PDF(Pubmed)
Abstract：
BACKGROUND: Pregnant women have an increased risk of getting infected with SARS-CoV-2 and are more prone to severe illness. Data on foetal demise in affected pregnancies and its underlying aetiology is scarce and pathomechanisms remain largely unclear.
METHODS: Herein we present the case of a pregnant woman with COVID-19 and intrauterine foetal demise. She had no previous obstetric or gynaecological history, and presented with mild symptoms at 34 + 3 weeks and no signs of foetal distress. At 35 + 6 weeks intrauterine foetal death was diagnosed. In the placental histopathology evaluation, we found inter- and perivillous fibrin depositions including viral particles in areas of degraded placental anatomy without presence of viral entry receptors and SARS-CoV-2 infection of the placenta.
CONCLUSIONS: This case demonstrates that maternal SARS-CoV-2 infection in the third trimester may lead to an unfavourable outcome for the foetus due to placental fibrin deposition in maternal COVID-19 disease possibly via a thrombogenic microenvironment, even when the foetus itself is not infected.
METHODS: Herein we present the case of a pregnant woman with COVID-19 and intrauterine foetal demise. She had no previous obstetric or gynaecological history, and presented with mild symptoms at 34 + 3 weeks and no signs of foetal distress. At 35 + 6 weeks intrauterine foetal death was diagnosed. In the placental histopathology evaluation, we found inter- and perivillous fibrin depositions including viral particles in areas of degraded placental anatomy without presence of viral entry receptors and SARS-CoV-2 infection of the placenta.
CONCLUSIONS: This case demonstrates that maternal SARS-CoV-2 infection in the third trimester may lead to an unfavourable outcome for the foetus due to placental fibrin deposition in maternal COVID-19 disease possibly via a thrombogenic microenvironment, even when the foetus itself is not infected.
摘要：
背景：孕妇感染SARS-CoV-2的风险增加，并且更容易患严重疾病。有关受影响妊娠胎儿死亡及其潜在病因的数据很少，而且发病机制仍不清楚。
方法：在此，我们介绍了一名患有COVID-19和宫内胎儿死亡的孕妇。她以前没有产科或妇科史，并在34+3周时出现轻微症状，没有胎儿窘迫的迹象。在35+6周时，诊断为宫内胎儿死亡。在胎盘组织病理学评估中，我们在胎盘解剖结构退化的区域发现了绒毛间和绒毛周围的纤维蛋白沉积,包括病毒颗粒,而不存在病毒进入受体和SARS-CoV-2感染胎盘.
结论：该病例表明，妊娠晚期的母体SARS-CoV-2感染可能会由于母体COVID-19疾病中胎盘纤维蛋白沉积而导致胎儿不良结局，可能是通过血栓形成微环境，即使胎儿本身没有被感染。
方法：在此，我们介绍了一名患有COVID-19和宫内胎儿死亡的孕妇。她以前没有产科或妇科史，并在34+3周时出现轻微症状，没有胎儿窘迫的迹象。在35+6周时，诊断为宫内胎儿死亡。在胎盘组织病理学评估中，我们在胎盘解剖结构退化的区域发现了绒毛间和绒毛周围的纤维蛋白沉积,包括病毒颗粒,而不存在病毒进入受体和SARS-CoV-2感染胎盘.
结论：该病例表明，妊娠晚期的母体SARS-CoV-2感染可能会由于母体COVID-19疾病中胎盘纤维蛋白沉积而导致胎儿不良结局，可能是通过血栓形成微环境，即使胎儿本身没有被感染。
