COVID-19 as an independent risk factor for subclinical placental dysfunction
| Autor: | Manju Puri, Barkha Vats, Narendra Tiwary, Reena Yadav, Smita Singh, Prerna Tayal, Kiran Agarwal, Nishtha Jaiswal |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Placenta Diseases Placenta Asymptomatic SARS-CoV-2 infection Severity of Illness Index Asymptomatic Young Adult Placental changes Pregnancy Full Length Article Ectasia Obstetrics and Gynaecology Birth Weight Humans Medicine Prospective Studies Pregnancy Complications Infectious Fibrinoid necrosis Subclinical infection Fetus SARS-CoV-2 business.industry Obstetrics Infant Newborn Pregnancy Outcome COVID-19 Obstetrics and Gynecology Gestational age medicine.disease medicine.anatomical_structure Neonatal outcomes Reproductive Medicine Case-Control Studies Carrier State Female medicine.symptom business |
| Zdroj: | European Journal of Obstetrics & Gynecology and Reproductive Biology European Journal of Obstetrics, Gynecology, and Reproductive Biology |
| ISSN: | 0301-2115 |
| DOI: | 10.1016/j.ejogrb.2021.01.049 |
| Popis: | Background The pandemic of the severe acute respiratory distress syndrome-associated Coronavirus-2 (SARS-CoV-2) has affected millions around the world. In pregnancy the dangers to the mother and fetus are still being explored. SARS-CoV2 can potentially compromise maternal and neonatal outcomes and this may be dependent on the pregnancy stage during which the infection occurs. Objective The present study was done to find the histopathological alterations in the placenta of SARS-CoV-2 positive pregnancies with either no symptoms or mild coronavirus disease (COVID)-19 related symptoms and its association with neonatal outcomes. Study design This was a prospective analytical study. Twenty seven asymptomatic or mildly symptomatic SARS-CoV-2 positive pregnant women with a singleton pregnancy delivered between 1st July 2020 and 15th September 2020, were included as cases. An equal number of SARS-CoV-2 negative singleton pregnancies matched for maternal and gestational age during the same period were included as controls. After delivery the histopathological examination of the placenta of these women was done and the findings recorded on a predesigned proforma based on the Amsterdam consensus criteria for evidence of maternal and fetal vascular malperfusion changes. Results The baseline characteristics were comparable between the cases and controls. The following features of maternal vascular malperfusion (MVM) were significantly higher in the placentae of COVID-19 positive pregnancies: retroplacental hematomas (RPH), accelerated villous maturation (AVM), distal villous hyperplasia (DVH), atherosis, fibrinoid necrosis, mural hypertrophy of membrane arterioles (MHMA), vessel ectasia and persistence of intramural endovascular trophoblast (PIEVT). Fetal vascular malperfusion (FVM) significantly associated with the positive pregnancies were chorioangiosis, thrombosis of the fetal chorionic plate (TFCP), intramural fibrin deposition (IMFD) and vascular ectasia. Additionally, perivillous fibrin deposition was also significantly higher in the placentae of cases. The percentage of spontaneously delivered women was comparable in the two groups. The sex and weight of the newborn and the number of live births were comparable between the two groups. Conclusions Asymptomatic or mildly symptomatic SARS-CoV-2 positive pregnant women, with otherwise uncomplicated pregnancies, show evidence of placental injury at a microscopic level. Similar findings have been demonstrated in other studies too. This placental injury apparently does not lead to poor pregnancy outcomes. The extent of this injury in symptomatic cases of COVID-19 pregnancies and its consequences on the outcomes need to be analysed. |
| Databáze: | OpenAIRE |
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