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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. Maternal COVID-19 causing intrauterine foetal demise with microthrombotic placental insufficiency: a case report. BMC Pregnancy Childbirth 2023; 23:653. [PMID: 37689629 PMCID: PMC10492311 DOI: 10.1186/s12884-023-05942-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 08/21/2023] [Indexed: 09/11/2023] Open
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.
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Affiliation(s)
- Olivia Nonn
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany.
- Experimental and Clinical Research Centre, Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité Universitätsmedizin Berlin, Berlin, Germany.
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany.
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria.
| | - Lilli Bonstingl
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
- Center for Biomarker Research in Medicine (CBmed), Graz, Austria
| | - Katja Sallinger
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
- Center for Biomarker Research in Medicine (CBmed), Graz, Austria
| | - Lena Neuper
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | - Julia Fuchs
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
- Division of Medical Physics and Biophysics, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | - Martin Gauster
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | - Berthold Huppertz
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | - Dagmar Brislinger
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | - Amin El-Heliebi
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
- Center for Biomarker Research in Medicine (CBmed), Graz, Austria
- BioTechMed, Graz, Austria
| | - Herbert Fluhr
- Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria
| | - Eva Kampelmühler
- Diagnostic and Research Institute of Pathology, Diagnostic and Research Center for Molecular Biomedicine, Medical University of Graz, Graz, Austria
| | - Philipp Klaritsch
- Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria
- Research Unit for Fetal Medicine, Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria
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Aliyeva S, Lokshin V, Kamaliev M, Sarmuldayeva S, Tanbayeva G, Shafranskyi V, Tsigengagel О, Mukhamedyarova A. Forward-Looking Strategies for the Advancement of Obstetrics and Gynecology to Operate in a COVID-19 Рandemic World and Beyond: A Scoping Review. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND: The difficult epidemiological situation of COVID‒19 infection in the world and in the country requires drastic measures to strengthen the material, technical, and staffing of health-care provision in the obstetrics and gynecology practices. It has also created an environment conducive to innovation and the accelerated implementation of new ideas. This is an attempt to discuss the potential implications for obstetrics and gynecologic practice in the world.
AIM: This study review gives a comprehensive overview on the effects of the COVID-19 pandemic of the potential implications for obstetrics and gynecologic practice.
METHODS: The data-based used in the source search were MEDLINE and PubMed databases using terms such as: COVID-19/SARS-CoV-2, impact of corona virus on the health sector and COVID-19 in obstetrics and gynecology care. We searched several databases for English articles published between January 2020 and February 2022 that discussed or touched on the effects the pandemic had of the potential implications for obstetrics and gynecologic practice in OECD countries.
RESULTS: In total, eight relevant articles discuss the relationship between reorganization of the practice of obstetrics and gynecology and other challenges that placed health-care providers under considerable psychological stress. Some studies showed that the discussed extensively the potential implications of COVID-19 for obstetrics and gynecologic practice.
CONCLUSION: Successful coping strategies have been adapted to local conditions and the working conditions of staff and, most importantly, patients, so we recommend turning these temporary strategies into permanent solutions that can be quickly applied during future pandemics.
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