The Microscopic and Macroscopic Findings of Placental Pathology in Pregnant Women with SARS-CoV-2

Abstract

Viral infections are usually transmitted through the mother's bloodstream, and the mother's immune system responds by sending white blood cells into the intervillous space, which can then spread into the amniotic fluid. The purpose of this research was to examine the histopathological alterations linked to SARS-CoV-2 infection in placentas. Histopathological changes of the placentas of 61 pregnant women with SARS-CoV-2 who delivered between 2021 and 2022 were examined at Besat Hospital in Sanandaj, Iran. The size of the placenta was normal in all cases. However, 3 samples (4.9%) showed the presence of hematoma, while 14 samples (23.0%) had microcalcifications. Thrombofibrin was observed in 27 samples (44.3%), and villous edema was observed in 22 samples (36.1%). Necrosis and ischemic infarction were present in 26 samples (42.6%), and inflammation was observed in 22 samples (36.1%). Hemorrhage was found in 27 samples (44.3%) and retroplacental hematoma was present in only 3 samples (4.9%). Trophoblastic proliferation was observed in 1 sample (98.4%). Maternal levels were normal in 55 samples (90.2%) and fetal levels were normal in all 61 samples (100.0%). Some of the placentas that were analyzed showed histopathological changes, primarily vascular and inflammatory, which suggest that the pregnant individuals were infected with SARS-CoV-2 at term. These changes could be linked to impaired placental function, fetal growth restriction, preeclampsia, and prematurity. However, more prospective studies are needed to confirm the type, prevalence, and prognosis of each of these changes.