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Placental Tissue Destruction and Insufficiency From COVID-19 Causes Stillbirth and Neonatal Death From Hypoxic-Ischemic Injury : A Study of 68 Cases With SARS-CoV-2 Placentitis From 12 Countries
- Source :
- Archives of Pathology and Laboratory Medicine, Archives of Pathology and Laboratory Medicine, College of American Pathologists, 2022, 146 (6), pp.660-676. ⟨10.5858/arpa.2022-0029-SA⟩, Schwartz, D A, Avvad-Portari, E, Babál, P, Baldewijns, M, Blomberg, M, Bouachba, A, Camacho, J, Collardeau-Frachon, S, Colson, A, Dehaene, I, Ferreres, J C, Fitzgerald, B, Garrido-Pontnou, M, Gerges, H, Hargitai, B, Helguera-Repetto, A C, Holmström, S, Irles, C L, Leijonhfvud, Å, Libbrecht, S, Marton, T, McEntagart, N, Molina, J T, Morotti, R, Nadal, A, Navarro, A, Nelander, M, Oviedo, A, Oyamada Otani, A R, Papadogiannakis, N, Petersen, A C, Roberts, D J, Saad, A G, Sand, A, Schoenmakers, S, Sehn, J K, Simpson, P R, Thomas, K, Valdespino-Vázquez, M Y, van der Meeren, L E, Van Dorpe, J, Verdijk, R M, Watkins, J C & Zaigham, M 2022, ' Placental Tissue Destruction and Insufficiency from COVID-19 Causes Stillbirth and Neonatal Death from Hypoxic-Ischemic Injury : A Study of 68 Cases with SARS-CoV-2 Placentitis from 12 Countries ', Archives of pathology & laboratory medicine, vol. 146, no. 6, pp. 660-676 . https://doi.org/10.5858/arpa.2022-0029-SA, Archives of Pathology and Laboratory Medicine, 146(6), 660-676. College of American Pathologists
- Publication Year :
- 2022
- Publisher :
- Uppsala universitet, Klinisk obstetrik, 2022.
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Abstract
- CONTEXT.—: Perinatal death is an increasingly important problem as the coronavirus disease 2019 (COVID-19) pandemic continues, but the mechanism of death has been unclear.OBJECTIVE.—: To evaluate the role of the placenta in causing stillbirth and neonatal death following maternal infection with COVID-19 and confirmed placental positivity for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).DESIGN.—: Case-based retrospective clinicopathologic analysis by a multinational group of 44 perinatal specialists from 12 countries of placental and autopsy pathology findings from 64 stillborns and 4 neonatal deaths having placentas testing positive for SARS-CoV-2 following delivery to mothers with COVID-19.RESULTS.—: Of the 3 findings constituting SARS-CoV-2 placentitis, all 68 placentas had increased fibrin deposition and villous trophoblast necrosis and 66 had chronic histiocytic intervillositis. Sixty-three placentas had massive perivillous fibrin deposition. Severe destructive placental disease from SARS-CoV-2 placentitis averaged 77.7% tissue involvement. Other findings included multiple intervillous thrombi (37%; 25 of 68) and chronic villitis (32%; 22 of 68). The majority (19; 63%) of the 30 autopsies revealed no significant fetal abnormalities except for intrauterine hypoxia and asphyxia. Among all 68 cases, SARS-CoV-2 was detected from a body specimen in 16 of 28 cases tested, most frequently from nasopharyngeal swabs. Four autopsied stillborns had SARS-CoV-2 identified in internal organs.CONCLUSIONS.—: The pathology abnormalities composing SARS-CoV-2 placentitis cause widespread and severe placental destruction resulting in placental malperfusion and insufficiency. In these cases, intrauterine and perinatal death likely results directly from placental insufficiency and fetal hypoxic-ischemic injury. There was no evidence that SARS-CoV-2 involvement of the fetus had a role in causing these deaths.
- Subjects :
- Fibrin
Pregnancy Complications, Infectious/mortality
Infectious Medicine
SARS-CoV-2
[SDV]Life Sciences [q-bio]
Infant, Newborn
Infektionsmedicin
Placenta/pathology
Stillbirth
Infectious Disease Transmission, Vertical
[SDV] Life Sciences [q-bio]
Pregnancy
Perinatal Death/etiology
COVID-19/complications
Humans
Female
Hypoxia/pathology
Retrospective Studies
Subjects
Details
- Language :
- English
- ISSN :
- 00039985 and 15432165
- Database :
- OpenAIRE
- Journal :
- Archives of Pathology and Laboratory Medicine, Archives of Pathology and Laboratory Medicine, College of American Pathologists, 2022, 146 (6), pp.660-676. ⟨10.5858/arpa.2022-0029-SA⟩, Schwartz, D A, Avvad-Portari, E, Babál, P, Baldewijns, M, Blomberg, M, Bouachba, A, Camacho, J, Collardeau-Frachon, S, Colson, A, Dehaene, I, Ferreres, J C, Fitzgerald, B, Garrido-Pontnou, M, Gerges, H, Hargitai, B, Helguera-Repetto, A C, Holmström, S, Irles, C L, Leijonhfvud, Å, Libbrecht, S, Marton, T, McEntagart, N, Molina, J T, Morotti, R, Nadal, A, Navarro, A, Nelander, M, Oviedo, A, Oyamada Otani, A R, Papadogiannakis, N, Petersen, A C, Roberts, D J, Saad, A G, Sand, A, Schoenmakers, S, Sehn, J K, Simpson, P R, Thomas, K, Valdespino-Vázquez, M Y, van der Meeren, L E, Van Dorpe, J, Verdijk, R M, Watkins, J C & Zaigham, M 2022, ' Placental Tissue Destruction and Insufficiency from COVID-19 Causes Stillbirth and Neonatal Death from Hypoxic-Ischemic Injury : A Study of 68 Cases with SARS-CoV-2 Placentitis from 12 Countries ', Archives of pathology & laboratory medicine, vol. 146, no. 6, pp. 660-676 . https://doi.org/10.5858/arpa.2022-0029-SA, Archives of Pathology and Laboratory Medicine, 146(6), 660-676. College of American Pathologists
- Accession number :
- edsair.dedup.wf.001..826e9393e7a40b9ac32e31f623f6d579