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

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

J E Mongula  1 , M W E Frenken  1   2   3 , G van Lijnschoten  4 , N L A Arents  5 , L D de Wit-Zuurendonk  1 , A P A Schimmel-de Kok  1 , P J van Runnard Heimel  1   2   3 , M M Porath  1 , S M T A Goossens  1   2   3
Affiliations
Case Reports

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

J E Mongula et al. Ultrasound Obstet Gynecol. 2020 Nov.

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.

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Figures

Figure 1
Figure 1
Placental abnormalities in patient diagnosed with COVID‐19. (a) Cross‐sections of placenta, showing multiple pale areas. (b) Microscopic overview of placenta, showing increased perivillous fibrin deposition and intervillositis. (c) Hematoxylin and eosin‐stained section showing fibrin around villi and infiltrate. (d) CD68‐stained section showing histiocytes (brown areas). (e) Myeloperoxidase‐stained section showing granulocytes (brown areas).
See this image and copyright information in PMC

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