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1. Placental Tissue Destruction and Insufficiency From COVID-19 Causes Stillbirth and Neonatal Death From Hypoxic-Ischemic Injury: A Study of 68 Cases With SARS-CoV-2 Placentitis From 12 Countries

Author

Schwartz, David A., Avvad-Portari, Elyzabeth, Babal, Pavel, Baldewijns, Marcella, Blomberg, Marie, Bouachba, Amine, Camacho, Jessica, Collardeau-Frachon, Sophie, Colson, Arthur, and Dehaene, Isabelle

Subjects
Brain -- Injuries, Fetal malnutrition -- Statistics -- Complications and side effects -- Patient outcomes, Still-birth -- Statistics -- Causes of, Health
Abstract

* Context.--Perinatal death is an increasingly important problem as the coronavirus disease 2019 (COVID-19) pandemic continues, but the mechanism of death has been unclear. Objective.--To evaluate the role of the placenta in causing stillbirth and neonatal death following maternal infection with COVID-19 and confirmed placental positivity for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Design.--Case-based retrospective clinicopathologic analysis by a multinational group of 44 perinatal specialists from 12 countries of placental and autopsy pathology findings from 64 stillborns and 4 neonatal deaths having placentas testing positive for SARS-CoV-2 following delivery to mothers with COVID-19. Results.--Of the 3 findings constituting SARS-CoV-2 placentitis, all 68 placentas had increased fibrin deposition and villous trophoblast necrosis and 66 had chronic histiocytic intervillositis. Sixty-three placentas had massive perivillous fibrin deposition. Severe destructive placental disease from SARS-CoV-2 placentitis averaged 77.7% tissue involvement. Other findings included multiple intervillous thrombi (37%; 25 of 68) and chronic villitis (32%; 22 of 68). The majority (19; 63%) of the 30 autopsies revealed no significant fetal abnormalities except for intrauterine hypoxia and asphyxia. Among all 68 cases, SARS-CoV-2 was detected from a body specimen in 16 of 28 cases tested, most frequently from nasopharyngeal swabs. Four autopsied stillborns had SARS-CoV-2 identified in internal organs. Conclusions.--The pathology abnormalities composing SARS-CoV-2 placentitis cause widespread and severe placental destruction resulting in placental malperfusion and insufficiency. In these cases, intrauterine and perinatal death likely results directly from placental insufficiency and fetal hypoxic-ischemic injury. There was no evidence that SARS-CoV-2 involvement of the fetus had a role in causing these deaths., The emergence of new viral diseases has always created anxiety among persons at risk for infection, but perhaps this is most true for pregnant women, who fear not only for [...]

Published
2022
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2. Pregnancy in Times of War: What Are the Fallouts? A Review.

Author

Bouachba, Amine, Gorincour, Guillaume, Charlier, Philippe, and Ville, Yves

Subjects
*RUSSIA-Ukraine Conflict, 2014-, *WAR, *PERINATAL death, *OBSTETRICS, *HUMAN abnormalities
Abstract

Background: The beginning of the conflict in Ukraine has reminded Europeans of the many and diverse consequences of armed conflicts. Indeed, the ever more sophisticated conflicts have led to the diffusion of numerous chemicals whose consequences spread even after the end of the war. We present through this paper a review of the consequences of pregnancies from the major conflicts that took place since the end of World War II. Summary: MEDLINE, Web of Science, and Embase were screened for articles linking perinatal death (PD) or birth defects (BD) to wartime. A total of 50 papers treating 8 countries and 4 major and medically documented conflicts were included in the final analysis. An increase in BD and PD during and after the end of the conflicts was reported through all the conflicts analyzed. Key Message: While more data are needed to conclude, maternal-fetal medicine specialists ought to be wary when dealing with exposed populations. [ABSTRACT FROM AUTHOR]

Published
2024
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5. Placental Tissue Destruction and Insufficiency From COVID-19 Causes Stillbirth and Neonatal Death From Hypoxic-Ischemic Injury

Author

Schwartz, David A., Avvad-Portari, Elyzabeth, Babal, Pavel, Baldewijns, Marcella, Blomberg, Marie, Bouachba, Amine, Camacho, Jessica, Collardeau-Frachon, Sophie, Colson, Arthur, Dehaene, Isabelle, Carles Ferreres, Joan, Fitzgerald, Brendan, Garrido-Pontnou, Marta, Gergis, Hazem, Hargitai, Beata, Cecilia Helguera-Repetto, A., Holmstrom, Sandra, Liliane Irles, Claudine, Leijonhfvud, Asa, Libbrecht, Sasha, Marton, Tamas, McEntagart, Noel, Molina, James T., Morotti, Raffaella, Nadal, Alfons, Navarro, Alexandra, Nelander, Maria, Oviedo, Angelica, Oyamada Otani, Andre Ricardo, Papadogiannakis, Nikos, Petersen, Astrid C., Roberts, Drucilla J., Saad, Ali G., Sand, Anna, Schoenmakers, Sam, Sehn, Jennifer K., Simpson, Preston R., Thomas, Kristen, Yolotzin Valdespino-Vazquez, M., van der Meeren, Lotte E., Van Dorpe, Jo, Verdijk, Robert M., Watkins, Jaclyn C., Zaigham, Mehreen, Schwartz, David A., Avvad-Portari, Elyzabeth, Babal, Pavel, Baldewijns, Marcella, Blomberg, Marie, Bouachba, Amine, Camacho, Jessica, Collardeau-Frachon, Sophie, Colson, Arthur, Dehaene, Isabelle, Carles Ferreres, Joan, Fitzgerald, Brendan, Garrido-Pontnou, Marta, Gergis, Hazem, Hargitai, Beata, Cecilia Helguera-Repetto, A., Holmstrom, Sandra, Liliane Irles, Claudine, Leijonhfvud, Asa, Libbrecht, Sasha, Marton, Tamas, McEntagart, Noel, Molina, James T., Morotti, Raffaella, Nadal, Alfons, Navarro, Alexandra, Nelander, Maria, Oviedo, Angelica, Oyamada Otani, Andre Ricardo, Papadogiannakis, Nikos, Petersen, Astrid C., Roberts, Drucilla J., Saad, Ali G., Sand, Anna, Schoenmakers, Sam, Sehn, Jennifer K., Simpson, Preston R., Thomas, Kristen, Yolotzin Valdespino-Vazquez, M., van der Meeren, Lotte E., Van Dorpe, Jo, Verdijk, Robert M., Watkins, Jaclyn C., and Zaigham, Mehreen

Abstract

Context.-Perinatal death is an increasingly important problem as the coronavirus disease 2019 (COVID-19) pandemic continues, but the mechanism of death has been unclear. Objective.-To evaluate the role of the placenta in causing stillbirth and neonatal death following maternal infection with COVID-19 and confirmed placental positivity for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Design.-Case-based retrospective clinicopathologic analysis by a multinational group of 44 perinatal specialists from 12 countries of placental and autopsy pathology findings from 64 stillborns and 4 neonatal deaths having placentas testing positive for SARS-CoV-2 following delivery to mothers with COVID-19. Results.-Of the 3 findings constituting SARS-CoV-2 placentitis, all 68 placentas had increased fibrin deposition and villous trophoblast necrosis and 66 had chronic histiocytic intervillositis. Sixty-three placentas had massive perivillous fibrin deposition. Severe destructive placental disease from SARS-CoV-2 placentitis averaged 77.7% tissue involvement. Other findings included multiple intervillous thrombi (37%; 25 of 68) and chronic villitis (32%; 22 of 68). The majority (19; 63%) of the 30 autopsies revealed no significant fetal abnormalities except for intrauterine hypoxia and asphyxia. Among all 68 cases, SARS-CoV-2 was detected from a body specimen in 16 of 28 cases tested, most frequently from nasopharyngeal swabs. Four autopsied stillborns had SARS-CoV-2 identified in internal organs. Conclusions.-The pathology abnormalities composing SARS-CoV-2 placentitis cause widespread and severe placental destruction resulting in placental malperfusion and insufficiency. In these cases, intrauterine and perinatal death likely results directly from placental insufficiency and fetal hypoxic-ischemic injury. There was no evidence that SARS-CoV-2 involvement of the fetus had a role in causing these deaths., Funding Agencies|Slovak Research and Development Agency grant [PP-COVID-20-051]; Belgian Fund for Scientific Research [40002773]; Fetus for Life charity

Published
2022
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6. Placental Tissue Destruction and Insufficiency From COVID-19 Causes Stillbirth and Neonatal Death From Hypoxic-Ischemic Injury:A Study of 68 Cases With SARS-CoV-2 Placentitis From 12 Countries

Author

Schwartz, David A., Avvad-Portari, Elyzabeth, Babal, Pavel, Baldewijns, Marcella, Blomberg, Marie, Bouachba, Amine, Camacho, Jessica, Collardeau-Frachon, Sophie, Colson, Arthur, Dehaene, Isabelle, Ferreres, Joan Carles, Fitzgerald, Brendan, Garrido-Pontnou, Marta, Gergis, Hazem, Hargitai, Beata, Cecilia Helguera-Repetto, A., Holmstrom, Sandra, Irles, Claudine Liliane, Leijonhfvud, Asa, Libbrecht, Sasha, Marton, Tamas, McEntagart, Noel, Molina, James T., Morotti, Raffaella, Nadal, Alfons, Navarro, Alexandra, Nelander, Maria, Oviedo, Angelica, Otani, Andre Ricardo Oyamada, Papadogiannakis, Nikos, Petersen, Astrid C., Roberts, Drucilla J., Saad, Ali G., Sand, Anna, Schoenmakers, Sam, Sehn, Jennifer K., Simpson, Preston R., Thomas, Kristen, Yolotzin Valdespino-Vazquez, M., Van der Meeren, Lotte E., Van Dorpe, Jo, Verdijk, Robert M., Watkins, Jaclyn C., Zaigham, Mehreen, Schwartz, David A., Avvad-Portari, Elyzabeth, Babal, Pavel, Baldewijns, Marcella, Blomberg, Marie, Bouachba, Amine, Camacho, Jessica, Collardeau-Frachon, Sophie, Colson, Arthur, Dehaene, Isabelle, Ferreres, Joan Carles, Fitzgerald, Brendan, Garrido-Pontnou, Marta, Gergis, Hazem, Hargitai, Beata, Cecilia Helguera-Repetto, A., Holmstrom, Sandra, Irles, Claudine Liliane, Leijonhfvud, Asa, Libbrecht, Sasha, Marton, Tamas, McEntagart, Noel, Molina, James T., Morotti, Raffaella, Nadal, Alfons, Navarro, Alexandra, Nelander, Maria, Oviedo, Angelica, Otani, Andre Ricardo Oyamada, Papadogiannakis, Nikos, Petersen, Astrid C., Roberts, Drucilla J., Saad, Ali G., Sand, Anna, Schoenmakers, Sam, Sehn, Jennifer K., Simpson, Preston R., Thomas, Kristen, Yolotzin Valdespino-Vazquez, M., Van der Meeren, Lotte E., Van Dorpe, Jo, Verdijk, Robert M., Watkins, Jaclyn C., and Zaigham, Mehreen

Abstract

Context.-Perinatal death is an increasingly important problem as the coronavirus disease 2019 (COVID-19) pandemic continues, but the mechanism of death has been unclear. Objective.-To evaluate the role of the placenta in causing stillbirth and neonatal death following maternal infection with COVID-19 and confirmed placental positivity for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Design.-Case-based retrospective clinicopathologic analysis by a multinational group of 44 perinatal specialists from 12 countries of placental and autopsy pathology findings from 64 stillborns and 4 neonatal deaths having placentas testing positive for SARS-CoV-2 following delivery to mothers with COVID-19. Results.-Of the 3 findings constituting SARS-CoV-2 placentitis, all 68 placentas had increased fibrin deposition and villous trophoblast necrosis and 66 had chronic histiocytic intervillositis. Sixty-three placentas had massive perivillous fibrin deposition. Severe destructive placental disease from SARS-CoV-2 placentitis averaged 77.7% tissue involvement. Other findings included multiple intervillous thrombi (37%; 25 of 68) and chronic villitis (32%; 22 of 68). The majority (19; 63%) of the 30 autopsies revealed no significant fetal abnormalities except for intrauterine hypoxia and asphyxia. Among all 68 cases, SARS-CoV-2 was detected from a body specimen in 16 of 28 cases tested, most frequently from nasopharyngeal swabs. Four autopsied stillborns had SARS-CoV-2 identified in internal organs. Conclusions.-The pathology abnormalities composing SARS-CoV-2 placentitis cause widespread and severe placental destruction resulting in placental malperfusion and insufficiency. In these cases, intrauterine and perinatal death likely results directly from placental insufficiency and fetal hypoxic-ischemic injury. There was no evidence that SARS-CoV-2 involvement of the fetus had a role in causing these deaths.

Published
2022

7. Placental Tissue Destruction and Insufficiency from COVID-19 Causes Stillbirth and Neonatal Death from Hypoxic-Ischemic Injury: A Study of 68 Cases with SARS-CoV-2 Placentitis from 12 Countries

Author

Pathologie Pathologen staf, Schwartz, David A, Avvad-Portari, Elyzabeth, Babál, Pavel, Baldewijns, Marcella, Blomberg, Marie, Bouachba, Amine, Camacho, Jessica, Collardeau-Frachon, Sophie, Colson, Arthur, Dehaene, Isabelle, Ferreres, Joan Carles, Fitzgerald, Brendan, Garrido-Pontnou, Marta, Gerges, Hazem, Hargitai, Beata, Helguera-Repetto, A Cecilia, Holmström, Sandra, Irles, Claudine Liliane, Leijonhfvud, Åsa, Libbrecht, Sasha, Marton, Tamás, McEntagart, Noel, Molina, James T, Morotti, Raffaella, Nadal, Alfons, Navarro, Alexandra, Nelander, Maria, Oviedo, Angelica, Oyamada Otani, Andre Ricardo, Papadogiannakis, Nikos, Petersen, Astrid C, Roberts, Drucilla J, Saad, Ali G, Sand, Anna, Schoenmakers, Sam, Sehn, Jennifer K, Simpson, Preston R, Thomas, Kristen, Valdespino-Vázquez, M Yolotzin, van der Meeren, Lotte E, Van Dorpe, Jo, Verdijk, Robert M, Watkins, Jaclyn C, Zaigham, Mehreen, Pathologie Pathologen staf, Schwartz, David A, Avvad-Portari, Elyzabeth, Babál, Pavel, Baldewijns, Marcella, Blomberg, Marie, Bouachba, Amine, Camacho, Jessica, Collardeau-Frachon, Sophie, Colson, Arthur, Dehaene, Isabelle, Ferreres, Joan Carles, Fitzgerald, Brendan, Garrido-Pontnou, Marta, Gerges, Hazem, Hargitai, Beata, Helguera-Repetto, A Cecilia, Holmström, Sandra, Irles, Claudine Liliane, Leijonhfvud, Åsa, Libbrecht, Sasha, Marton, Tamás, McEntagart, Noel, Molina, James T, Morotti, Raffaella, Nadal, Alfons, Navarro, Alexandra, Nelander, Maria, Oviedo, Angelica, Oyamada Otani, Andre Ricardo, Papadogiannakis, Nikos, Petersen, Astrid C, Roberts, Drucilla J, Saad, Ali G, Sand, Anna, Schoenmakers, Sam, Sehn, Jennifer K, Simpson, Preston R, Thomas, Kristen, Valdespino-Vázquez, M Yolotzin, van der Meeren, Lotte E, Van Dorpe, Jo, Verdijk, Robert M, Watkins, Jaclyn C, and Zaigham, Mehreen

Published
2022

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