Placental Pathology in SARS-CoV-2 Infection During Second and Third Trimester: A Study in a Tertiary Care Center

Sucheta Devi Khuraijam; Pratima Devi Khumanthem; Sushma Khuraijam; Sheronica Laishram; Robedi Choudhurimayum; Opendro Singh Narengbam

doi:10.21276/apalm.3401

Authors

Sucheta Devi Khuraijam Regional Institute of Medical Sciences, Imphal, Manipur, India
Pratima Devi Khumanthem Regional Institute of Medical Sciences, Imphal, Manipur, India
Sushma Khuraijam Regional Institute of Medical Sciences, Imphal, Manipur, India
Sheronica Laishram Regional Institute of Medical Sciences, Imphal, Manipur, India
Robedi Choudhurimayum Regional Institute of Medical Sciences, Imphal, Manipur, India
Opendro Singh Narengbam Regional Institute of Medical Sciences, Imphal, Manipur, India

DOI:

https://doi.org/10.21276/apalm.3401

Keywords:

Placenta, pathology, COVID-19, immunohistochemistry, fetal death

Abstract

Background: The pandemic caused by the novel coronavirus named SARS-CoV-2 (COVID-19) has affected millions. As of June 2024, the number of deaths has reached more than 7.1 million across the globe. The clinical spectrum ranges from mild respiratory tract infection to life-threatening complications and death. Pregnant women are a particular group, and pathological changes in the placentas of SARS-CoV-2 positive patients are needed to understand the effects and outcomes of pregnancy. This study was conducted to assess any specific placental histopathology related to COVID-19.

Materials and Methods: We conducted a cross-sectional study on all placentas from women who were COVID-19 positive during the second and third trimesters of pregnancy in the Department of Pathology of a tertiary care center in Northeast India.

Results: We encountered twelve (12) placentas from COVID-19 positive mothers. There were nine (75%) live births and three (25%) intrauterine fetal deaths. Features of maternal vascular malperfusion, such as increased perivillous and intervillous fibrin, were the most common findings. Chorangiosis and avascular villi were the most common features of fetal vascular malperfusion. Also observed were marked macrophage infiltration (CD 68 positive), chorioamnionitis, and calcification.

Conclusion: Infection with COVID-19 has adverse clinical outcomes and significant placental histopathological and immunohistochemistry findings.

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