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Open Access 01-12-2024 | SARS-CoV-2 | Case Report

Placental inflammation in a fetal demise of a SARS-CoV-2-asymptomatic, COVID-19-unvaccinated pregnant woman: a case-report

Authors: Maricarmen Abrego-Navarro, Rodrigo Villalobos, Jaime Sanchez, Deisa Lamela, Cindy Fu, Erika Guerrero, Paulino Vigil-De Gracia, Sandra López-Vergès, Mairim A. Solis

Published in: BMC Pregnancy and Childbirth | Issue 1/2024

Abstract

Background

Intrauterine fetal demise is a recognized complication of coronavirus disease 2019 in pregnant women and is associated with histopathological placental lesions. The pathological mechanism and virus-induced immune response in the placenta are not fully understood. A detailed description of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-induced inflammation in the placenta during fetal demise is crucial for improved clinical management.

Case presentation

We report the case of a 27-week gestation SARS-CoV-2-asymptomatic unvaccinated pregnant woman without comorbidities or other risk factors for negative pregnancy outcomes with a diagnosis of intrauterine fetal demise. Histopathological findings corresponded to patterns of subacute inflammation throughout the anatomic compartments of the placenta, showing severe chorioamnionitis, chronic villitis and deciduitis, accompanied by maternal and fetal vascular malperfusion. Our immunohistochemistry results revealed infiltration of CD68⁺ macrophages, CD56⁺ Natural Killer cells and scarce CD8⁺ T cytotoxic lymphocytes at the site of placental inflammation, with the SARS-CoV-2 nucleocapsid located in stromal cells of the chorion and chorionic villi, and in decidual cells.

Conclusion

This case describes novel histopathological lesions of inflammation with infiltration of plasma cells, neutrophils, macrophages, and natural killer cells associated with malperfusion in the placenta of a SARS-CoV-2-infected asymptomatic woman with intrauterine fetal demise. A better understanding of the inflammatory effects exerted by SARS-CoV-2 in the placenta will enable strategies for better clinical management of pregnant women unvaccinated for SARS-CoV-2 to avoid fatal fetal outcomes during future transmission waves.

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Title: Placental inflammation in a fetal demise of a SARS-CoV-2-asymptomatic, COVID-19-unvaccinated pregnant woman: a case-report
Authors: Maricarmen Abrego-Navarro
Rodrigo Villalobos
Jaime Sanchez
Deisa Lamela
Cindy Fu
Erika Guerrero
Paulino Vigil-De Gracia
Sandra López-Vergès
Mairim A. Solis
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: SARS-CoV-2
COVID-19
Pathology
Published in: BMC Pregnancy and Childbirth / Issue 1/2024
Electronic ISSN: 1471-2393
DOI: https://doi.org/10.1186/s12884-024-06530-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Placental inflammation in a fetal demise of a SARS-CoV-2-asymptomatic, COVID-19-unvaccinated pregnant woman: a case-report

Abstract

Background

Case presentation

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Case presentation

Conclusion

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