Placental pathology of the third trimester pregnant women from COVID-19

Diagnostic Pathology

Cuifang Fan¹  Likun Gao²  Xiaoli Tian²  Honglin Yan²  Jiacai Ren²  Xiaokang Ke²  Li Xu²  Jingping Yuan²  Lin Xiong² 

[1]Department of Obstetrics and Gynecology, Renmin Hospital of Wuhan University, 430060, Wuhan City, Hubei Province, People’s Republic of China

[2]Department of Pathology, Renmin Hospital of Wuhan University, 99 Ziyang Road, Wuchang District, 430060, Wuhan, Hubei Province, People’s Republic of China

关键词: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2);    Placenta pathology;    The third trimester pregnancy;    Hofbauer cells;    Syncytial knots;   

DOI  :  10.1186/s13000-021-01067-6

来源: Springer

【 摘 要 】

AimsTo explore the clinical characteristics and placental pathological changes of pregnant women with 2019 novel coronavirus (CoV) disease (COVID-19) in the third trimester, and to assess the possibility of vertical transmission.Methods and resultsThe placenta tissues were evaluated by using immunohistochemistry for inflammatory cells and Hofbauer cells, and using severe acute respiratory syndrome (SARS) CoV-2 RNA Fluorescence In-Situ Hybridization (FISH) and SARS-CoV-2 spike protein immunofluorescence (IF) double staining. All eight placentas from the third trimester pregnancy women were studied. All patients were cured, no clinical or serological evidence pointed to vertical transmission of SARS-CoV-2. Features of maternal vascular malperfusion (MVM) such as increased syncytial knots were present in all 8 cases (8/8), and increased focal perivillous fibrin depositions were presented in 7 cases (7/8). No significate chronic histiocytic intervillositis was noted in the placenta. The number of macrophages and inflammatory cells such as T cells, B cells and plasma cells in the placental villous was not significantly increased in all cases. Moreover, all of eight cases demonstrated negative results by FISH using a SARS-CoV-2 virus RNA probe and by IF using a monoclonal antibody against SARS-CoV-2 spike protein.ConclusionsWe found no evidence of vertical transmission and adverse maternal-fetal outcomes in the placentas of third trimester COVID-19 pregnancy women, which provided further information for the clinical management of those women in the third trimester. However, further studies are still needed for patients with infections in different stage of gestation, especially in first and second trimester.

【 授权许可】

CC BY