Kramar Solomiia, Nebesna Zoia, Yakymchuk Yuliia, Boychuk Alla, Shevchuk Oksana, Korda Mykhaylo, Vari Sandor George
Department of Histology and Embryology, I. Horbachevsky Ternopil National Medical University, 46001 Ternopil, Ukraine.
Department of the Obstetrics and Gynecology, I. Horbachevsky Ternopil National Medical University, 46001 Ternopil, Ukraine.
Int J Mol Sci. 2025 Sep 4;26(17):8596. doi: 10.3390/ijms26178596.
SARS-CoV-2 infection in pregnant women can lead to pregnancy-related complications. This work aims to study the spectrum of pathological changes in the placentas of SARS-CoV-2-infected pregnant women. The study involved 50 pregnant women with COVID-19 disease in the first (group I), second (group II), and third (group III) trimesters. Placental sections were examined by histopathology, electron microscopy, and immunohistochemistry to assess structural and molecular changes. The placentas of SARS-CoV-2-affected pregnant women exhibit nonspecific pathological changes, primarily associated with impaired blood circulation. The most frequent findings include thrombosis, chorangiosis, villous edema, and fibrinoid necrosis, all indicative of endothelial dysfunction. Increased expression of sclerostin and Annexin A2 was also detected in affected placentas. The main submicroscopic manifestations of placental insufficiency in COVID-19-affected women are dystrophic-destructive changes in the stroma of the villi, manifested by edema and fibrous processes, which cause significant disruption of the fetoplacental barrier. SARS-CoV-2 causes thrombotic and sclerotic changes, mainly in the maternal portion of the placenta. The manifestation of pathological changes in the placenta of COVID-19-affected women depends on the pregnancy period during which infection by SARS-CoV-2 has occurred. The established findings may provide insights into the connection between COVID-19 in pregnancy and antenatal and perinatal outcomes.
孕妇感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）可导致与妊娠相关的并发症。这项研究旨在探讨SARS-CoV-2感染孕妇胎盘的病理变化谱。该研究纳入了50例处于妊娠第一期（第一组）、第二期（第二组）和第三期（第三组）的新冠肺炎孕妇。通过组织病理学、电子显微镜和免疫组织化学检查胎盘切片，以评估结构和分子变化。受SARS-CoV-2影响的孕妇胎盘呈现非特异性病理变化，主要与血液循环受损有关。最常见的表现包括血栓形成、绒毛膜血管增多、绒毛水肿和纤维蛋白样坏死，所有这些均提示内皮功能障碍。在受影响的胎盘中还检测到硬化蛋白和膜联蛋白A2的表达增加。新冠肺炎感染女性胎盘功能不全的主要亚微观表现为绒毛基质的营养不良性破坏变化，表现为水肿和纤维样改变，这会导致胎盘屏障严重受损。SARS-CoV-2主要在胎盘的母体部分引起血栓形成和硬化改变。受新冠肺炎影响女性胎盘病理变化的表现取决于感染SARS-CoV-2时的孕周。这些既定的发现可能有助于深入了解妊娠期新冠肺炎与产前和围产期结局之间的联系。
