TUESDAY, May 26, 2020 (HealthDay News) — Higher rates of decidual arteriopathy and other maternal vascular malperfusion features are seen in placentas of women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), according to a study published online May 22 in the American Journal of Clinical Pathology.

Elisheva D. Shanes, M.D., from the Feinberg School of Medicine at Northwestern University in Chicago, and colleagues identified pregnant women with COVID-19 delivering between March 18 and May 5, 2020. Placentas were examined and compared to thos of historical controls and women with placental evaluation for history of melanoma.

The researchers examined 16 placentas from patients with SARS-CoV-2 (15 with live birth in the third trimester; one delivered in the second trimester following intrauterine fetal demise). Third-trimester placentas were significantly more likely to show at least one feature of maternal vascular malperfusion compared with controls, particularly abnormal or injured maternal vessels and intervillous thrombi. Decidual arteriopathy was seen in seven of 15 cases. There was no increase noted in the rates of acute and chronic inflammation. Villous edema and a retroplacental hematoma were seen in the placenta from the patient with intrauterine fetal demise.

“These findings provide mechanistic insight into the observed epidemiologic associations between COVID-19 in pregnancy and adverse perinatal outcomes,” the authors write. “Collectively, these findings suggest that increased antenatal surveillance for women diagnosed with SARS-CoV-2 may be warranted.”

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