{Reference Type}: Case Reports {Title}: Maternal COVID-19 causing intrauterine foetal demise with microthrombotic placental insufficiency: a case report. {Author}: Nonn O;Bonstingl L;Sallinger K;Neuper L;Fuchs J;Gauster M;Huppertz B;Brislinger D;El-Heliebi A;Fluhr H;Kampelmühler E;Klaritsch P; {Journal}: BMC Pregnancy Childbirth {Volume}: 23 {Issue}: 1 {Year}: 2023 Sep 9 {Factor}: 3.105 {DOI}: 10.1186/s12884-023-05942-6 {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.