Case Report: SARS-CoV-2 Mother-to-Child Transmission and Fetal Death Associated With Severe Placental Thromboembolism

Penélope Saldanha Marinho; Antonio José Ledo Alves da Cunha; Leila Chimelli; Elyzabeth Avvad-Portari; Felipe da Matta Andreiuolo; Patrícia Soares de Oliveira-Szejnfeld; Mayara Abud Mendes; Ismael Carlos Gomes; Letícia Rocha Q Souza; Marilia Zaluar Guimarães; Suzan Menasce Goldman; Mariana Barros Genuíno de Oliveira; Stevens Rehen; Joffre Amim Jr; Fernanda Tovar-Moll; Arnaldo Prata-Barbosa

doi:10.3389/fmed.2021.677001

Case Report: SARS-CoV-2 Mother-to-Child Transmission and Fetal Death Associated With Severe Placental Thromboembolism

Front Med (Lausanne). 2021 Aug 16:8:677001. doi: 10.3389/fmed.2021.677001. eCollection 2021.

Authors

Penélope Saldanha Marinho¹, Antonio José Ledo Alves da Cunha^{1

2}, Leila Chimelli³, Elyzabeth Avvad-Portari^{4

5}, Felipe da Matta Andreiuolo³, Patrícia Soares de Oliveira-Szejnfeld^{6

7}, Mayara Abud Mendes⁸, Ismael Carlos Gomes^{9

10}, Letícia Rocha Q Souza⁸, Marilia Zaluar Guimarães^{8

11}, Suzan Menasce Goldman⁶, Mariana Barros Genuíno de Oliveira², Stevens Rehen^{7

8}, Joffre Amim Jr¹, Fernanda Tovar-Moll^{6

7}, Arnaldo Prata-Barbosa^{1

2}

Affiliations

¹ Maternity School, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
² Department of Pediatrics, D'Or Institute for Research and Education, Rio de Janeiro, Brazil.
³ Laboratory of Neuropathology, Rio de Janeiro State Brain Institute, Rio de Janeiro, Brazil.
⁴ Department of Pathological Anatomy, Fernandes Figueira Institute, Fiocruz, Rio de Janeiro, Brazil.
⁵ School of Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
⁶ Diagnostic Imaging Department, Escola Paulista de Medicina, School of Medicine, Universidade Federal de São Paulo, São Paulo, Brazil.
⁷ Diagnostic Imaging Department, D'Or Institute for Research and Education, Rio de Janeiro, Brazil.
⁸ Stem Cell Laboratory, D'Or Institute for Research and Education, Rio de Janeiro, Brazil.
⁹ Genetics Department, Institute of Biology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
¹⁰ Anatomic Pathology Service, Jesus Municipal Hospital, Rio de Janeiro, Brazil.
¹¹ Department of Phamacology, Institute of Biomedical Sciences, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.

Abstract

SARS-CoV-2 infection during pregnancy is not usually associated with significant adverse effects. However, in this study, we report a fetal death associated with mild COVID-19 in a 34-week-pregnant woman. The virus was detected in the placenta and in an unprecedented way in several fetal tissues. Placental abnormalities (MRI and anatomopathological study) were consistent with intense vascular malperfusion, probably the cause of fetal death. Lung histopathology also showed signs of inflammation, which could have been a contributory factor. Monitoring inflammatory response and coagulation in high-risk pregnant women with COVID-19 may prevent unfavorable outcomes, as shown in this case.

Keywords: COVID-19; SARS-CoV-2; fetal death; mother-to-child transmission; placental thromboembolism; pregnancy.

Publication types

Case Reports