Histopathological Features of Placentas from Mothers Infected with COVID-19 During Pregnancy

Abstract

Purpose: After the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) enters the body, it can cause morphological changes in various tissues, particularly those of the respiratory system. In pregnant individuals with COVID-19, vertical transmission of SARS-CoV-2 may occur and has been associated with pregnancy complications such as miscarriage, fetal malformations, fetal growth restriction, and stillbirth. This study aimed to investigate the histopathological changes observed in the placentas of women infected with COVID-19 during pregnancy. Materials and Methods: In this study, the histopathological features of the placenta of 29 women with COVID-19 at any period of pregnancy were evaluated. Results: The women included in the study ranged in age from 18 to 40 years, with a mean age of 30.3. The birth weeks of one patient was the 32nd week, eight patients was the 40th week, and the others were at 36 and 39 weeks. None of the patients had comorbidities. In histopathological examination, calcifications, congestive chorionic villi, intervillous hemorrhage and increase in syncytial knots were common findings. Fibromuscular stenosis was observed in 3 cases and marked distal villous hypoplasia in 2 cases. Conclusion: The placenta possesses several mechanisms that act as barriers to prevent the transmission of viral infections to the fetus. Studies have demonstrated an increase in placental pathologies, particularly a higher frequency of maternal vascular malperfusion, in pregnant women with COVID-19. Moreover, these studies have shown that placental abnormalities, including both fetal and maternal vascular malperfusion, may occur in the placentas of mothers infected with COVID-19 during pregnancy.

Keywords

• COVID-19 pandemic
• placenta
• pregnancy complications

Gebeliği Sürecinde COVID-19 Enfeksiyonu Geçiren Annelerin Plasentalarının Histopatolojik Özellikleri

Abstract

Amaç: Şiddetli akut solunum sendromu koronavirüs 2 (SARS-CoV-2) vücuda alındıktan sonra solunum sistemi başta olmak üzere birçok dokuda morfolojik değişikliklere neden olabilir. COVID-19'lu gebe bireylerde, SARS-CoV-2’nin dikey geçişi mümkün olabilir ve düşük, fetal malformasyonlar, fetal büyüme kısıtlaması veya ölü doğum gibi gebelik komplikasyonlarına neden olabilir. Bu çalışmada COVID-19'lu kadınların plasentalarında meydana gelen değişiklikler araştırılmıştır. Araçlar ve Yöntem: Bu çalışmada gebeliğin herhangi bir döneminde COVID-19 tanısı alan 29 kadının plasentasının histopatolojik özellikleri değerlendirildi. Bulgular: Çalışmaya dahil edilen kadınların yaşları 18 ile 40 arasında değişmekte olup, yaş ortalaması 30.3'tür. Bir hastanın doğum haftaları 32. hafta, sekiz hastanın doğum haftası 40. hafta, diğerleri ise 36 ve 39. haftalardı. Hiçbir hastada herhangi bir komorbidite yoktu. Histopatolojik incelemede kalsifikasyonlar, konjestif koryon villuslar, intervillöz kanamalar ve sinsityal düğümlerde artış sık görülen bulgulardı. 3 olguda fibromusküler stenoz, 2 olguda belirgin distal villöz hipoplazi gözlendi. Sonuç: Plasenta, viral enfeksiyonların fetüse bulaşmasını önlemek için bariyer görevi gören çeşitli mekanizmalara sahiptir. Çalışmalar, COVID-19'lu gebe kadınlarda plasental patolojide, özellikle maternal vasküler malperfüzyon sıklığında bir artış olduğunu göstermiştir. Çalışma ayrıca hamilelik sırasında COVID-19 enfeksiyonu olan annelerin plasentasında fetal ve maternal vasküler malperfüzyon dahil olmak üzere plasental anormalliklerin meydana gelebileceğini gösterdi.

Keywords

• COVID-19 pandemisi
• gebelik komplikasyonları
• plasenta

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