| Literature DB >> 35142798 |
David A Schwartz1, Elyzabeth Avvad-Portari2, Pavel Babál3, Marcella Baldewijns4, Marie Blomberg5, Amine Bouachba6,7, Jessica Camacho8, Sophie Collardeau-Frachon7,9, Arthur Colson10, Isabelle Dehaene11, Joan Carles Ferreres12,13, Brendan Fitzgerald14, Marta Garrido-Pontnou8,15, Hazem Gergis16, Beata Hargitai17, A Cecilia Helguera-Repetto18, Sandra Holmström19, Claudine Liliane Irles20, Åsa Leijonhfvud21, Sasha Libbrecht22, Tamás Marton23, Noel McEntagart24, James T Molina25, Raffaella Morotti26, Alfons Nadal27,28, Alexandra Navarro8, Maria Nelander29, Angelica Oviedo30, Andre Ricardo Oyamada Otani31, Nikos Papadogiannakis32,33, Astrid C Petersen34, Drucilla J Roberts35, Ali G Saad36, Anna Sand37,38, Sam Schoenmakers39, Jennifer K Sehn40, Preston R Simpson41, Kristen Thomas42, M Yolotzin Valdespino-Vázquez43, Lotte E van der Meeren44,45, Jo Van Dorpe46, Robert M Verdijk39, Jaclyn C Watkins35, Mehreen Zaigham47,48.
Abstract
CONTEXT.—: Perinatal death is an increasingly important problem as the coronavirus disease 2019 (COVID-19) pandemic continues, but the mechanism of death has been unclear. OBJECTIVE.—: To evaluate the role of the placenta in causing stillbirth and neonatal death following maternal infection with COVID-19 and confirmed placental positivity for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). DESIGN.—: Case-based retrospective clinicopathologic analysis by a multinational group of 44 perinatal specialists from 12 countries of placental and autopsy pathology findings from 64 stillborns and 4 neonatal deaths having placentas testing positive for SARS-CoV-2 following delivery to mothers with COVID-19. RESULTS.—: Of the 3 findings constituting SARS-CoV-2 placentitis, all 68 placentas had increased fibrin deposition and villous trophoblast necrosis and 66 had chronic histiocytic intervillositis. Sixty-three placentas had massive perivillous fibrin deposition. Severe destructive placental disease from SARS-CoV-2 placentitis averaged 77.7% tissue involvement. Other findings included multiple intervillous thrombi (37%; 25 of 68) and chronic villitis (32%; 22 of 68). The majority (19; 63%) of the 30 autopsies revealed no significant fetal abnormalities except for intrauterine hypoxia and asphyxia. Among all 68 cases, SARS-CoV-2 was detected from a body specimen in 16 of 28 cases tested, most frequently from nasopharyngeal swabs. Four autopsied stillborns had SARS-CoV-2 identified in internal organs. CONCLUSIONS.—: The pathology abnormalities composing SARS-CoV-2 placentitis cause widespread and severe placental destruction resulting in placental malperfusion and insufficiency. In these cases, intrauterine and perinatal death likely results directly from placental insufficiency and fetal hypoxic-ischemic injury. There was no evidence that SARS-CoV-2 involvement of the fetus had a role in causing these deaths.Entities:
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Year: 2022 PMID： 35142798 DOI： 10.5858/arpa.2022-0029-SA
Source DB: PubMed Journal: Arch Pathol Lab Med ISSN： 0003-9985 Impact factor: 5.534