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Clinical-pathologic...
Clinical-pathological features in placentas of pregnancies with SARS-CoV-2 infection and adverse outcome: case series with and without congenital transmission
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- Zaigham, Mehreen (author)
- Lund University,Lunds universitet,Obstetrik och gynekologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Obstetrics and Gynaecology (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital,Lund Univ, Inst Clin Sci Lund, Obstet & Gynaecol, Lund, Sweden.;Skane Univ Hosp, Dept Obstet & Gynaecol, Lund, Sweden
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- Gisselsson, David (author)
- Lund University,Lunds universitet,Avdelningen för klinisk genetik,Institutionen för laboratoriemedicin,Medicinska fakulteten,Cancercellers evolution,Forskargrupper vid Lunds universitet,Division of Clinical Genetics,Department of Laboratory Medicine,Faculty of Medicine,Pathways of cancer cell evolution,Lund University Research Groups,Skåne University Hospital,Skane Univ Hosp, Lab Med, Clin Genet & Pathol, Lund, Sweden.;Lund Univ, Dept Lab Med, Div Clin Genet, Lund, Sweden
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- Sand, A. (author)
- Karolinska Institute,Karolinska Institutet,Karolinska University Hospital,Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Obstet & Gynaecol, Stockholm, Sweden
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- Wikström, Anna-Karin, 1965- (author)
- Uppsala universitet,Uppsala University,Klinisk obstetrik,Uppsala Univ, Sweden
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- von Wowern, Emma (author)
- Lund University,Lunds universitet,Perinatal och kardiovaskulär epidemiologi,Forskargrupper vid Lunds universitet,Perinatal and cardiovascular epidemiology,Lund University Research Groups,Skåne University Hospital,Skane Univ Hosp, Dept Obstet & Gynaecol, Lund, Sweden.;Lund Univ, Inst Clin Sci Malmö, Perinatal & Cardiovasc Epidemiol, Lund, Sweden
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- Schwartz, D. A. (author)
- Medical College of Georgia,Augusta Univ, Med Coll Georgia, Dept Pathol, Augusta, GA USA
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- Iorizzo, Linda (author)
- Lund University,Lunds universitet,Obstetrik och gynekologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Obstetrics and Gynaecology (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Helsingborg Hospital,Lund Univ, Helsingborg Hosp, Dept Obstet & Gynaecol, Dept Clin Sci Helsingborg, Lund, Sweden
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- Nelander, Maria (author)
- Uppsala universitet,Uppsala University,Klinisk obstetrik,Uppsala Univ, Sweden
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- Blomberg, Marie (author)
- Linköpings universitet,Linköping University,Linköping Univ, Dept Obstet & Gynaecol, Linköping, Sweden.;Linköping Univ, Dept Biomed & Clin Sci, Linköping, Sweden,Avdelningen för barns och kvinnors hälsa,Medicinska fakulteten,Region Östergötland, Kvinnokliniken US
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- Papadogiannakis, N. (author)
- Karolinska Institutet,Karolinska University Hospital,Karolinska Univ Hosp, Karolinska Inst, Dept Lab Med, Div Pathol, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Pathol, Stockholm, Sweden
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- Holmström, Sandra (author)
- Hallands sjukhus, Varberg,Aarhus University Hospital,Sparbanksstiftelsen i Varberg,Halland Hosp, Dept Obstet & Gynaecol, Varberg, Sweden
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- Leijonhfvud, A. (author)
- Lund University,Lund Univ, Helsingborg Hosp, Dept Obstet & Gynaecol, Dept Clin Sci Helsingborg, Lund, Sweden
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- Sengpiel, Verena, 1977 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för obstetrik och gynekologi,Institute of Clinical Sciences, Department of Obstetrics and Gynecology,Gothenburg Responsibility Project, Gothenburg University,Univ Gothenburg, Sahlgrenska Acad, Dept Obstet & Gynaecol, Gothenburg, Sweden.;Sahlgrens Univ Hosp, Dept Obstet & Gynaecol, Reg Vastra Gotaland, Gothenburg, Sweden
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(creator_code:org_t)
- 2022-04-22
- 2022
- English.
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In: BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY. - : Wiley. - 1470-0328 .- 1471-0528. ; 129:8, s. 1361-1374
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Abstract
Subject headings
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- Objective To correlate clinical outcomes to pathology in SARS-CoV-2 infected placentas in stillborn and live-born infants presenting with fetal distress. Design Retrospective, observational. Setting Nationwide. Population Five stillborn and nine live-born infants from 13 pregnant women infected with SARS-CoV-2 seeking care at seven different maternity units in Sweden. Methods Clinical outcomes and placental pathology were studied in 14 cases (one twin pregnancy) of maternal SARS-CoV-2 infection with impaired fetal outcome. Outcomes were correlated to placental pathology in order to investigate the impact of virus-related pathology on the villous capillary endothelium, trophoblast and other cells. Main outcome measures Maternal and fetal clinical outcomes and placental pathology in stillborn and live-born infants. Results Reduced fetal movements were reported (77%) and time from onset of maternal COVID-19 symptoms to signs of fetal distress among live-born infants was 6 (3-12) days and to diagnosis of stillbirth 11 (2-25) days. Two of the live-born infants died during the postnatal period. Signs of fetal distress led to emergency caesarean section in all live-born infants with umbilical cord blood gases and low Apgar scores confirming intrauterine hypoxia. Five stillborn and one live-born neonate had confirmed congenital transmission. Massive perivillous fibrinoid deposition, intervillositis and trophoblast necrosis were associated with SARS-CoV-2 placental infection and congenital transmission. Conclusions SARS-CoV-2 can cause rapid placental dysfunction with subsequent acute fetal hypoxia leading to intrauterine fetal compromise. Associated placental pathology included massive perivillous fibrinoid deposition, intervillositis and trophoblast degeneration.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reproduktionsmedicin och gynekologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Obstetrics, Gynaecology and Reproductive Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Infectious Medicine (hsv//eng)
Keyword
- chronic histiocytic intervillositis
- coronavirus
- COVID-19
- COVID-19
- maternal-fetal transmission
- fetal distress
- maternal floor infarction
- placental endothelial cells
- placental pathology
- SARS-CoV-2
- SARS-CoV-2
- placental infection
- vertical SARS-CoV-2 transmission
- villous
- macrophages
- maternal floor infarction
- fetal
- association
- covid-19
- Obstetrics & Gynecology
- chronic histiocytic intervillositis
Publication and Content Type
- ref (subject category)
- art (subject category)
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Zaigham, Mehreen
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Gisselsson, Davi ...
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Sand, A.
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Wikström, Anna-K ...
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von Wowern, Emma
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Schwartz, D. A.
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Iorizzo, Linda
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Nelander, Maria
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Blomberg, Marie
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Papadogiannakis, ...
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Holmström, Sandr ...
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Leijonhfvud, A.
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Sengpiel, Verena ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Obstetrics Gynae ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Infectious Medic ...
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BJOG-AN INTERNAT ...
- By the university
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University of Gothenburg
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Karolinska Institutet
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Lund University
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Uppsala University
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Linköping University