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Vol. 25, Art. 6 (pp. 102-111)    |    2024       

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Morphological features of the placenta in adverse pregnancy outcomes during a pandemic caused by a new coronavirus infection covid-19.

Kolobov A.V.1,2

1St Petersburg University, 7-9 Universitetskaya Embankment, St Petersburg, 199034, Russia,
2City pathological bureau, Uchebniy per. 5, St Petersburg, 194354, Russia

Brief summary

Introduction. The new coronavirus infection COVID-19, caused by the coronavirus SARS-CoV-2, is accompanied by dysregulation of all cells of the unified human neuroimmunoendocrine system with the formation of inflammation in the form of a so-called «cytokine storm», which results in the destruction of tissues and organs, and, as a result, the death. Today, the possibility of the SARS-CoV-2 virus infecting placental cells and transplacental transmission is beyond doubt, while infection of the placenta is accompanied by an inflammatory cellular reaction of varying severity depending on the duration of pregnancy and the presence of previous placental pathology. Purpose of the study. Conducting an analysis of morphological changes in placentas obtained from adverse pregnancy outcomes in the context of the new coronavirus infection COVID-19. Material and methods. From 2019 to 2021 inclusive, a study was conducted on 415 placentas obtained as a result of adverse pregnancy outcomes. The material was studied according to the recommendations of the Amsterdam placental workshop group. Research results. An increase in the proportion of miscarriages, both spontaneous and miscarried, was shown in 2020-2021 compared to pre-Covid 2019. Thus, failed miscarriages in 2019 amounted to 7% of the total volume of material studied during the year, in 2020 - 12%, and in 2021 - already 16%. At the same time, the relative rate of spontaneous miscarriages increased by more than 1.5 times. The study noted that during spontaneous miscarriages, signs of acute chorioamnionitis are revealed in the placental membranes. In case of failed miscarriages, an inflammatory reaction develops in the placenta with lymphocytic-macrophage exudate filling the intervillous space, which is characteristic of the new coronavirus infection COVID-19. In addition, perivillous fibrinoid deposition and ischemic necrosis are noted. Conclusion. As a result of a new coronavirus infection in pregnant women, an inflammatory reaction develops in the intervillous space of the placenta with perivillous deposition of fibrinoid and/or infarction of the placenta, which leads to the impossibility of performing the functions of the placenta (primarily gas exchange and trophic) and, as a consequence, to intrauterine fetal death with subsequent termination of pregnancy.


Key words

COVID-19; placenta; miscarriage; pregnancy

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