Scientists talked about damage to the placenta in women with Covid-19

(ORDO NEWS) — Scientists from Northwestern University (Chicago) found that a positive result on Covid-19 during pregnancy is associated with signs of placental trauma in pregnant women – as shown by data from pathological studies performed immediately after childbirth. An article about this was published in the American Journal of Clinical Pathology .

A new complication of coronavirus creates an abnormal blood flow between the mother and the fetus. The results of the work set the vector for future research and indicate that it requires increased attention of doctors conducting pregnancy of women during a pandemic. Today it is the largest study to study the status of the placenta in women with a positive result on Covid-19.

At the same time, the sample, for obvious reasons, is still small: 16 Covid-positive pregnant patients were monitored by a pre-assembled group of specialists, 14 of them gave birth on time, some deliveries were premature and one had a miscarriage. Regarding miscarriages (four more cases are known, however, women were not in the observation group), the authors have not yet drawn conclusions, but note that in all cases, except one, severe inflammation was noted in the placenta.

“Most of these babies were born full-term after a normal pregnancy, so it’s hard to expect that something is wrong with the placenta, but this virus causes some damage,” explains Dr. Jeffrey Goldstein, senior author of the article. He notes that this fact does not negate the fact that intrauterine infection of the child does not occur, but confirms the need for more careful monitoring of pregnant women infected with SARS-CoV-2.

In the framework of enhanced monitoring, according to the researchers, mandatory non-stress tests are required that check how well the placenta delivers oxygen, as well as ultrasound studies of the normal growth rate. Co-author of the work, Dr. Emily Miller, notes that the data from this preliminary study bother her. Such changes in the placenta can have quite significant consequences for the course of pregnancy and the health of the unborn baby.

The placenta is the first organ that is formed during the development of the fetus. For a child connected to the mother’s body and not yet using many of its organs, the placenta replaces the lungs, intestines, kidneys and liver, taking oxygen and nutrients from the mother’s bloodstream and exchanging them for waste products of growth and life of the baby.

The placenta is also responsible for many hormonal changes in the body of a pregnant woman. A study of the placenta after childbirth allows the pathologist to find out what happened to the baby in the womb or what could happen to both the mother and the baby after birth.

The placentas taken from Covid-positive patients had two common abnormalities: insufficient blood flow from the mother to the fetus with pathological changes in the blood vessels of the placenta and blood clots in it – signs of thrombosis of the intervillous space.

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With such vascular changes, maternal blood pressure usually rises. This condition is usually observed in women with preeclampsia or hypertension. In this case, only one of the women in the studied group really had preeclampsia. The authors note that the results are in good agreement with the scientific consensus developed today that patients with Covid-19 have problems with coagulation and damage to blood vessels.

Despite serious damage to the placenta discovered by the authors of the work, most of the children were able to be born healthy and full-term, with good Apgar scores. However, the results show that most of the blood flow was blocked, and many placentas were smaller than they should have been.

Dr. Miller notes that placentas are formed with enormous redundancy, and even when only half of the organ functions normally, children are often born completely healthy. However, one must understand that everyone has a different margin of safety, and many pregnancies can go much worse than those that fell into the sample.

Interestingly, previous studies have shown that children who were in the womb during the Spanish flu pandemic of 1918-1919, which is often compared to the current Covid-19 pandemic, had lower incomes and an increased risk of heart disease throughout their lives.

At the same time, the influenza virus, like the current coronavirus, is not inclined to overcome the barrier between mother and child. The authors draw the following conclusion from this: perhaps the problems of the children of the “Spanish” are connected, among other things, with immune activity and damage to the placenta. Scientists note that early diagnosis and correction can significantly mitigate the effects.

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