COVID-19 during pregnancy: non-reassuring fetal heart rate, placental pathology and coagulopathy

Ultrasound Obstet Gynecol. 2020 Nov;56(5):773-776. doi: 10.1002/uog.22189. Epub 2020 Oct 19.

Abstract

We report a case of a pregnant woman with COVID-19 who developed coagulopathy in the absence of severe clinical symptoms. A polymerase chain reaction test of a vaginal swab was positive for SARS-CoV-2 RNA, suggesting a possibility of perinatal transmission. Cesarean delivery was performed because of a non-reassuring fetal heart rate; the placenta showed increased perivillous fibrin deposition and intervillositis. Moreover, placental infection with SARS-CoV-2 was demonstrated by placental immunostaining. The findings suggest a possible relationship between placental fibrin deposition and chronic and acute intervillositis, non-reassuring fetal heart rate and coagulopathy in pregnant women with COVID-19. © 2020 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Keywords: COVID-19; SARS-CoV-2; coagulopathy; placental pathology; pregnancy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Betacoronavirus* / isolation & purification
  • COVID-19
  • COVID-19 Testing
  • Clinical Laboratory Techniques / methods*
  • Coronavirus Infections / complications
  • Coronavirus Infections / diagnosis*
  • Coronavirus Infections / pathology
  • Coronavirus Infections / transmission
  • Disseminated Intravascular Coagulation / diagnosis
  • Disseminated Intravascular Coagulation / virology*
  • Female
  • Heart Rate, Fetal
  • Humans
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical
  • Pandemics
  • Placenta / pathology
  • Placenta / virology
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / diagnosis*
  • Pneumonia, Viral / pathology
  • Pneumonia, Viral / transmission
  • Pregnancy
  • Pregnancy Complications, Hematologic / diagnosis
  • Pregnancy Complications, Hematologic / virology*
  • Pregnancy Complications, Infectious / diagnosis*
  • Pregnancy Complications, Infectious / pathology
  • SARS-CoV-2