Department of Obstetrics & Gynecology, University of Connecticut, USA.
Department of Pathology, University of Connecticut, USA.
Placenta. 2022 Jun 24;124:62-66. doi: 10.1016/j.placenta.2022.05.014. Epub 2022 May 20.
COVID-19 has been associated with several adverse pregnancy outcomes, including perinatal loss. Differential effects of COVID-19 in a twin pregnancy may provide unique insights into virus-placental interactions. We present a case of perinatal loss of a female fetus with survival of the male co-twin in a pregnancy complicated by COVID-19 and premature delivery.
Viral detection methods recommended by the NICHD task force were used to identify SARS-CoV-2 and its viral receptors in the placentas and fetal tissue (Antoun et al., 2020) [1] RESULTS: Compared with the surviving twin, we found a more severe intervillous necrosis and a relatively low detection of ACE2 membranous expression in the syncytiotrophoblasts of the female twin that succumbed.
The interactions of SARS-CoV-2 and ACE2 at the maternal fetal interface within the placenta may play a significant role in perinatal loss, and the effects of fetal sex and gestational age at time of infection need to be explored further.
COVID-19 与多种不良妊娠结局相关，包括围产期损失。COVID-19 在双胞胎妊娠中的不同影响可能为病毒-胎盘相互作用提供独特的见解。我们报告了一例 COVID-19 合并早产的孕妇中女性胎儿围产期死亡而男性胎儿存活的病例。
使用 NICHD 工作组推荐的病毒检测方法来鉴定胎盘和胎儿组织中的 SARS-CoV-2 及其病毒受体（Antoun 等人，2020 年）[1]。
与存活的双胞胎相比，我们发现死亡的女性双胞胎绒毛间隙坏死更严重，合体滋养层中 ACE2 膜表达的检出率相对较低。
SARS-CoV-2 和 ACE2 在胎盘母体胎儿界面的相互作用可能在围产期损失中起重要作用，需要进一步探讨胎儿性别和感染时的胎龄的影响。
