Remoué Annabelle, Suazo Yurina, Uguen Marie, Uguen Arnaud, Marcorelles Pascale, de Moreuil Claire
Service d'Anatomie et Cytologie Pathologiques, CHRU Morvan, 2 Avenue Foch, 29609 Brest, France.
CHRU de Brest, LBAI (Lymphocytes B, Autoimmunité et Immunotherapies), University of Brest, Inserm, UMR 1227, 29200 Brest, France.
Life (Basel). 2023 Feb 9;13(2):479. doi: 10.3390/life13020479.
(1) Background: Placental histological lesions reported in relation with SARS-CoV-2 infection are various, with potential consequences such as fetal growth retardation, prematurity or stillbirth/neonatal death. We report here on a placental pathological association which could be specific for SARS-CoV-2 infection and associated with poor fetal outcome; (2) Methods: We collected all the placental pathological examinations performed in Brest University Hospital (France) since the beginning of COVID-19 pandemic with a known maternal SARS-CoV-2 infection and a poor pregnancy outcome. In these cases, we described the pathological lesions and we searched for these lesions in a large series of placentas collected and examined in the same institution before the SARS-CoV-2 pandemic; (3) Results: Three cases with severe fetal outcome (tardive abortion, prematurity, neonatal death), from the first to the third trimesters of pregnancy, were included. The three cases showed features of massive and acute "placentitis triad" consisting in massive perivillous fibrin deposition, sub-acute intervillositis and trophoblastic necrosis. This association was not encountered in any of 8857 placentas analyzed during the period between 2002 and 2012 in our institution; (4) Conclusions: The "placentitis triad" appears to be specific for SARS-CoV-2 infection and, in case of massive and acute presentation, could result in poor fetal outcome.
(1) 背景：与严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染相关的胎盘组织学病变多种多样，可能导致胎儿生长受限、早产或死产/新生儿死亡等后果。我们在此报告一种可能是SARS-CoV-2感染特有的胎盘病理关联，且与不良胎儿结局相关；(2) 方法：我们收集了自新冠疫情开始以来在法国布雷斯特大学医院进行的所有胎盘病理检查，这些病例的孕妇已知感染SARS-CoV-2且妊娠结局不良。在这些病例中，我们描述了病理病变，并在SARS-CoV-2疫情之前在同一机构收集和检查的大量胎盘中寻找这些病变；(3) 结果：纳入了3例妊娠晚期出现严重胎儿结局（晚期流产、早产、新生儿死亡）的病例，分别处于妊娠的早、中、晚期。这3例均表现出大量急性“胎盘炎三联征”的特征，包括大量绒毛周围纤维蛋白沉积、亚急性绒毛间炎和滋养层坏死。在我们机构2002年至2012年期间分析的8857份胎盘中，未发现这种关联；(4) 结论：“胎盘炎三联征”似乎是SARS-CoV-2感染特有的，若出现大量急性表现，可能导致不良胎儿结局。
