeneration in the intervillous space, the presence of particles of undetermined origin, and mild or moderate maternal decidual inflammatory exudates consisting of monocytes, macrophages, T-lymphocytes, and plasmacytes. Mild inflammation and incipient mural thrombus formation were noted in the fetal vasculature, as well as endothelial vacuolation of the umbilical vessels, not previously described. The maternal changes were more prominent in the case with a relatively longer clinical manifestation-to-delivery interval, and were associated to a prolonged postpartum maternal viral carriage of 30 days and the development of a low-grade febrile response in the neonate. Both infants showed mild morbidity but eventually had a very good outcome. RT-PCR was negative for SARS-CoV-2 RNA in both cases.We concluded that placental involvement in mild COVID-19 of very short duration at term pregnancy suggested the systemic nature of the disease and appeared related to, though not pathognomonic of COVID-19. Fetoplacental vascular changes and endothelial vacuolation associated with mild neonatal morbidity may suggest a possible transplacental impact on the fetus, to be further investigated.

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Section: Discussion Main Ndings -Tendency Toward Thrombosis and Brin supporting

confidence: 70%

Section: Fetal Vascular Malperfusion (Fvm)mentioning

confidence: 46%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Further placental pathology in mild COVID-19 of term pregnancy with pathophysiological correlates

Konstantinidou¹,

Papaevangelou²,

Tsakris³

et al. 2020

Preprint

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“…Seven (1.9%) women were aged 40 years or older. Presenting symptoms were reported in 55 studies, comprising 515 pregnant women 4,5,7,11–19,21–30,32–57 . Of these, the most common symptoms at presentation were fever (n=273, 53.0%), cough (n=224, 43.5%), myalgia/malaise (n=79, 15.3%), dyspnea (n=64, 12.4%), diarrhea (n=18, 3.5%), and sore throat (n=18, 3.5%), regardless of gestational age.…”

Section: Resultsmentioning

confidence: 99%

“…Four women presented with reduced fetal movements and three with prepartum hemorrhage. Notably, 68 (10.7%) women in 10 studies were asymptomatic on admission 4,5,12,13,21,37,41,53,55,64 …”

Section: Resultsmentioning

confidence: 99%

Clinical characteristics, prognostic factors, and maternal and neonatal outcomes of SARS‐CoV‐2 infection among hospitalized pregnant women: A systematic review

Turan

Hakim

Dashraath

et al. 2020

Intl J Gynecology & Obste

123

192

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Background Pregnant women represent a potentially high‐risk population in the COVID‐19 pandemic. Objective To summarize clinical characteristics and outcomes among pregnant women hospitalized with COVID‐19. Search strategy Relevant databases were searched up until May 29, 2020. Selection criteria Case series/reports of hospitalized pregnant women with laboratory‐confirmed COVID‐19. Data collection and analysis PRISMA guidelines were followed. Methodologic quality was assessed via NIH assessment tools. Main results Overall, 63 observational studies of 637 women (84.6% in third trimester) with laboratory‐confirmed SARS‐CoV‐2 infection were included. Most (76.5%) women experienced mild disease. Maternal fatality, stillbirth, and neonatal fatality rates were 1.6%, 1.4%, and 1.0%, respectively. Older age, obesity, diabetes mellitus, and raised serum D‐dimer and interleukin‐6 were predictive of poor outcomes. Overall, 33.7% of live births were preterm, of which half were iatrogenic among women with mild COVID‐19 and no complications. Most women underwent cesarean despite lacking a clear indication. Eight (2.0%) neonates had positive nasopharyngeal swabs after delivery and developed chest infection within 48 hours. Conclusions Advanced gestation, maternal age, obesity, diabetes mellitus, and a combination of elevated D‐dimer and interleukin‐6 levels are predictive of poor pregnancy outcomes in COVID‐19. The rate of iatrogenic preterm birth and cesarean delivery is high; vertical transmission may be possible but has not been proved.

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Association of SARS-CoV-2 Infection With Serious Maternal Morbidity and Mortality From Obstetric Complications

Metz

Clifton

Hughes

et al. 2022

JAMA

192

157

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Placental Pathology in Covid-19 Positive Mothers: Preliminary Findings

Cited by 298 publications

References 9 publications

Further placental pathology in mild COVID-19 of term pregnancy with pathophysiological correlates

Further placental pathology in mild COVID-19 of term pregnancy with pathophysiological correlates

Clinical characteristics, prognostic factors, and maternal and neonatal outcomes of SARS‐CoV‐2 infection among hospitalized pregnant women: A systematic review

Association of SARS-CoV-2 Infection With Serious Maternal Morbidity and Mortality From Obstetric Complications

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