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SARS-CoV-2 placentitis: An uncommon complication of maternal COVID-19

We present a case of third trimester pregnancy with SARS-CoV-2 infection and reduced fetal movements. Placental histology showed SARS-CoV-2 placentitis that may be a marker of potential vertical transmission, possibly causing fetal compromise through placental injury.

Authors
Laura Linehan, Keelin O'Donoghue, Brendan Fitzgerald
Year
2021
Journal Name
Placenta
Category
Journal Article
Keywords
COVID-19
Full Citation
Linehan L, O'Donoghue K, Dineen S, White J, Higgins JR, Fitzgerald B. SARS-CoV-2 placentitis: An uncommon complication of maternal COVID-19. Placenta. 2021;104: 261-266. https://doi.org/10.1016/j.placenta.2021.01.012.
Link to Publication
https://doi.org/10.1016/j.placenta.2021.01.012

Abstract

This case study examined a woman in the third trimester who was unwell with SARS-Cov-2. She noted reduced fetal movements and presented to hospital, where fetal monitoring was not reassuring and prompted emergency Caesarean section. Placental examination after delivery showed an abnormal placenta that was inflamed and had areas of fibrosis (scarring) which occupied a quarter of the placenta. This scarring was as a result of inflammation caused by the SARS-Cov-2 infection. This suggests that SARS-Cov-2 can infect the placenta and may potentially cause harm to the baby when the placenta becomes fibrosed (scarred), affecting the blood supply to the baby. This could result in reduced growth or even fetal death. This paper also discusses the other case reports of SARS-Cov-2 placental infections at the time (early in the pandemic). Based on this case and the supporting evidence, we suggest that the inflammation we found, “chronic histiocytic intervillositis”, may be specific to SARS-Cov-2 and that pregnant women with COVID-19 should receive extra monitoring of their baby after infection, particularly if they have reduced movements.

Pregnancy Loss Research Group

Pregnancy Loss Research Group, Department of Obstetrics & Gynaecology, University College Cork, Fifth Floor, Cork University Maternity Hospital, Wilton, Cork, T12 YE02, Ireland,

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