Thrombotic Pathology in Placenta of COVID Positive Pregnancy

Abstract

Covid positive pregnant women were increasingly getting delivery in the health institution. Most of them were asymptomatic and had positive report after their obstetric event was over because of emergency nature of care. Lack of autopsy is the lacunae in determining tissue pathology. One case of sudden intrauterine fetal death in Covid positive patient had induced delivery in the hospital and the placental histopathology examination showed widespread villous infarction, decidual arteriopathy with thrombosis and chorioamnionitis.Keywords: Covid positive; fetal death; placenta; thrombosis

Maternal and perinatal outcomes in the COVID-19 Omicron wave in comparison with the Delta wave: a multicenter observational study

“…The COVID-19 severity can impact the mode of delivery and the maternal and fetal outcomes as a consequence. Maternal hypoxemia due to COVID-19 pneumonia, ARDS, and villous infraction (thrombotic lesions in the placenta) [20], often seen in the Delta wave, can lead to emergent cesarean section delivery for fetal distress or maternal life-saving [21]. However, vaginal delivery can be accepted only in patients who have no need or low flow of oxygen [22].…”

COVID-19 Vaccination in Pregnancy, Paediatrics, Immunocompromised Patients, and Persons with History of Allergy or Prior SARS-CoV-2 Infection: Overview of Current Recommendations and Pre- and Post-Marketing Evidence for Vaccine Efficacy and Safety

“…Regarding perinatal outcomes following SARS-CoV-2 infection, several reports of miscarriage and stillbirth were published [49,50], as well as pathological findings such as placentitis [51] and placenta thrombosis [52]. Premature births have been shown to be more common in SARS-CoV-2-positive mothers and their newborns are more likely to be admitted to the neonatal care unit [45].…”

TIMELESS is a key gene mediating thrombogenesis in COVID-19 and antiphospholipid syndrome

“…As of February 2022, more than 424,822,000 patients were confirmed to be infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and among them, more than 5,890,300 cases of death were reported ( https://covid19.who.int/ ). Although the novel coronavirus is considered as a pneumophilic virus, severe COVID-19 is not only a viral pulmonary infection, but also causes pathological clinical manifestations in multiple organs, accompanied by major coagulation abnormalities and thromboembolic events, such as pulmonary embolism, carotid thrombosis, deep vein thrombosis, and pregnancy thrombosis 1 – 4 . The incidence rate of thrombotic complications in severe COVID-19 patients was reported to be 31% by Klok et al 5 , which is much higher than the incidence of thrombotic complications in critically ill patients prior to the COVID-19 pandemic.…”

“…Firstly, patients with APS or COVID-19 showed a marked clinical heterogeneity. Patients with APS or COVID-19 developed spontaneous thrombosis of large vessels, affecting a single site, while a small percentage of patients developed rapidly progressive, life-threatening, and multi-organ micro-vessel thrombosis 1 – 4 , 7 . Secondly, APLs can be detected in the serum of patients with COVID-19, especially in critical COVID-19 patients, with a detection rate close to 47% (31/66) 8 .…”