Background:Maternal infection by SARS-CoV-2 may lead to adverse pregnancy outcomes and causes pathological changes in the placenta.However,consensus regarding characteristic pathological features is lacking.Researchof...Background:Maternal infection by SARS-CoV-2 may lead to adverse pregnancy outcomes and causes pathological changes in the placenta.However,consensus regarding characteristic pathological features is lacking.Researchof the placental histopathology in a cohort of women from Mizoram,India,was conducted to relate the SARS-CoV-2 infection's effectswith pregnancy and its outcome.Materials and methods:The characteristics of 72 pregnant women diagnosed positive for SARS-CoV-2 who eventually delivered at Zoram Medical College Hospital,Mizoram,neonates'well-being,and histopathological features of placentas were studied.Results:Of 72 women in this study,59(81.9%)gave birth at full term.Among these births,5 were normal vaginal deliveries,while the remaining 67(93.1%)were delivered via cesarean section.The reasons for cesarean delivery were either related to SARS-CoV-2 infection(n=49),existing obstetric problems(n=15)or fetal-distress(n=5).All deliveries resulted in live births of COVID-negative babies,with 80.6%(n=58)of the newborns having a birth weight of over 2.5 kg.APGAR scores ranged from 4 to 6 in 61(84.7%)of the babies,and 10 neonates required resuscitation,of which 8 were managed in the neonatal intensive care unit(NICU).The placental histopathology showed increased fibrin thrombi in 8 cases(11.1%),while 20 cases(28%)showed focal infarction,microcalcification levels were elevated in 16 cases(22.2%),and a small percentage of cases(1.4%)exhibited small fibrotic villi and inter-villus agglutination.Placental chorioangiosis was detected in 28(38.9%)of the cases,while avascular villi were seen in 6 cases.Meconium-stained liquor was observed in a single case.Intervillous hemorrhage was found in 42 cases,whileintervillous inflammation and increased syncytial knots were present in 14 and 5 cases,respectively.The placenta pathology of 10 neonates who required resuscitation/NICU admission was not significantly different from that of the 62 neonates who did not require it.However,a higher proportion of placenta from the asymptomatic group showed no abnormality compared to the symp-tomatic group(p=0.046).Conclusion:SARS-CoV-2 infection causes a range of morphological changes and lesions in the placenta,including chorangiosis,villositis,chorioamnionitis,fetal vascular malperfusion/thrombosis,fibrin-deposition,increased syncytial-knotting,increased microcalcification,increased villous agglutination,focal infarct,intervilloush-emorrhage as well as inflammation.Placental histopathological findings from this study can provide additional information to the existing literature on the subject.展开更多
文摘Background:Maternal infection by SARS-CoV-2 may lead to adverse pregnancy outcomes and causes pathological changes in the placenta.However,consensus regarding characteristic pathological features is lacking.Researchof the placental histopathology in a cohort of women from Mizoram,India,was conducted to relate the SARS-CoV-2 infection's effectswith pregnancy and its outcome.Materials and methods:The characteristics of 72 pregnant women diagnosed positive for SARS-CoV-2 who eventually delivered at Zoram Medical College Hospital,Mizoram,neonates'well-being,and histopathological features of placentas were studied.Results:Of 72 women in this study,59(81.9%)gave birth at full term.Among these births,5 were normal vaginal deliveries,while the remaining 67(93.1%)were delivered via cesarean section.The reasons for cesarean delivery were either related to SARS-CoV-2 infection(n=49),existing obstetric problems(n=15)or fetal-distress(n=5).All deliveries resulted in live births of COVID-negative babies,with 80.6%(n=58)of the newborns having a birth weight of over 2.5 kg.APGAR scores ranged from 4 to 6 in 61(84.7%)of the babies,and 10 neonates required resuscitation,of which 8 were managed in the neonatal intensive care unit(NICU).The placental histopathology showed increased fibrin thrombi in 8 cases(11.1%),while 20 cases(28%)showed focal infarction,microcalcification levels were elevated in 16 cases(22.2%),and a small percentage of cases(1.4%)exhibited small fibrotic villi and inter-villus agglutination.Placental chorioangiosis was detected in 28(38.9%)of the cases,while avascular villi were seen in 6 cases.Meconium-stained liquor was observed in a single case.Intervillous hemorrhage was found in 42 cases,whileintervillous inflammation and increased syncytial knots were present in 14 and 5 cases,respectively.The placenta pathology of 10 neonates who required resuscitation/NICU admission was not significantly different from that of the 62 neonates who did not require it.However,a higher proportion of placenta from the asymptomatic group showed no abnormality compared to the symp-tomatic group(p=0.046).Conclusion:SARS-CoV-2 infection causes a range of morphological changes and lesions in the placenta,including chorangiosis,villositis,chorioamnionitis,fetal vascular malperfusion/thrombosis,fibrin-deposition,increased syncytial-knotting,increased microcalcification,increased villous agglutination,focal infarct,intervilloush-emorrhage as well as inflammation.Placental histopathological findings from this study can provide additional information to the existing literature on the subject.
