ABSTRACT
Introduction: Viral infections in pregnant mothers can result in neurological disorders. Because of this, it is important to establish that there is fetal brain affectation due to COVID-19. Objective: To establish a direct and indirect relationship between SARS-CoV-2 infection during pregnancy, and adverse results on perinatalneurologicaldevelopment, as much as psychological long-term results. Material and methods: A narrative review of available evidence linked to the placenta and SARS-CoV-2 relationship, fetal brain physiopathology, and neuropsychiatric affectation was performed using PubMed, LILACS, and Google Scholar databases, on the time lapse between January 1997 to June 2022. Results: 66 studies with methodology, qualitative representability, and citation impact, according to the present research´s objective, were reviewed. Evidence review over COVID-19 and fetal central nervous system (CNS), establishes that chronic histiocytic intervillositis and trophoblast necrosis are risk factors for placental infection by SARS-CoV-2, viral vertical transmission, and breach of the maternal barrier-fetal. Fetal brain expression of protein S receptors suggests fetal brain incursion of SARS-CoV-2 in infected pregnancies, especially during the second and third trimesters of pregnancy. Infections during critical periods of early fetal neurodevelopment have been shown to increase the likelihood of neurodegenerative and neurobehavioral disorders, including autism or autism spectrum disorders (ASDs), and psychiatric illnesses in offspring. Conclusion: Evidence supports the possibility to establish a direct and indirect relationship between SARS-CoV-2 infection during pregnancy, and adverse results on perinatalneurologicaldevelopment, as much as psychological long-term results. © 2022 Academia Nacional de Medicina. All rights reserved.
ABSTRACT
COVID-19 infection is novel, so data on clinical presentation during pregnancy and perinatal outcomes are scarce. The types of cells in the placenta that express ECA2 are the syncytiotrophoblast and cytotrophoblast in chorionic villi, decidual stromal cells, perivascular decidual cells, and endothelial and vascular smooth muscle cells. Histopathological findings report placental involvement in all trimesters. Chronic histiocytic intervillositis and trophoblast necrosis are risk factors for placental infection by SARS-CoV-2, viral vertical transmission, and trespassing the maternal-fetal barrier. The success rate of transplacental viral infection (intrauterine transmission) to the fetus appears to be low. The fetal brain during the second and third trimesters of pregnancy may be vulnerable to SARS-CoV-2 infection. © 2022 Academia Nacional de Medicina. All rights reserved.
ABSTRACT
Pregnant women who have COVID-19 have an increased risk of hospitalization and death;however, there are many restrictions for the application of COVID-19 vaccines on pregnant patients, mainly because there is no confirmation of the safety of their use during pregnancy. None of the vaccines approved to date are based on live attenuated SARS-CoV-2, so the possibility of generating an infection in the fetus is nonexistent. Likewise, current evidence does not suggest that COVID-19 vaccines can induce a complication or adverse pregnancy outcome and due to the emergence of new waves of COVID-19, the potential protective benefits of these vaccines far outweigh the possible risks in most patients. A review of the evidence of the safety of COVID-19 vaccines, recommendations, and restrictions for the use of COVID-19 vaccines in pregnant women made by international health organisms and professional associations, as well as prospects and information on clinical trials of these vaccines in pregnant women are presented. © 2021 Academia Nacional de Medicina. All rights reserved.
ABSTRACT
Introduction: Fetus and placenta are an immunologically privileged unit, whose physiological changes during pregnancy intervenes in the behavior against SARS-CoV- 2, describing a theoretical potential teratogenic damage due to receptors ACE-2 expression, necessary for SARS-CoV-2 intracellular transport in the epiblast, vital in organogenesis, as well as the current pharmacological therapy teratogenic effects, abortions, and fetal demise. Early Chinese reports pointed to the unlikely vertical transmission, however, the diagnostic test’s low sensibility with the serological detection in fetal and neonatal blood samples of IgM Anti- E SARS-CoV-2 and IL-6 caused great controversy. Purpose of the study: To resume current data about fetal risks (real or potential) from a viral agent, pharmacological therapy, or placental damage from a worldwide literature data review. M ethods: Articles in all languages about the SARS-CoV-2 infection in pregnant women and fetuses as a patient searched from LILACS, PUBMED, and Google Scholar from March 2020 to February 2021 were review. Conclusion: A year later, it is seen that the placental damage is maternal and fetal vascular bad perfusion, like preeclampsia and chorioamnionitis, endothelitis, thrombosis, and inflammation, reconsidering fetal surveillance in COVID-19 pregnant women. © 2021 Academia Nacional de Medicina. All rights reserved.
ABSTRACT
The relationship of COVID-19 and pregnancy implies a novel clinical condition, information regarding the true medical picture is currently being collected. The present work aims to carry out a review of the most prominent publications on COVID-19 and Pregnancy: epidemiology and clinical evolution based on currently available evidence. The risk of infection in the pregnant woman, clinical findings, infection by gestation trimester and risks, risk of perinatal death, cesarean section and delivery, and finally maternal risk of admission to intensive care, mechanical ventilation, and death are summarized. © 2021 Academia Nacional de Medicina. All rights reserved.