Placental lesions and SARS-Cov-2 infection: Diffuse placenta damage associated to poor fetal outcome
| Autor: | Jérôme Massardier, Fabienne Allias, Maude Bouscambert Duchamp, Yahia Mekki, Amine Bouachba, Cyril Huissoud, Alexis Trecourt, Beatrice Nadaud, Sophie Collardeau-Frachon, Benoit De La. Fourniere |
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| Přispěvatelé: | Hospices Civils de Lyon (HCL), Société Française de Foetopathologie [Paris] (SOFFOET), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hôpital Femme Mère Enfant [CHU - HCL] (HFME), Hôpital de la Croix-Rousse [CHU - HCL], Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CarMeN, laboratoire |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Pathology Placenta Diseases Amniotic fluid Perinatal Death Placenta SARS-Cov-2 [SDV]Life Sciences [q-bio] Histopathology Article Pregnancy medicine sFLT1/PIGF Humans Pregnancy Complications Infectious Diffuse alveolar damage Fetal Death Fetus business.industry Prenatal ultrasounds Infant Newborn Pregnancy Outcome Obstetrics and Gynecology Trophoblast COVID-19 Stillbirth medicine.disease Trophoblasts [SDV] Life Sciences [q-bio] medicine.anatomical_structure Reproductive Medicine Chronic histiocytic intervillositis embryonic structures Premature Birth Female France Fetal demise business Developmental Biology |
| Zdroj: | Placenta Placenta, Elsevier, 2021, 112, pp.97-104. ⟨10.1016/j.placenta.2021.07.288⟩ |
| ISSN: | 0143-4004 |
| DOI: | 10.1016/j.placenta.2021.07.288⟩ |
| Popis: | International audience; INTRODUCTION: Pregnant women with covid-19 are more likely to experience preterm birth. The virus seems to be associated with a wide range of placental lesions, none of them specific. METHOD: We collected cases of Covid-19 maternal infection during pregnancy associated with poor pregnancy outcomes, for which we received the placenta. We studied clinical data and described pathological findings of placenta and post-mortem examination of fetuses. We performed an immunohistochemical study and RT-PCR of SARS-Cov-2 on placenta samples. RESULTS: We report 5 cases of poor fetal outcome, 3 fetal deaths and 2 extreme premature neonates, one with growth restriction, without clinical and biological sign of SARS-Cov-2 infection. All placenta presented massive perivillous fibrin deposition and large intervillous thrombi associated with strong SARS-Cov-2 expression in trophoblast and SARS-CoV-2 PCR positivity in amniotic fluid or on placenta samples. Chronic histiocytic intervillositis was present in 4/5 cases. Placental ultrasound was abnormal and the sFLT1-PIGF ratio was increased in one case. Timing between mothers' infection and the poor fetal outcome was ≤10 days in 4 cases. The massive placental damage are directly induced by the virus whose receptors are expressed on trophoblast, leading to trophoblast necrosis and massive inflammation in villous chamber, in a similar way it occurs in diffuse alveolar damage in adults infected by SARS-Cov-2. DISCUSSION: SARS-Cov-2 can be associated to a rare set of placental lesions which can lead to fetal demise, preterm birth, or growth restriction. Stronger surveillance of mothers infected by SARS-Cov-2 is required. |
| Databáze: | OpenAIRE |
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