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Placental lesions and SARS-Cov-2 infection: Diffuse placenta damage associated to poor fetal outcome.
Bouachba, Amine; Allias, Fabienne; Nadaud, Beatrice; Massardier, Jerome; Mekki, Yahia; Bouscambert Duchamp, Maude; Fourniere, Benoit De LA; Huissoud, Cyril; Trecourt, Alexis; Collardeau-Frachon, Sophie.
  • Bouachba A; Institut de Pathologie Multisite des Hospices Civils de Lyon, 69677, Bron Cedex, Lyon, France; SOFFOET-Société Française de Fœtopathologie, 75014, Paris, France. Electronic address: bouachba.amine@gmail.com.
  • Allias F; SOFFOET-Société Française de Fœtopathologie, 75014, Paris, France; Institut de Pathologie, Centre hospitalier Lyon Sud, Hospices Civils de Lyon, 69495, Pierre Bénite, Lyon, France.
  • Nadaud B; Institut de Pathologie Multisite des Hospices Civils de Lyon, 69677, Bron Cedex, Lyon, France; SOFFOET-Société Française de Fœtopathologie, 75014, Paris, France.
  • Massardier J; SOFFOET-Société Française de Fœtopathologie, 75014, Paris, France; Service de gynécologie-obstétrique de l'Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, 69677, Bron Cedex, Lyon, France.
  • Mekki Y; Institut des Agents Infectieux des Hospices Civils de Lyon, Service de Virologie, 69004, Lyon, France.
  • Bouscambert Duchamp M; Institut des Agents Infectieux des Hospices Civils de Lyon, Service de Virologie, 69004, Lyon, France.
  • Fourniere B; Service de Gynécologie-obstétrique de La Croix-Rousse, Hospices Civils de Lyon, 69004, Lyon, France.
  • Huissoud C; Service de Gynécologie-obstétrique de La Croix-Rousse, Hospices Civils de Lyon, 69004, Lyon, France; Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Est, 69008, France.
  • Trecourt A; Institut de Pathologie Multisite des Hospices Civils de Lyon, 69677, Bron Cedex, Lyon, France.
  • Collardeau-Frachon S; Institut de Pathologie Multisite des Hospices Civils de Lyon, 69677, Bron Cedex, Lyon, France; SOFFOET-Société Française de Fœtopathologie, 75014, Paris, France; Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Est, 69008, France.
Placenta ; 112: 97-104, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1333705
ABSTRACT

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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Placenta Diseases / Premature Birth / Stillbirth / COVID-19 Type of study: Case report / Diagnostic study / Prognostic study Topics: Long Covid Limits: Adult / Female / Humans / Male / Infant, Newborn / Pregnancy Country/Region as subject: Europa Language: English Journal: Placenta Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Placenta Diseases / Premature Birth / Stillbirth / COVID-19 Type of study: Case report / Diagnostic study / Prognostic study Topics: Long Covid Limits: Adult / Female / Humans / Male / Infant, Newborn / Pregnancy Country/Region as subject: Europa Language: English Journal: Placenta Year: 2021 Document Type: Article