Placental pathology and fetal demise at 35 weeks of gestation in a woman with SARS-CoV-2 infection: A case report

Poisson, Tiffany M.; Pierone, Gerald

The consequences of SARS-CoV-2 infection in pregnancy have not been well defined. However, there have been a number of reports of poor maternal and fetal outcomes worldwide. This report presents a case of stillbirth with associated placental pathology during week 35 in an otherwise healthy pregnant woman with SARS-CoV-2 infection. Placental findings in this case showed patchy acute chorionitis and diffuse infarction/villous necrosis of the placental parenchyma resulting in extensive vascular malperfusion. Fetal autopsy was most significant for placental findings and no congenital malformations were discovered. The findings in this case are consistent with reports in the literature of pathological placental changes associated with COVID-19. This case of fetal demise in a woman with confirmed SARS-CoV-2 infection without any other medical or obstetric disorders and no alternate cause suggests that fetal death can be an outcome of COVID-19 during pregnancy. This outcome was supported by the histopathological findings in the placenta. Continued research is imperative to confirm the findings in this case and multiple similar cases. Additionally, increased screening and collection of COVID-19 data specific to pregnant women and their fetuses and infants is needed to increase knowledge, support research efforts, and create guidelines for clinical practice that will prevent potential negative outcomes and loss of life.