SARS-CoV-2 Infection in Pregnancy: Clinical Signs, Placental Pathology, and Neonatal Outcome—Implications for Clinical Care

Introduction: The current COVID-19 pandemic has been associated with high rates of mortality and significant morbidity. Both the risk of infection for pregnant women and the risk of vertical transmission have been evaluated, and the presence of the SARS-CoV-2 virus has been demonstrated both in the...

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Autores principales: Sascia Moresi, Marco Dell'Aquila, Silvia Salvi, Roberta Rullo, Stefano Fruci, Francesca Stollagli, Vincenzo Arena, Antonio Lanzone
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Publicado: Frontiers Media S.A. 2021
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spelling oai:doaj.org-article:330790d4058541888c6a785ed9d462142021-11-08T04:58:14ZSARS-CoV-2 Infection in Pregnancy: Clinical Signs, Placental Pathology, and Neonatal Outcome—Implications for Clinical Care2296-858X10.3389/fmed.2021.676870https://doaj.org/article/330790d4058541888c6a785ed9d462142021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fmed.2021.676870/fullhttps://doaj.org/toc/2296-858XIntroduction: The current COVID-19 pandemic has been associated with high rates of mortality and significant morbidity. Both the risk of infection for pregnant women and the risk of vertical transmission have been evaluated, and the presence of the SARS-CoV-2 virus has been demonstrated both in the placenta and in the amniochorionic membranes. However, the actual effects of this pathogen on pregnancy and on placental morphology are still unclear.Objective: To describe histopathologic findings in the placentas of women with SARS-CoV-2 infection during pregnancy and their correlation with clinical signs and perinatal outcome.Methods: Placental tissues from pregnant women with SARS-CoV-2 infection delivering between March 2020 and February 2021 were analyzed.Results: One hundred six placentas from women with SARS-CoV-2 infection during pregnancy who delivered in Fondazione Policlinico A. Gemelli were examined. Most of them were asymptomatic. All neonates had available test results for SARS-CoV-2 and only one resulted positive. Placental tissues mainly showed signs of maternal vascular malperfusion and of placenta injury in terms of syncytial node increase (96.2%), villar agglutination (77.3%), neointimal hyperplasia (76.4%), excessive fibrin deposition (43.3%), and chorangiosis (35.8%). No significant differences in the frequency of the histopathological lesions were observed according to maternal symptoms.Conclusion: Looking to placental tissues from SARS-CoV-2 positive women at the screening performed close to delivery, placental injuries could be detected without any correlation with fetal and neonatal outcomes. We hypothesize that short latency between SARS-CoV-2 infection and delivery is the main reason for these observations.Sascia MoresiMarco Dell'AquilaSilvia SalviRoberta RulloRoberta RulloStefano FruciStefano FruciFrancesca StollagliVincenzo ArenaAntonio LanzoneAntonio LanzoneFrontiers Media S.A.articlepregnancySARS-CoV-2placentachronic histiocytic intervillositistransplacental transmission of virusesMedicine (General)R5-920ENFrontiers in Medicine, Vol 8 (2021)
institution DOAJ
collection DOAJ
language EN
topic pregnancy
SARS-CoV-2
placenta
chronic histiocytic intervillositis
transplacental transmission of viruses
Medicine (General)
R5-920
spellingShingle pregnancy
SARS-CoV-2
placenta
chronic histiocytic intervillositis
transplacental transmission of viruses
Medicine (General)
R5-920
Sascia Moresi
Marco Dell'Aquila
Silvia Salvi
Roberta Rullo
Roberta Rullo
Stefano Fruci
Stefano Fruci
Francesca Stollagli
Vincenzo Arena
Antonio Lanzone
Antonio Lanzone
SARS-CoV-2 Infection in Pregnancy: Clinical Signs, Placental Pathology, and Neonatal Outcome—Implications for Clinical Care
description Introduction: The current COVID-19 pandemic has been associated with high rates of mortality and significant morbidity. Both the risk of infection for pregnant women and the risk of vertical transmission have been evaluated, and the presence of the SARS-CoV-2 virus has been demonstrated both in the placenta and in the amniochorionic membranes. However, the actual effects of this pathogen on pregnancy and on placental morphology are still unclear.Objective: To describe histopathologic findings in the placentas of women with SARS-CoV-2 infection during pregnancy and their correlation with clinical signs and perinatal outcome.Methods: Placental tissues from pregnant women with SARS-CoV-2 infection delivering between March 2020 and February 2021 were analyzed.Results: One hundred six placentas from women with SARS-CoV-2 infection during pregnancy who delivered in Fondazione Policlinico A. Gemelli were examined. Most of them were asymptomatic. All neonates had available test results for SARS-CoV-2 and only one resulted positive. Placental tissues mainly showed signs of maternal vascular malperfusion and of placenta injury in terms of syncytial node increase (96.2%), villar agglutination (77.3%), neointimal hyperplasia (76.4%), excessive fibrin deposition (43.3%), and chorangiosis (35.8%). No significant differences in the frequency of the histopathological lesions were observed according to maternal symptoms.Conclusion: Looking to placental tissues from SARS-CoV-2 positive women at the screening performed close to delivery, placental injuries could be detected without any correlation with fetal and neonatal outcomes. We hypothesize that short latency between SARS-CoV-2 infection and delivery is the main reason for these observations.
format article
author Sascia Moresi
Marco Dell'Aquila
Silvia Salvi
Roberta Rullo
Roberta Rullo
Stefano Fruci
Stefano Fruci
Francesca Stollagli
Vincenzo Arena
Antonio Lanzone
Antonio Lanzone
author_facet Sascia Moresi
Marco Dell'Aquila
Silvia Salvi
Roberta Rullo
Roberta Rullo
Stefano Fruci
Stefano Fruci
Francesca Stollagli
Vincenzo Arena
Antonio Lanzone
Antonio Lanzone
author_sort Sascia Moresi
title SARS-CoV-2 Infection in Pregnancy: Clinical Signs, Placental Pathology, and Neonatal Outcome—Implications for Clinical Care
title_short SARS-CoV-2 Infection in Pregnancy: Clinical Signs, Placental Pathology, and Neonatal Outcome—Implications for Clinical Care
title_full SARS-CoV-2 Infection in Pregnancy: Clinical Signs, Placental Pathology, and Neonatal Outcome—Implications for Clinical Care
title_fullStr SARS-CoV-2 Infection in Pregnancy: Clinical Signs, Placental Pathology, and Neonatal Outcome—Implications for Clinical Care
title_full_unstemmed SARS-CoV-2 Infection in Pregnancy: Clinical Signs, Placental Pathology, and Neonatal Outcome—Implications for Clinical Care
title_sort sars-cov-2 infection in pregnancy: clinical signs, placental pathology, and neonatal outcome—implications for clinical care
publisher Frontiers Media S.A.
publishDate 2021
url https://doaj.org/article/330790d4058541888c6a785ed9d46214
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