Intrauterine fetal death in a COVID positive pregnant woman: a case report and literature review.

SARS-CoV-2 disease mechanisms are not yet fully understood, especially in cases affecting pregnant women. In fact, although they suffer from the same symptoms as non-pregnant women, they are more susceptible to adverse outcomes of COVID-19 as well as pregnancy complications leading to stillbirth, premature rupture of membrane, or intrauterine fetal demise (IUFD). The consequences on pregnancy are not clearly correlated with the severity of the infection. We present a case of fetal death in a 30-year-old woman with a confirmed SARS-CoV-2 infection without any other significant clinical or obstetric disorders. A histopathological examination of the placenta indicated massive and diffuse intervillar fibrinoid deposits associated with chronic histiocytic intervillositis that can be associated with SARS-CoV-2 placentitis. Given the high rates of SARS-CoV-2 infections in pregnancy, it is important to understand the factors that determine negative pregnancy outcomes, regardless of the severity of the patient's symptoms.

Lung Ultrasound Signs and Their Correlation With Clinical Symptoms in COVID-19 Pregnant Women: The "PINK-CO" Observational Study.

OBJECTIVE: To analyze the application of lung ultrasound (LUS) diagnostic approach in obstetric patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and compare LUS score and symptoms of the patients. DESIGN: A single-center observational retrospective study from October 31, 2020 to March 31, 2021. SETTING: Department of Ob/Gyn at the University-Hospital of Udine, Italy. PARTICIPANTS: Pregnant women with SARS-CoV-2 diagnosed with reverse transcription-PCR (RT-PCR) swab test were subdivided as symptomatic and asymptomatic patients with COVID-19. EXPOSURE: Lung ultrasound evaluation both through initial evaluation upon admission and through serial evaluations. MAIN OUTCOME: Reporting LUS findings and LUS score characteristics. RESULTS: Symptomatic patients with COVID-19 showed a higher LUS (median 3.5 vs. 0, p < 0.001). LUS was significantly correlated with COVID-19 biomarkers as C-reactive protein (CPR; p = 0.011), interleukin-6 (p = 0.013), and pro-adrenomedullin (p = 0.02), and inversely related to arterial oxygen saturation (p = 0.004). The most frequent ultrasound findings were focal B lines (14 vs. 2) and the light beam (9 vs. 0). CONCLUSION: Lung ultrasound can help to manage pregnant women with SARS-CoV-2 infection during a pandemic surge. STUDY REGISTRATION: ClinicalTrials.gov, NCT04823234. Registered on March 29, 2021.