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Placentas from COVID-19 positive pregnant women show injury: study

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The placentas from 16 women who tested positive for COVID-19 while pregnant showed evidence of injury, pathological exams completed directly following birth have showed, according to a Northwestern Medicine study.

The 16 women in the study delivered their babies at Northwestern Medicine Prentice Women’s Hospital. Four patients came in with flu-like symptoms three to five weeks before delivery and tested positive for the virus. The remaining patients all tested positive when they came in to deliver. Five patients never developed symptoms, others were symptomatic at delivery.

“They were healthy, full-term, beautifully normal babies, but our findings indicate a lot of the blood flow was blocked off and many of the placentas were smaller than they should have been,” said co-author Emily Miller, assistant professor of obstetrics and gynecology at NU Feinberg School of Medicine and Northwestern Medicine obstetrician. “Placentas get built with an enormous amount of redundancy. Even with only half of it working, babies are often completely fine. Still, while most babies will be fine, there’s a risk that some pregnancies could be compromised.”

The placentas in these patients had two common abnormalities: insufficient blood flow from the mother to the fetus with abnormal blood vessels called maternal vascular malperfusion (MVM) and blood clots in the placenta, called intervillous thrombi.

The placenta is the first organ to form in fetal development. It acts as the fetus’ lungs, gut, kidneys and liver, taking oxygen and nutrients from the mother’s blood stream and exchanging waste. The placenta also is responsible for many of the hormonal changes within the mother’s body.

“The placenta acts like a ventilator for the fetus, and if it gets damaged, there can be dire outcomes,” Miller said. “In this very limited study, these findings provide some signs that the ventilator might not work as well for as long as we’d like it to if the mother tests positive for SARS-CoV2.”

“There is an emerging consensus that there are problems with coagulation and blood vessel injury in COVID-19 patients,” said senior author Jeffrey Goldstein, assistant professor of pathology at NU Feinberg School of Medicine and a Northwestern Medicine pathologist. “Our finding support that there might be something clot-forming about coronavirus, and it’s happening in the placenta.”

The study was published Friday in the journal American Journal of Clinical Pathology.

Northwestern Medicine is the collaboration between Northwestern Memorial Healthcare and NU Feinberg School of Medicine, which includes research, teaching and patient care.

(XINHUA)

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