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Placental pathologies and fetal outcome in pregnant women with COVID-19: A retrospective study
Soheila Sarmadi1, Ara Omranipour2, Elham Mirzaian3, Roghayyeh Ahangari4, Zahra Yazdi4, Azadeh Asgarian5, Monireh Mirzaie4
1 Department of Pathology, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
2 Department of Obstetrics and Gynecology, School of Medicine, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran
3 Department of Pathology, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
4 Department of Obstetrics and Gynecology, Clinical Research Development Unit, School of Medicine, Nekouei-Hedayati-Forghani Hospital, Qom University of Medical Sciences, Qom, Iran
5 Department of Nursing, Clinical Research Development Unit, Nekouei-Hedayati-Forghani Hospital, Qom University of Medical Sciences, Qom, Iran
Correspondence Address:
Monireh Mirzaie
Department of Obstetrics and Gynecology, Clinical Research Development Unit, School of Medicine, Nekouei-Hedayati-Forghani Hospital, Qom University of Medical Sciences, Qom
Iran
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/2305-0500.346091
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Objective: To describe histopathologic findings in the placentas in women with coronavirus disease 2019 (COVID-19) during pregnancy.
Methods: In a cross-sectional study, 38 pregnant women with COVID-19 and undergoing delivery between March 2020 and January 2022, were included. The patients had positive polymerase chain reaction (PCR) test for SARS-CoV-2 infection and the placentas after delivery were sent for histopathologic evaluation based on the Amsterdam Placental Workshop Group Consensus Statement and assessed by two pathologists.
Results: Our results showed that maternal vascular malperfusion was the most common and was present in 17 cases (44.7%). These features included accelerated villous maturation (36.8%) distal villous hypoplasia (5.3%), placental infarction (5.3%) and intervillous fibrin deposition (10.5%). Other pathologic findings included focal calcification (10.5%), intravillous congestion and hemorrhage (10.5%), sub-chorionic hemorrhage (5.3%), acute villitis, chronic histiocytic intervillositis and delayed villous maturation each in one case (2.6%). Twelve out of 38 cases showed no significant pathologic changes. Fetal outcomes included neonatal intensive care unit admission rate of 13.2%, dyspnea 31.6%, newborn’s anosmia 7.9%, intrauterine fetal demise 2.6%, asphyxia 2.6% and neonate COVID infection 5.3%.
Conclusions: Microvasculopathy, as a sign of maternal vascular malperfusion, is a common finding in placentas from SARS-CoV-2 positive pregnant women in the present study. Further studies with larger sample sizes and comparative studies between COVID-19 positive and negative, as well as information from patient follow-up are suggested. |
