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. 2021 May;43(5):377-383.
doi: 10.1055/s-0041-1729146. Epub 2021 Jun 28.

Placental Sampling for Understanding Viral Infections - A Simplified Protocol for the COVID-19 Pandemic

Guilherme de Moraes Nobrega  1 , José Paulo Siqueira Guida  1 , Rodolfo Rosa Japecanga  1 , Arthur Antolini-Tavares  1 , Indira Mysorekar  2 , Maria Laura Costa  1
Affiliations

Placental Sampling for Understanding Viral Infections - A Simplified Protocol for the COVID-19 Pandemic

Guilherme de Moraes Nobrega et al. Rev Bras Ginecol Obstet. 2021 May.

Abstract
in English, Portuguese

Objective: The coronavirus disease 2019 (COVID-19) is a pandemic viral disease, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The impact of the disease among the obstetric population remains unclear, and the study of the placenta can provide valuable information. Adequate sampling of the placental tissue can help characterize the pathways of viral infections.

Methods: A protocol of placental sampling is proposed, aiming at guaranteeing representativity of the placenta and describing the adequate conservation of samples and their integrity for future analysis. The protocol is presented in its complete and simplified versions, allowing its implementation in different complexity settings.

Results: Sampling with the minimum possible interval from childbirth is the key for adequate sampling and storage. This protocol has already been implemented during the Zika virus outbreak.

Conclusion: A protocol for adequate sampling and storage of placental tissue is fundamental for adequate evaluation of viral infections on the placenta. During the COVID-19 pandemic, implementation of this protocol may help to elucidate critical aspects of the SARS-CoV-2 infection.

Objetivo: A doença do novo coronavírus (COVID-19) é uma doença viral pandêmica causada pelo coronavírus da síndrome respiratória aguda 2 (SARS-CoV-2). O impacto da doença entre a população obstétrica ainda é incerto, e o estudo da placenta pode fornecer informações valiosas. Assim, a coleta adequada do tecido placentário pode ajudar a caracterizar algumas propriedades das infecções virais. MéTODOS: Um protocolo de coleta placentária é proposto, objetivando a garantia de representatividade da placenta, descrevendo a maneira de conservação adequada das amostras, e visando garantir sua integridade para análises futuras. O protocolo é apresentado em suas versões completa e simplificada, permitindo sua implementação em diferentes configurações de infraestrutura.

Resultados: A amostragem com o intervalo mínimo possível do parto é essencial para coleta e armazenamento adequados. Esse protocolo já foi implementado durante a epidemia de vírus Zika. CONCLUSãO: Um protocolo para coleta e armazenamento adequados de tecido placentário é fundamental para a avaliação adequada de infecções virais na placenta. Durante a pandemia de COVID-19, a implementação deste protocolo pode ajudar a elucidar aspectos críticos da infecção por SARS-CoV-2.

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Conflict of interest statement

The authors have no conflict of interests to declare.

Figures

Fig. 1
Fig. 1
Cross section of the placenta showing its components in different versions of the protocol—complete (A) and simplified (B) placental protocol version.
Fig. 2
Fig. 2
Placental sampling based on umbilical cord insertion site — central (A) and peripheral (B) insertion.
Fig. 3
Fig. 3
Tissue sample storage process for each sampling site. (A). Histology cassettes storage. (B). Cryotube storage.
Fig. 4
Fig. 4
Placenta sample storage process for simplified protocol version.
See this image and copyright information in PMC

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