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Placental Histopathology in COVID-19-Positive Mothers

  • Sherwani, Nikita (Virology Lab, Department of Microbiology, Pt. JNM Medical College) ;
  • Singh, Neha (Virology Lab, Department of Microbiology, Pt. JNM Medical College) ;
  • Neral, Arvind (Department of Pathology, Pt. JNM Medical College) ;
  • Jaiswal, Jyoti (Department of Obstetrics and Gynaecology, Pt. JNM Medical College) ;
  • Nagaria, Tripti (Department of Obstetrics and Gynaecology, Pt. JNM Medical College) ;
  • Khandwal, Onkar (Department of Paediatrics, Pt. JNM Medical College)
  • Received : 2022.06.27
  • Accepted : 2022.08.07
  • Published : 2022.09.28

Abstract

The placenta is a captivating multifunctional organ of fetal origin and plays an essential role during pregnancy by intimately connecting mother and baby. This study explicates placental pathology and information about 25 placentas collected from the mothers infected with novel coronavirus (SARS-COV-2). So far, congenital transmission of SARS-CoV-2 seems to be remarkably uncommon in spite of many cases of COVID-19 during pregnancy. Out of the 25 placental tissue samples collected, none has shown gene expression of SARS-CoV-2 when confirmed by RT-PCR. At the same time, nasal and throat swab samples collected from newborns of SARS-CoV-2-positive mothers correspondingly tested negative by RT-PCR. The shielding properties of placental barriers against viral infections from mothers to newborns remains a mystery. Major histopathological findings have been recorded as choriodecidual tissue with necrosis, intramural fibrin deposition, chorionic villi with fibrosis, and calcification. Moreover, although recent findings are insufficient to prove direct placental transmission of COVID-19, the abundance of angiotensin-converting enzymes-2 (ACE-2) on the placental surface could potentially contribute to unpleasant outcomes during pregnancy as SARS-CoV-2 gains access to human cells via ACE-2. Finally, the significance of these findings is vague and needs further study.

Keywords

Acknowledgement

This study was approved by the Institutional Ethics Committee (IEC), Pt. JNM Medical College, Raipur, India (Approval Number: No./MC/Ethics/2020/10). The author(s) received financial support from NUMH (National Urban Health Mission), Raipur, India for the research, and/or publication of this article.

References

  1. Joudi N, Henkel A, Lock WS, Lyell D. 2020. Preeclampsia treatment in severe acute respiratory syndrome coronavirus 2. Am. J. Obstet. Gynecol. MFM 2: 100146. https://doi.org/10.1016/j.ajogmf.2020.100146
  2. Levy A, Yagil Y, Bursztyn M, Barkalifa R, Scharf S, Yagil C. 2008. ACE2 expression and activity are enhanced during pregnancy. Am. J. Physiol. Regul. Integr. Comp. Physiol. 295: 1953-1961.
  3. Valdes G, Neves LA, Anton L. 2006. Distribution of angiotensin-(1-7) and ACE2 in human placentas of normal and pathological pregnancies. Placenta 27: 200-207. https://doi.org/10.1016/j.placenta.2005.02.015
  4. Redline RW. 2015. Classification of placental lesions. Am. J. Obstet. Gynecol. 213: 21-28. https://doi.org/10.1016/j.ajog.2015.05.056
  5. Benirschke B, Burton GJ, Baergen RN. 2012. Pathology of the Human Placenta. 6th ed. Berlin, Heidelberg: Springer 10: 978-993.
  6. Guttmacher AE, Maddox YT, Spong CY. 2014. The human placenta project: placental structure, development, and function in real time. Placenta 35: 303-304. https://doi.org/10.1016/j.placenta.2014.02.012
  7. Spinillo A, Gardella B, Muscettola G, Cesari S, Fiandrino G, Tzialla C. 2019 The impact of placental massive perivillous fibrin deposition on neonatal outcome in pregnancies complicated by fetal growth restriction. Placenta 87: 46-52. https://doi.org/10.1016/j.placenta.2019.09.007
  8. Romero, Roberto et al. 2013 Maternal floor infarction/massive perivillous fibrin deposition: a manifestation of maternal antifetal rejection? Am. J. Reprod. Immunol. 70: 285-298. https://doi.org/10.1111/aji.12143
  9. Tindall VR, Scott J S. 1965. Placental calcification a study of 3,025 singleton and multiple pregnancies. J. Obstet. Gynaecol. Br. Commonw. 72: 356-373. https://doi.org/10.1111/j.1471-0528.1965.tb01470.x
  10. Chen KH, Chen LR, Lee YH. 2011. Exploring the relationship between preterm placental calcification and adverse maternal and fetal outcome. Ultrasound Obstet. Gynecol. 37: 328-334. https://doi.org/10.1002/uog.7733
  11. Patterson RM, Hayashi R, Cavazos D. 1983. Ultrasonographically observed early placental maturation and perinatal outcome. Am. J. Obstet. Gynecol. 147: 773-777. https://doi.org/10.1016/0002-9378(83)90035-2
  12. Bulmer JN, Sunderland CA. 1984. Immunohistological characterization of lymphoid cell populations in the early human placental bed. Immunology 52: 349-357.
  13. Pandey M, Chauhan M, Awasthi S. 2017. Interplay of cytokines in preterm birth. Indian J. Med. Res. 146: 316-327.
  14. Raffaella Di Girolamo, Asma Khalil, Sara Alameddine, Emanuela D'Angelo, Carmen Galliani, Barbara Matarrelli, et al. 2021. Placental histopathology after SARS-CoV-2 infection in pregnancy: a systematic review and meta-analysis. Am. J. Obstet. Gynecol.MFM 3: 1004-1068.
  15. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. 2020. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 395: 497-506. https://doi.org/10.1016/s0140-6736(20)30183-5