ABSTRACT
Background: Adverse perinatal outcomes in patients with novel coronavirus infection (COVID-19) have been described in isolated cases. The ongoing effect of the virus on the body necessitates the accumulation of information on the causes of complications during the gestation period, especially in mild and moderate disease forms that do not lead to severe respiratory and multiple organ failure, which is important for managing pregnancy and developing measures to prevent adverse perinatal outcomes in patients with COVID-19. Case report: The paper describes 2 cases of antenatal fetal death in pregnant patients with mild and moderate COVID-19 and a familial history of non-developing pregnancies that occurred in the third wave of the epidemic process. One patient was recorded to have antenatal fetal death that occurred at 37–38 weeks’ gestation with a birth weight of 2670 g and the other patient had that at 23–24 weeks’ gestation with a birth weight of 520 g in the late stages of the disease (days 9 and 13, respectively). These patients are described to have placental morphological alterations;there was a preponderance of the signs of severe maternal vascular malperfusion as thrombosis in the intervillous space with massive fibrin deposits;large hematomas and infarcts, extensive numerous areas of fibrinoid villous agglutination and an inflammatory reaction. At the same time, the standard methods were used to detect viral RNA in the tissues of the placenta, fetal lungs, and maternal nasopharynx. Conclusion: The analysis of each antenatal fetal death case in pregnant patients with COVID-19 is the basis for the formation of recommendations for the prevention of perinatal complications.