%0 Case Reports
%T Maternal COVID-19 causing intrauterine foetal demise with microthrombotic placental insufficiency: a case report.
%A Nonn O
%A Bonstingl L
%A Sallinger K
%A Neuper L
%A Fuchs J
%A Gauster M
%A Huppertz B
%A Brislinger D
%A El-Heliebi A
%A Fluhr H
%A Kampelmühler E
%A Klaritsch P
%J BMC Pregnancy Childbirth
%V 23
%N 1
%D 2023 Sep 9
%M 37689629
%F 3.105
%R 10.1186/s12884-023-05942-6
%X 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.