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Severe placental lesions due to maternal SARS-CoV-2 infection associated to intrauterine fetal death()
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can cause severe placental lesions leading rapidly to intrauterine fetal death (IUFD). From August 2020 to September 2021, in the pathology department of Toulouse Oncopole, we analyzed 50 placentas from COVID-19–positive unvaccin...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8730375/ https://www.ncbi.nlm.nih.gov/pubmed/34995674 http://dx.doi.org/10.1016/j.humpath.2021.12.012 |
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author | Dubucs, Charlotte Groussolles, Marion Ousselin, Jessie Sartor, Agnès Van Acker, Nathalie Vayssière, Christophe Pasquier, Christophe Reyre, Joëlle Batlle, Laïa Favarel clinical research associate, Stèphanie Duchanois midwife, Delphine Jauffret clinical research associate, Valèrie Courtade-Saïdi, Monique Aziza, Jacqueline |
author_facet | Dubucs, Charlotte Groussolles, Marion Ousselin, Jessie Sartor, Agnès Van Acker, Nathalie Vayssière, Christophe Pasquier, Christophe Reyre, Joëlle Batlle, Laïa Favarel clinical research associate, Stèphanie Duchanois midwife, Delphine Jauffret clinical research associate, Valèrie Courtade-Saïdi, Monique Aziza, Jacqueline |
author_sort | Dubucs, Charlotte |
collection | PubMed |
description | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can cause severe placental lesions leading rapidly to intrauterine fetal death (IUFD). From August 2020 to September 2021, in the pathology department of Toulouse Oncopole, we analyzed 50 placentas from COVID-19–positive unvaccinated mothers. The purpose of our study is to describe the clinicopathological characteristics of these placental damages and to understand the pathophysiology. Ten of them (20%) showed placental lesions with positive immunohistochemistry for SARS-CoV-2 in villous trophoblasts. In five cases (10%), we observed massive placental damage associating trophoblastic necrosis, fibrinous deposits, intervillositis, as well as extensive hemorrhagic changes due to SARS-CoV-2 infection probably responsible of IUFD by functional placental insufficiency. In five other cases, we found similar placental lesions but with a focal distribution that did not lead to IUFD but live birth. These lesions are independent of maternal clinical severity of COVID-19 infection because they occur despite mild maternal symptoms and are therefore difficult to predict. In our cases, they occurred 1–3 weeks after positive SARS-CoV-2 maternal real-time polymerase chain reaction testing and were observed in the 2nd and 3rd trimesters of pregnancies. When these lesions are focal, they do not lead to IUFD and can be involved in intrauterine growth restriction. Our findings, together with recent observations, suggest that future pregnancy guidance should include stricter pandemic precautions such as screening for a wider array of COVID-19 symptoms, enhanced ultrasound monitoring, as well as newborn medical surveillance. |
format | Online Article Text |
id | pubmed-8730375 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Elsevier Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-87303752022-01-06 Severe placental lesions due to maternal SARS-CoV-2 infection associated to intrauterine fetal death() Dubucs, Charlotte Groussolles, Marion Ousselin, Jessie Sartor, Agnès Van Acker, Nathalie Vayssière, Christophe Pasquier, Christophe Reyre, Joëlle Batlle, Laïa Favarel clinical research associate, Stèphanie Duchanois midwife, Delphine Jauffret clinical research associate, Valèrie Courtade-Saïdi, Monique Aziza, Jacqueline Hum Pathol Original Contribution Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can cause severe placental lesions leading rapidly to intrauterine fetal death (IUFD). From August 2020 to September 2021, in the pathology department of Toulouse Oncopole, we analyzed 50 placentas from COVID-19–positive unvaccinated mothers. The purpose of our study is to describe the clinicopathological characteristics of these placental damages and to understand the pathophysiology. Ten of them (20%) showed placental lesions with positive immunohistochemistry for SARS-CoV-2 in villous trophoblasts. In five cases (10%), we observed massive placental damage associating trophoblastic necrosis, fibrinous deposits, intervillositis, as well as extensive hemorrhagic changes due to SARS-CoV-2 infection probably responsible of IUFD by functional placental insufficiency. In five other cases, we found similar placental lesions but with a focal distribution that did not lead to IUFD but live birth. These lesions are independent of maternal clinical severity of COVID-19 infection because they occur despite mild maternal symptoms and are therefore difficult to predict. In our cases, they occurred 1–3 weeks after positive SARS-CoV-2 maternal real-time polymerase chain reaction testing and were observed in the 2nd and 3rd trimesters of pregnancies. When these lesions are focal, they do not lead to IUFD and can be involved in intrauterine growth restriction. Our findings, together with recent observations, suggest that future pregnancy guidance should include stricter pandemic precautions such as screening for a wider array of COVID-19 symptoms, enhanced ultrasound monitoring, as well as newborn medical surveillance. Elsevier Inc. 2022-03 2022-01-05 /pmc/articles/PMC8730375/ /pubmed/34995674 http://dx.doi.org/10.1016/j.humpath.2021.12.012 Text en © 2022 Elsevier Inc. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Original Contribution Dubucs, Charlotte Groussolles, Marion Ousselin, Jessie Sartor, Agnès Van Acker, Nathalie Vayssière, Christophe Pasquier, Christophe Reyre, Joëlle Batlle, Laïa Favarel clinical research associate, Stèphanie Duchanois midwife, Delphine Jauffret clinical research associate, Valèrie Courtade-Saïdi, Monique Aziza, Jacqueline Severe placental lesions due to maternal SARS-CoV-2 infection associated to intrauterine fetal death() |
title | Severe placental lesions due to maternal SARS-CoV-2 infection associated to intrauterine fetal death() |
title_full | Severe placental lesions due to maternal SARS-CoV-2 infection associated to intrauterine fetal death() |
title_fullStr | Severe placental lesions due to maternal SARS-CoV-2 infection associated to intrauterine fetal death() |
title_full_unstemmed | Severe placental lesions due to maternal SARS-CoV-2 infection associated to intrauterine fetal death() |
title_short | Severe placental lesions due to maternal SARS-CoV-2 infection associated to intrauterine fetal death() |
title_sort | severe placental lesions due to maternal sars-cov-2 infection associated to intrauterine fetal death() |
topic | Original Contribution |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8730375/ https://www.ncbi.nlm.nih.gov/pubmed/34995674 http://dx.doi.org/10.1016/j.humpath.2021.12.012 |
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