Placental pathology in COVID-19

Area of Science:

• Obstetrics and Gynecology
• Pathology
• Infectious Diseases

Background:

• COVID-19 in pregnancy presents unique challenges.
• Understanding placental pathology is crucial for managing pregnancy outcomes.
• Maternal vascular malperfusion (MVM) is linked to adverse perinatal events.

Approach:

• Histopathologic examination of 16 placentas from women with SARS-CoV-2 infection.
• Comparison with historical controls and placentas from women with a history of melanoma.

Key Points:

• Third-trimester placentas from COVID-19 patients showed significantly increased maternal vascular malperfusion (MVM) features.
• MVM indicators included abnormal maternal vessels, delayed villous maturation, chorangiosis, and intervillous thrombi.
• No increased rates of acute or chronic placental inflammation were observed.

Conclusions:

• COVID-19 placentas exhibit an increased rate of MVM, indicating impaired intervillous oxygenation.
• These placental changes may stem from a systemic inflammatory or hypercoagulable state in COVID-19.
• MVM findings in COVID-19 pregnancies warrant further investigation regarding perinatal outcomes.