Maternal COVID-19 causing intrauterine foetal demise with microthrombotic placental insufficiency: a case report

Olivia Nonn; Lilli Bonstingl; Katja Sallinger; Lena Neuper; Julia Fuchs; Martin Gauster; Berthold Huppertz; Dagmar Brislinger; Amin El-Heliebi; Herbert Fluhr; Eva Kampelmühler; Philipp Klaritsch

doi:10.1186/s12884-023-05942-6

Maternal COVID-19 causing intrauterine foetal demise with microthrombotic placental insufficiency: a case report

Olivia Nonn, Lilli Bonstingl, Katja Sallinger, Lena Neuper, Julia Fuchs, Martin Gauster, Berthold Huppertz, Dagmar Brislinger, Amin El-Heliebi, Herbert Fluhr, Eva Kampelmühler, Philipp Klaritsch

BioTechMed-Graz

Publikation: Beitrag in einer Fachzeitschrift › Artikel › Begutachtung

Abstract

BACKGROUND: Pregnant women have an increased risk of getting infected with SARS-CoV-2 and are more prone to severe illness. Data on foetal demise in affected pregnancies and its underlying aetiology is scarce and pathomechanisms remain largely unclear.

CASE: Herein we present the case of a pregnant woman with COVID-19 and intrauterine foetal demise. She had no previous obstetric or gynaecological history, and presented with mild symptoms at 34 + 3 weeks and no signs of foetal distress. At 35 + 6 weeks intrauterine foetal death was diagnosed. In the placental histopathology evaluation, we found inter- and perivillous fibrin depositions including viral particles in areas of degraded placental anatomy without presence of viral entry receptors and SARS-CoV-2 infection of the placenta.

CONCLUSION: This case demonstrates that maternal SARS-CoV-2 infection in the third trimester may lead to an unfavourable outcome for the foetus due to placental fibrin deposition in maternal COVID-19 disease possibly via a thrombogenic microenvironment, even when the foetus itself is not infected.

Originalsprache	englisch
Seiten (von - bis)	653
Fachzeitschrift	BMC Pregnancy and Childbirth
Jahrgang	23
Ausgabenummer	1
DOIs	https://doi.org/10.1186/s12884-023-05942-6
Publikationsstatus	Veröffentlicht - 9 Sept. 2023

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10.1186/s12884-023-05942-6

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Nonn, O., Bonstingl, L., Sallinger, K., Neuper, L., Fuchs, J., Gauster, M., Huppertz, B., Brislinger, D., El-Heliebi, A., Fluhr, H., Kampelmühler, E., & Klaritsch, P. (2023). Maternal COVID-19 causing intrauterine foetal demise with microthrombotic placental insufficiency: a case report. BMC Pregnancy and Childbirth, 23(1), 653. https://doi.org/10.1186/s12884-023-05942-6

Nonn, O, Bonstingl, L, Sallinger, K, Neuper, L, Fuchs, J, Gauster, M, Huppertz, B, Brislinger, D, El-Heliebi, A, Fluhr, H, Kampelmühler, E & Klaritsch, P 2023, 'Maternal COVID-19 causing intrauterine foetal demise with microthrombotic placental insufficiency: a case report', BMC Pregnancy and Childbirth, Jg. 23, Nr. 1, S. 653. https://doi.org/10.1186/s12884-023-05942-6

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AU - Bonstingl, Lilli

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AU - Neuper, Lena

AU - Fuchs, Julia

AU - Gauster, Martin

AU - Huppertz, Berthold

AU - Brislinger, Dagmar

AU - El-Heliebi, Amin

AU - Fluhr, Herbert

AU - Kampelmühler, Eva

AU - Klaritsch, Philipp

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N2 - BACKGROUND: Pregnant women have an increased risk of getting infected with SARS-CoV-2 and are more prone to severe illness. Data on foetal demise in affected pregnancies and its underlying aetiology is scarce and pathomechanisms remain largely unclear.CASE: Herein we present the case of a pregnant woman with COVID-19 and intrauterine foetal demise. She had no previous obstetric or gynaecological history, and presented with mild symptoms at 34 + 3 weeks and no signs of foetal distress. At 35 + 6 weeks intrauterine foetal death was diagnosed. In the placental histopathology evaluation, we found inter- and perivillous fibrin depositions including viral particles in areas of degraded placental anatomy without presence of viral entry receptors and SARS-CoV-2 infection of the placenta.CONCLUSION: This case demonstrates that maternal SARS-CoV-2 infection in the third trimester may lead to an unfavourable outcome for the foetus due to placental fibrin deposition in maternal COVID-19 disease possibly via a thrombogenic microenvironment, even when the foetus itself is not infected.

AB - BACKGROUND: Pregnant women have an increased risk of getting infected with SARS-CoV-2 and are more prone to severe illness. Data on foetal demise in affected pregnancies and its underlying aetiology is scarce and pathomechanisms remain largely unclear.CASE: Herein we present the case of a pregnant woman with COVID-19 and intrauterine foetal demise. She had no previous obstetric or gynaecological history, and presented with mild symptoms at 34 + 3 weeks and no signs of foetal distress. At 35 + 6 weeks intrauterine foetal death was diagnosed. In the placental histopathology evaluation, we found inter- and perivillous fibrin depositions including viral particles in areas of degraded placental anatomy without presence of viral entry receptors and SARS-CoV-2 infection of the placenta.CONCLUSION: This case demonstrates that maternal SARS-CoV-2 infection in the third trimester may lead to an unfavourable outcome for the foetus due to placental fibrin deposition in maternal COVID-19 disease possibly via a thrombogenic microenvironment, even when the foetus itself is not infected.

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KW - Humans

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KW - COVID-19/complications

KW - Placenta

KW - SARS-CoV-2

KW - Stillbirth

KW - Fibrin

U2 - 10.1186/s12884-023-05942-6

DO - 10.1186/s12884-023-05942-6

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JO - BMC Pregnancy and Childbirth

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Maternal COVID-19 causing intrauterine foetal demise with microthrombotic placental insufficiency: a case report

Abstract

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