Aghaamoo Shahrzad, Ghods Kamran, Rahmanian Mojgan
Research Center of Abnormal Uterine Bleeding, Semnan University of Medical Sciences, Semnan, Iran.
Clinical Research Development Unit, Kowsar Educational, Research and Therapeutic Hospital, Semnan University of Medical Sciences, Semnan, Iran.
J Mol Histol. 2021 Jun;52(3):427-435. doi: 10.1007/s10735-021-09970-4. Epub 2021 Apr 19.
SARS-CoV-2, the leading cause of COVID-19 pandemic, was detected for the first time in Wuhan. In this study, we investigated the potential undesirable maternal and feto-neonatal consequences of COVID-19, and the related pathophysiological alterations in mother, neonate, and especially in the placenta as a vital organ, were reviewed. Also, the possibility of vertical transmission of virus and placental abnormalities were evaluated. The pregnant women were a vulnerable population for COVID-19, and several obstetric consequences were reported following SARS-CoV-2 infection. The higher risk of abruption, preterm labor, maternal death, stillbirth, intrauterine growth restriction, and newborns with fetal distress were adverse pregnancy and perinatal outcomes of COVID-19. Despite the ACE2 expression on placental components was confirmed, there is no agreement on the mother-child vertical transmission of this virus. Therefore, feto-neonatal consequences might be associated with placental abnormalities. The placental abnormalities are characterized by feto-maternal vascular malperfusion. Additionally, these adverse consequences lead to early termination of pregnancy in some cases, mostly via cesarean section. The pregnant women screening, coordination between healthcare personnel and neonatal unit, and infected women quarantine may decrease the risk of maternal and neonatal death after delivery.
新型冠状病毒(SARS-CoV-2)是导致新冠疫情的主要病原体,首次在武汉被发现。在本研究中,我们调查了新冠病毒感染对孕产妇及胎儿-新生儿可能产生的不良后果,并对母亲、新生儿尤其是作为重要器官的胎盘的相关病理生理改变进行了综述。此外,还评估了病毒垂直传播的可能性以及胎盘异常情况。孕妇是新冠病毒的易感人群,感染SARS-CoV-2后出现了多种产科后果。胎盘早剥、早产、孕产妇死亡、死产、胎儿生长受限以及胎儿窘迫新生儿等较高风险是新冠病毒感染的不良妊娠和围产期结局。尽管已证实在胎盘成分上存在血管紧张素转换酶2(ACE2)表达,但对于该病毒的母婴垂直传播尚无定论。因此,胎儿-新生儿后果可能与胎盘异常有关。胎盘异常的特征是母胎血管灌注不良。此外,这些不良后果在某些情况下会导致早期终止妊娠,大多通过剖宫产进行。对孕妇进行筛查、医护人员与新生儿科之间的协调以及对感染妇女进行隔离,可能会降低分娩后孕产妇和新生儿死亡的风险。