Poisson Tiffany M, Pierone Gerald
Department of General Pediatrics, Whole Family Health Center, Vero Beach, FL, USA.
Department of Infectious Disease, Whole Family Health Center, Vero Beach, FL, USA.
Case Rep Womens Health. 2021 Apr;30:e00289. doi: 10.1016/j.crwh.2021.e00289. Epub 2021 Jan 28.
The consequences of SARS-CoV-2 infection in pregnancy have not been well defined. However, there have been a number of reports of poor maternal and fetal outcomes worldwide. This report presents a case of stillbirth with associated placental pathology during week 35 in an otherwise healthy pregnant woman with SARS-CoV-2 infection. Placental findings in this case showed patchy acute chorionitis and diffuse infarction/villous necrosis of the placental parenchyma resulting in extensive vascular malperfusion. Fetal autopsy was most significant for placental findings and no congenital malformations were discovered. The findings in this case are consistent with reports in the literature of pathological placental changes associated with COVID-19. This case of fetal demise in a woman with confirmed SARS-CoV-2 infection without any other medical or obstetric disorders and no alternate cause suggests that fetal death can be an outcome of COVID-19 during pregnancy. This outcome was supported by the histopathological findings in the placenta. Continued research is imperative to confirm the findings in this case and multiple similar cases. Additionally, increased screening and collection of COVID-19 data specific to pregnant women and their fetuses and infants is needed to increase knowledge, support research efforts, and create guidelines for clinical practice that will prevent potential negative outcomes and loss of life.
新型冠状病毒2(SARS-CoV-2)感染对妊娠的影响尚未明确界定。然而,全球已有多项关于孕产妇和胎儿不良结局的报告。本报告介绍了一例在妊娠35周时出现死产并伴有胎盘病理改变的病例,该孕妇身体健康,但感染了SARS-CoV-2。该病例的胎盘检查结果显示散在性急性绒毛膜羊膜炎以及胎盘实质弥漫性梗死/绒毛坏死,导致广泛的血管灌注不良。胎儿尸检结果中最显著的是胎盘检查结果,未发现先天性畸形。该病例的发现与文献中关于与新型冠状病毒肺炎(COVID-19)相关的胎盘病理变化的报告一致。该确诊感染SARS-CoV-2且无任何其他内科或产科疾病及其他病因的孕妇发生胎儿死亡的病例表明,胎儿死亡可能是妊娠期COVID-19的一个结局。这一结局得到了胎盘组织病理学检查结果的支持。必须继续开展研究以证实该病例及多个类似病例的发现。此外,需要加强针对孕妇及其胎儿和婴儿的COVID-19数据的筛查和收集,以增加相关知识、支持研究工作并制定临床实践指南,从而预防潜在的不良结局和生命损失。