Paul H Hartel^1-3* and Weronika Wudarczyk⁴

¹Sligo University Hospital, The Mall, Sligo, Ireland
²National University of Ireland, Galway School of Medicine, Galway, Ireland
³West Virginia University School of Medicine, Morgantown, WV, USA
⁴Sligo Institute of Technology, Ireland

*Corresponding Author: Paul H Hartel, Sligo University Hospital, The Mall, Sligo, Ireland.

Received: January 27, 2022; Published: February 16, 2022

Abstract

Maternal COVID-19 infection during pregnancy has been associated with a myriad of pathologic placental changes. Clinically, rare studies have highlighted intrauterine growth restriction (IUGR), pre-term birth, intrauterine fatal demise and stillbirth in association with maternal gestational COVID-19 infection. Third trimester infants should be protected from acquiring COVID-19 infection since there is a paucity of the required angiotensin-converting enzyme (ACE) receptors present in the placenta, and earlier maternal gestational infections theoretically pose higher risk. We reviewed the total of 20 placentas from first trimester maternal COVID-positive pregnancies and clinical outcomes in the Sligo University Hospital catchment area from 2020-2021 to add to the literature of COVID-19 clinical and pathologic findings. Clinical audit was performed on placentas from maternal COVID-positive pregnancies from 2020-2021. Anonymised data from patient pathology reports including maternal and gestational age, clinically provided morbidity and maternal and neonatal outcome data and placental pathologic findings and were reviewed. Haematoxylin and eosin-stained slides were available in all cases and reviewed by a consultant pathologist. All variables were compared with known background incidence and a cohort of 20 randomly selected non-COVID cases from the same time period. Maternal age ranged from 20-41 years (m = 31), and gestational age from 25 to 41 weeks (m = 36). All maternal COVID-19 positive results were from first trimester. Placental weights ranged from 312 to 897 grams (m = 594). All cases showed increased peri-villous fibrin deposition with 3 showing extensive fibrin. Ten cases had infarctions and 2 with extensive infarctions (>15% of placenta). Five cases had increased syncytial knotting. Our results support that placental pathology from early maternal gestational COVID-19 infection is associated with maternal pro-coagulopathic state, not fetal or ‘placental’ infection.

Keywords:COVID-19; Gestational Infection; Pregnancy; Coagulopathy

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Citation

Citation: Paul H Hartel and Weronika Wudarczyk. “Maternal First Trimester Gestational COVID-19 Infection is Associated with Increased Placental Maternal Vascular Malperfusion, But Not Clinical Morbidity or Mortality". Acta Scientific Women's Health 4.3 (2022): 02-07.

Copyright

Copyright: © 2022 Paul H Hartel and Weronika Wudarczyk. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.