Placental histopathology after SARS-CoV-2 infection in pregnancy: a systematic review and meta-analysis.

American Journal of Obstetrics & Gynecology MFM
Raffaella Di GirolamoFrancesco D'Antonio

Abstract

This study aimed to report the spectrum of placental pathology findings in pregnancies complicated by SARS-CoV-2 infection. MEDLINE, Embase, Google Scholar, and the Web of Science databases were searched up to August 11, 2021. Histopathologic anomalies included maternal vascular malperfusion, fetal vascular malperfusion, acute inflammatory pathology, chronic inflammatory pathology, increased perivillous fibrin, and intervillous thrombosis. Moreover, subanalyses of symptomatic women only and high-risk pregnancies were performed. Histopathologic analysis of the placenta included gross examination, histopathology on hematoxylin and eosin, immunohistochemistry, fluorescence in situ hybridization, quantitative reverse transcription-polymerase chain reaction on placental tissue, and transmission electron microscope. Random-effect meta-analyses were used to analyze the data. A total of 56 studies (1008 pregnancies) were included. Maternal vascular malperfusion was reported in 30.7% of placentas (95% confidence interval, 20.3-42.1), whereas fetal vascular malperfusion was observed in 27.08 % of cases (95% confidence interval, 19.2-35.6). Acute and chronic inflammatory pathologies were reported in 22.68% (95% confidence interval, 16.9-2...Continue Reading

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