Histopathological changes in placenta in pregnancies affected by Covid-19 infection

Sami Jan; Nowsheen Khan; Sabreen Wani

doi:10.18203/2320-1770.ijrcog20243176

Authors

Sami Jan Department of Obstetrics and Gynecology, SKIMS MCH Bemina, Jammu and Kashmir, India
Nowsheen Khan Department of Obstetrics and Gynecology, SKIMS MCH Bemina, Jammu and Kashmir, India
Sabreen Wani Department of Obstetrics and Gynecology, SKIMS MCH Bemina, Jammu and Kashmir, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20243176

Keywords:

Covid 19 infection, Histopathological changes, Placenta

Abstract

Background: The 2019 coronavirus disease (COVID-19), a novel zoonotic disease, was first discovered in late December 2019 following an outbreak of severe pneumonia of unknown etiology in Wuhan, Hubei Province, China. There is increasing evidence that COVID-19 infection leaves tell-tale signs of injuries in the placenta. This study was conducted to study the histopathological changes in placenta in pregnancies affected by COVID-19 infection in any trimester.

Methods: It was a prospective observational study conducted in the Department of Gynaecology and Obstetrics SKIMS MCH for a period of one year in all pregnant patients attending our department with the history of Covid 19 infection in any trimester during this pregnancy. The placentas of patients delivered by NVD or LSCS were sent for histopathology.

Results: The women enrolled in the study were from Kashmir. The average age was 25-39 years. The average duration of pregnancy at delivery was 37-40 weeks. 37% pregnant women were affected by covid infection in their first trimester, 49% in 2^nd trimester and 14% in third trimester. 29% had acute inflammatory pathology, 34% had chronic pathology, 23% had placental infarction meanwhile no placental pathology was seen in 49% patients.

Conclusions: This study concludes that Covid 19 infection does affect the placentas in pregnancies complicated by Covid infection during any trimester of their pregnancy and it does play a role in the fetal outcome as well due to the placental changes.

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References

Mackenzie JS, Smith DW. COVID-19: A novel zoonotic disease caused by a coronavirus from China: What we know and what we don’t. Microbiol Aust. 2020;41(1):45-50.

Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. nature. 2020;579(7798):270-3.

Robbins JR, Bakardjiev AI. Pathogens and the placental fortress. Curr Opini Microbiol. 2012;15(1):36-43.

Redline RW. Classification of placental lesions. Am J Obstet. Gynecol. 2015;213(4):21-8.

Benirschke B, Burton GJ, Baergen RN. Pathology of the Human Placenta. 6th ed. Vol. 10. Berlin, Heidelberg: Springer; 2012:978-993.

Khong TY, Mooney EE, Ariel I, Balmus NC, Boyd TK, Brundler MA, et al. Sampling and definitions of placental lesions: Amsterdam placental workshop group consensus statement. Arch Pathol Laborat Medic. 2016;140(7):698-713.

Ernst LM. Maternal vascular malperfusion of the placental bed. APMIS. 2018;126(7):551-60.

Mahyuddin AP, Kanneganti A, Wong JJ, Dimri PS, Su LL, Biswas A, et al. Mechanisms and evidence of vertical transmission of infections in pregnancy including SARS‐CoV‐2s. Prenatal Diagn. 2020;40(13):1655-70.

Adhikari EH, Moreno W, Zofkie AC, MacDonald L, McIntire DD, Collins RR, et al. Pregnancy outcomes among women with and without severe acute respiratory syndrome coronavirus 2 infection. JAMA network open. 2020;3(11):e2029256.

Hoffmann M, Kleine-Weber H, Schroeder S, Krüger N, Herrler T, Erichsen S, et al. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. cell. 2020;181(2):271-80.

Patiño Escarcina JE, da Silva AK, Medeiros MO, Fernandes SS, Agareno LA, et al. Histological Alterations in Placentas of Pregnant Women with SARS-CoV-2 Infection: A Single-Center Case Series. Pathogens. 2023;12(10):1197.

Suhren JT, Meinardus A, Hussein K, Schaumann N. Meta-analysis on COVID-19-pregnancy-related placental pathologies shows no specific pattern. Placenta. 2022;117:72-7.

Joshi B, Chandi A, Srinivasan R, Saini SS, Prasad GR, Puri GD, Bhalla A, Suri V, Bagga R. The placental pathology in Coronavirus disease 2019 infected mothers and its impact on pregnancy outcome. Placenta. 2022;127:1-7.

Tripathy S, Sreelakshmi S, Das A. Histopathological changes and clinical outcomes in placentas of COVID-19 positive mothers: a cohort study. J Clin Diagnos Res. 2024;18(2).

Sharps MC, Hayes DJ, Lee S, Zou Z, Brady CA, Almoghrabi Y, et al. A structured review of placental morphology and histopathological lesions associated with SARS-CoV-2 infection. Placenta. 2020;101:13-29.