Sudha Vasudevan Associate Professor, Department of Pathology, Saveetha Medical College and Hospital, Chennai, Tamil Nadu, 600092, India
Muthu Subramanian Senior Resident, Department of Pathology, Sri Ramachandra Medical College and Hospital, Chennai, Tamil Nadu 600116, India
Ganthimathi Sekhar Professor, Department of Pathology, Saveetha Medical College and Hospital, Chennai, Tamil Nadu, 600092, India
Chitra Srinivasan Professor and Head, Department of Pathology, Saveetha Medical College and Hospital, Chennai, Tamil Nadu, 600092, India
Address for correspondence: Sudha Vasudevan, Associate Professor, Department of Pathology, Saveetha Medical College and Hospital, Chennai, Tamil Nadu, 600092, India E-mail: sudh7828@gmail.com
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
Sudha V, Subramanian M, Sekhar G, et al. A study on histopathological changes and neonatal outcomes in the placenta of COVID-19 positive mothers: a prospective study. Indian J Forensic Med Pathol. 2022;15(1):17-24.
Timeline
Received : December 26, 2021
Accepted : February 25, 2022
Published : March 30, 2022
Abstract
Context: It has been estimated that are about 168 million lab confirmed COVID 19 cases worldwide as of 28th may, 2021. Due to the high prevalence of this disease, it is of utmost importance to study its effect on the vulnerable population of pregnant women. aim: Aim of the study are 1) the histopathological changes in placenta of COVID19 mothers. 2) To correlate the histopathological changes with the fetal outcome in COVID 19 positive mothers. materials & method: Twenty five placentas of Covid 19 positive mothers were received in formalin with proper clinical history including age of the mother, gestational age, mode of delivery, complications during pregnancy and during labor, baby weight and APGAR score of the baby. The specimen were allowed to fix in neutral buffered formalin for a period of 48 hrs. The placentas were then grossly and histopathologically examined. results: Out of 25 placentas, some showed features of maternal vascular malperfusion (MVM), particularly villous infarct, villous agglutination and intervillous and perivillous fibrin deposits. Some showed fetal vascular malperfusion features like avascular villi, stem vessel obliteration were also present in a few of the cases. Out of the 25 pregnancies, 21 babies were delivered live with normal birth weight. There were 4 spontaneous abortions ranging from 14 - 22 weeks. conclusion: As the placenta acts as a bridge between the mother and the developing baby, any insult to the placenta in the form of maternal or fetal vascular malperfusion may result in an adverse perinatal outcome
References
1. Zhou P, Yang XL, Wang XG, Hu B, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. nature. 2020 Mar;579(7798):270-3.
2. Riviere G, Michaud A, Breton C, VanCamp G, et al. Angiotensinconverting enzyme 2 (ACE2) and ACE activities display tissue-specific sensitivity to undernutrition-programmed hypertension in the adult rat. Hypertension. 2005 Nov 1;46(5):1169-74.
3. Harmer D, Gilbert M, Borman R, Clark KL. Quantitative mRNA expression profiling of ACE 2, a novel homologue of angiotensin converting enzyme. FEBS letters. 2002 Dec 4;532(1-2):107-10.
5. Pringle KG, Tadros MA, Callister RJ, Lumbers ER. The expression and localization of the human placental prorenin/renin-angiotensin system throughout pregnancy: roles in trophoblast invasion and angiogenesis ? Placenta. 2011 Dec 1;32(12):956-62.
6. Taylor DM, Aronow BJ, Tan K, et al. The Pediatric Cell Atlas: defining the growth phase of human development at single-cell resolution. Developmental cell. 2019 Apr 8;49(1):10-29.
7. Wong SF, Chow KM, Leung TN, Ng WF, et al. Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome. American journal of obstetrics and gynecology. 2004 Jul 1;191(1):292-7.
8. Alfaraj SH, Al-Tawfiq JA, Memish ZA. Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection during pregnancy: Report of two cases & review of the literature.
9. Mullins E, Evans D, Viner RM, et al. Coronavirus in pregnancy and delivery: rapid review. Ultrasound in Obstetrics & Gynecology. 2020 May 1;55(5):586-92.
10. Di Mascio D, Khalil A, Saccone G, Rizzo G, et al. Outcome of Coronavirus spectrum infections (SARS, MERS, COVID 1-19) during pregnancy: a systematic review and metaanalysis. American journal of obstetrics & gynecology MFM. 2020 Mar 25:100107.
11. Redline RW, Boyd T, Campbell V, et al. Society for Pediatric Pathology, Perinatal
12. Fox H, Sebire N. Pathology of the Placenta. Elsevier Health Sciences; 2007 Jun 25.
13. NAEYE RL. Placental infarction leading to fetal or neonatal death: a prospective study. Obstetrics & Gynecology. 1977 Nov 1;50(5):583-8.
14. Wiredu EK, Tettey Y. Autopsy studies on still births in Korle Bu Teaching Hospital. II: Causes of death in 93 still births. West African journal of medicine. 1998;17(3):148.
15. Baird JK. Malaria zoonoses. Travel medicine and infectious disease. 2009 Sep 1;7(5):269-77.
16. Hantoushzadeh S, Shamshirsaz AA, Aleyasin A, et al. Maternal death due to COVID-19 disease. American journal of obstetrics and gynecology. 2020 Apr 28.
17. Shanes ED, Mithal LB, Otero S, et al. Placental pathology in COVID-19. American Journal of Clinical Pathology. 2020 Jun 8;154(1):23-32.
18. Redline RW, Pappin A. Fetal thrombotic vasculopathy: the clinical significance of extensive avascular villi. Human pathology. 1995 Jan 1;26(1):80-5.
19. Kirtsman M, Diambomba Y, Poutanen SM, et al. Probable congenital SARS-CoV-2 infection in a neonate born to a woman with active SARS-CoV-2 infection. CMAJ. 2020 Jan 1.
20. Hosier H, Farhadian S, Morotti R, Deshmukh U, et al. SARS-CoV-2 infection of the placenta. medRxiv. 2020 Jan 1.
21. Patanè L, Morotti D, Giunta MR, et al. Vertical transmission of coronavirus disease 2019: severe acute respiratory syndrome coronavirus 2 RNA on the fetal side of the placenta in pregnancies with coronavirus disease 2019–positive mothers and neonates at birth. American journal of obstetrics & gynecology MFM. 2020 Aug 1;2(3).
Data Sharing Statement
There are no additional data available. All raw data and code are available upon request.
Funding
This research received no funding.
Author Contributions
All authors contributed significantly to the work and approve its publication.
Ethics Declaration
This article does not involve any human or animal subjects, and therefore does not require ethics approval.
Acknowledgements
We would like to express our gratitude to the patients, their families, and all those who have contributed to this study.
About this article
Cite this article
Sudha V, Subramanian M, Sekhar G, et al. A study on histopathological changes and neonatal outcomes in the placenta of COVID-19 positive mothers: a prospective study. Indian J Forensic Med Pathol. 2022;15(1):17-24.
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.