Placental Tissue Destruction and Insufficiency From COVID-19 Causes Stillbirth and Neonatal Death From Hypoxic-Ischemic Injury.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Schwartz David A, Avvad-Portari Elyzabeth, Babál Pavel, Baldewijns Marcella, Blomberg Marie, Bouachba Amine, Camacho Jessica, Collardeau-Frachon Sophie, Colson Arthur, Dehaene Isabelle, Ferreres Joan Carles, Fitzgerald Brendan, Garrido-Pontnou Marta, Gergis Hazem, Hargitai Beata, Helguera-Repetto A Cecilia, Holmström Sandra, Irles Claudine Liliane, Leijonhfvud Åsa, Libbrecht Sasha, Marton Tamás, McEntagart Noel, Molina James T, Morotti Raffaella, Nadal Alfons, Navarro Alexandra, Nelander Maria, Oviedo Angelica, Otani Andre Ricardo Oyamada, Papadogiannakis Nikos, Petersen Astrid C, Roberts Drucilla J, Saad Ali G, Sand Anna, Schoenmakers Sam, Sehn Jennifer K, Simpson Preston R, Thomas Kristen, Valdespino-Vázquez M Yolotzin, van der Meeren Lotte E, Van Dorpe Jo, Verdijk Robert M, Watkins Jaclyn C, Zaigham Mehreen
Аннотация
OBJECTIVE.—: To evaluate the role of the placenta in causing stillbirth and neonatal death following maternal infection with COVID-19 and confirmed placental positivity for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
DESIGN.—: Case-based retrospective clinicopathologic analysis by a multinational group of 44 perinatal specialists from 12 countries of placental and autopsy pathology findings from 64 stillborns and 4 neonatal deaths having placentas testing positive for SARS-CoV-2 following delivery to mothers with COVID-19.
RESULTS.—: Of the 3 findings constituting SARS-CoV-2 placentitis, all 68 placentas had increased fibrin deposition and villous trophoblast necrosis and 66 had chronic histiocytic intervillositis. Sixty-three placentas had massive perivillous fibrin deposition. Severe destructive placental disease from SARS-CoV-2 placentitis averaged 77.7% tissue involvement. Other findings included multiple intervillous thrombi (37%; 25 of 68) and chronic villitis (32%; 22 of 68). The majority (19; 63%) of the 30 autopsies revealed no significant fetal abnormalities except for intrauterine hypoxia and asphyxia. Among all 68 cases, SARS-CoV-2 was detected from a body specimen in 16 of 28 cases tested, most frequently from nasopharyngeal swabs. Four autopsied stillborns had SARS-CoV-2 identified in internal organs.
CONCLUSIONS.—: The pathology abnormalities composing SARS-CoV-2 placentitis cause widespread and severe placental destruction resulting in placental malperfusion and insufficiency. In these cases, intrauterine and perinatal death likely results directly from placental insufficiency and fetal hypoxic-ischemic injury. There was no evidence that SARS-CoV-2 involvement of the fetus had a role in causing these deaths.