scholarly journals SARS-CoV-2 Placental Infection in an Unvaccinated Mother Resulting in Fetal Demise

Cureus ◽  
2021 ◽  
Author(s):  
Dominic J Bewley ◽  
Jessica Lee ◽  
Oana Popescu ◽  
Angelica Oviedo
Keyword(s):  
Fetal Demise ◽  
Placental Infection

Florid Bacillus cereus Infection of the Placenta Associated With Intrauterine Fetal Demise

2021 ◽  
pp. 109352662199902
Author(s):  
Stephanie Shea ◽  
Alberto Paniz-Mondolfi ◽  
Emilia Sordillo ◽  
Michael Nowak ◽  
Fumiko Dekio
Keyword(s):  
Bacillus Cereus ◽  
Placental Tissue ◽  
Maternal Blood ◽  
Gastrointestinal Infections ◽  
Gram Positive ◽  
Fetal Demise ◽  
Placental Infection ◽  
Intrauterine Fetal Demise ◽  
Acute Necrotizing ◽  
Poor Outcomes

Bacillus cereus is a gram-positive, rod-shaped bacterium that is commonly implicated in foodborne illness but has also become increasingly recognized as a source of serious non-gastrointestinal infections, including sepsis, meningitis, and pneumonia. Non-gastrointestinal B. cereus infections have been identified in children, especially in neonates; however, there are no previously described cases of fetal demise associated with B. cereus placental infection. We present a case of acute chorioamnionitis-related intrauterine fetal demise of twin A at 17 weeks gestation, noted two days after selective termination of twin B. Histological examination revealed numerous gram-positive bacilli in placental tissue, as well as fetal vasculature, in the setting of severe acute necrotizing chorioamnionitis and subchorionitis, intervillous abscesses, acute villitis, and peripheral acute funisitis. Cultures of maternal blood and placental tissue both yielded growth of B. cereus. This case underscores the importance of B. cereus as a human pathogen, and specifically demonstrates its potential as an agent of severe intraamniotic and placental infection with poor outcomes for the fetus.

scholarly journals Persistence of SARS-CoV-2 in the first trimester placenta leading to transplacental transmission and fetal demise from an asymptomatic mother

2020 ◽  
Author(s):  
Prajakta Shende ◽  
Pradip Gaikwad ◽  
Manisha Gandhewar ◽  
Pawankumar Ukey ◽  
Anshul Bhide ◽  
...  
Keyword(s):  
Clinical Course ◽  
First Trimester ◽  
Hydrops Fetalis ◽  
Viral Rna ◽  
Fetal Membrane ◽  
Fibrin Deposition ◽  
Fetal Demise ◽  
Placental Infection ◽  
The Impact ◽  
S Proteins

Summary Coronavirus disease 2019 (COVID-19) is caused by infection of the respiratory tract by SARS-CoV-2 which survives in the tissues during the clinical course of infection but there is limited evidence on placental infection and vertical transmission of SARS-CoV-2. The impact of COVID-19 in first trimester pregnancy remains poorly understood. Moreover, how long SARS-CoV-2 can survive in placenta is unknown. Herein we report a case of a pregnant woman in the first trimester who tested positive for SARS-CoV-2 at 8 weeks of gestation although her clinical course was asymptomatic. At 13 weeks of gestation, her throat swab tested negative for SARS-CoV-2 but viral RNA was detected in the placenta and the Spike (S) proteins (S1 and S2) were immunolocalized in cytotrophoblast and syncytiotrophoblast cells of the placental villi. Histologically, the villi were generally avascular with peri-villus fibrin deposition and in some areas the syncytiotrophoblast layer appeared lysed. The decidua also had fibrin deposition with extensive leucocyte infiltration suggestive of inflammation. The SARS-CoV-2 crossed the placental barrier, as the viral RNA was detected in the amniotic fluid and the S proteins were detected in the fetal membrane. Ultrasonography revealed extensively subcutaneous edema with pleural effusion suggestive of hydrops fetalis and the absence of cardiac activity indicated fetal demise. This is the first study to provide concrete evidence of persistent placental infection of SARS-CoV-2 and its congenital transmission associated with hydrops fetalis and intrauterine fetal demise in early pregnancy.

scholarly journals Rift Valley fever virus induces fetal demise in Sprague-Dawley rats through direct placental infection

2018 ◽  
Vol 4 (12) ◽  
pp. eaau9812 ◽  
Author(s):  
Cynthia M. McMillen ◽  
Nitin Arora ◽  
Devin A. Boyles ◽  
Joseph R. Albe ◽  
Michael R. Kujawa ◽  
...  
Keyword(s):  
Vertical Transmission ◽  
Rift Valley ◽  
Rift Valley Fever ◽  
Rift Valley Fever Virus ◽  
Fever Virus ◽  
Intrauterine Fetal Death ◽  
Pregnant Rats ◽  
Fetal Demise ◽  
Valley Fever ◽  
Placental Infection

Rift Valley fever virus (RVFV) infections in pregnant livestock cause high rates of fetal demise; miscarriage in pregnant women has also been associated with RVFV infection. To address how RVFV infection during pregnancy causes detrimental effects on the fetus, we developed a pregnant rodent model of RVFV infection. We found that pregnant rats were more susceptible to RVFV-induced death than their nonpregnant counterparts and that RVFV infection resulted in intrauterine fetal death and severe congenital abnormalities, even in pups from infected asymptomatic pregnant rats. Virus distribution in infected dams was widespread, with a previously unrecognized preference for infection, replication, and tissue damage in the placenta. In human mid-gestation placental tissue, RVFV directly infected placental chorionic villi, with replication detected in the outermost syncytial layer. Our work identifies direct placental infection by RVFV as a mechanism for vertical transmission. This is the first study to show vertical transmission of RVFV with a lethal outcome in a species other than livestock. This study highlights the potential impact of a future epidemic of this emerging mosquito-borne virus.

scholarly journals Rift Valley fever virus induces fetal demise through direct placental infection

2018 ◽  
Author(s):  
Cynthia M. McMillen ◽  
Nitin Arora ◽  
Devin A. Boyles ◽  
Joseph R. Albe ◽  
Michael R. Kujawa ◽  
...  
Keyword(s):  
Vertical Transmission ◽  
Rift Valley ◽  
Rift Valley Fever ◽  
Rift Valley Fever Virus ◽  
Fever Virus ◽  
Intrauterine Fetal Death ◽  
Pregnant Rats ◽  
Fetal Demise ◽  
Valley Fever ◽  
Placental Infection

AbstractRift Valley fever virus (RVFV) infections in pregnant livestock are associated with high rates of fetal demise and have been linked to miscarriage in pregnant women. To address how acute RVFV infection during pregnancy causes detrimental effects on the fetus, we developed an immunocompetent pregnant rodent model of RVFV infection. We found that pregnant rats were more susceptible to RVFV-induced death than their non-pregnant counterparts and that RVFV infection resulted in intrauterine fetal death and severe congenital abnormalities, even in pups from infected asymptomatic pregnant rats. Virus distribution in infected dams was widespread, with a previously unrecognized preference for infection, replication, and tissue damage in the placenta. In human mid-gestation placental tissue, RVFV directly infected placental chorionic villi, with replication detected in the outermost syncytial layer. Our work identifies direct placental infection by RVFV as a mechanism for vertical transmission and points to the teratogenic potential of this virus in humans. This is the first time vertical transmission of RVFV has been shown in species other than livestock. This study highlights the potential impact of a future epidemic of this emerging mosquito-borne virus.

scholarly journals Acute Placental Infection Due toKlebsiella pneumoniae: Report of a Unique Case

2005 ◽  
Vol 13 (1) ◽  
pp. 49-52 ◽  
Author(s):  
Salwa S. Sheikh ◽  
Samir S. Amr ◽  
Janice M. Lage
Keyword(s):  
Klebsiella Pneumoniae ◽  
Vaginal Discharge ◽  
English Literature ◽  
Healthy Children ◽  
Unique Case ◽  
Fetal Demise ◽  
Placental Infection ◽  
History Of

A 40-year-old woman, gravida 9, with seven healthy children and a history of one abortion (p 7 + 1) , presented at 18 weeks of gestation with fever and malodorous vaginal discharge. Ultrasound revealed a macerated fetus. The placenta showed acute chorioamnionitis and acute villitis with microabscess formation. Blood and vaginal cultures both grewKlebsiella pneumoniae. This is the first reported case in English literature ofKlebsiella pneumoniaecausing suppurative placentitis leading to fetal demise.

scholarly journals Severe Acute Respiratory Syndrome Coronavirus 2 Placental Infection and Inflammation Leading to Fetal Distress and Neonatal Multi-Organ Failure in an Asymptomatic Woman

2020 ◽  
Author(s):  
Sam Schoenmakers ◽  
Pauline Snijder ◽  
Robert M Verdijk ◽  
Thijs Kuiken ◽  
Sylvia S M Kamphuis ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Vertical Transmission ◽  
Neonatal Intensive Care ◽  
Quantitative Polymerase Chain Reaction ◽  
Antigen Expression ◽  
Fetal Distress ◽  
Adverse Outcomes ◽  
Placental Infection ◽  
Emergency Cesarean ◽  
Increased Risk

Abstract Background In general, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy is not considered to be an increased risk for severe maternal outcomes but has been associated with an increased risk for fetal distress. Maternal-fetal transmission of SARS-CoV-2 was initially deemed uncertain; however, recently a few cases of vertical transmission have been reported. The intrauterine mechanisms, besides direct vertical transmission, leading to the perinatal adverse outcomes are not well understood. Methods Multiple maternal, placental, and neonatal swabs were collected for the detection of SARS-CoV-2 using real-time quantitative polymerase chain reaction (RT-qPCR). Serology of immunoglobulins against SARS-CoV-2 was tested in maternal, umbilical cord, and neonatal blood. Placental examination included immunohistochemical investigation against SARS-CoV-2 antigen expression, with SARS-CoV-2 ribonucleic acid (RNA) in situ hybridization and transmission electron microscopy. Results RT-qPCRs of the oropharynx, maternal blood, vagina, placenta, and urine were all positive over a period of 6 days, while breast milk, feces, and all neonatal samples tested negative. Placental findings showed the presence of SARS-CoV-2 particles with generalized inflammation characterized by histiocytic intervillositis with diffuse perivillous fibrin depositions with damage to the syncytiotrophoblasts. Conclusions Placental infection by SARS-CoV-2 leads to fibrin depositions hampering fetal-maternal gas exchange with resulting fetal distress necessitating a premature emergency cesarean section. Postpartum, the neonate showed a fetal or pediatric inflammatory multisystem-like syndrome with coronary artery ectasia temporarily associated with SARS-CoV-2 for which admittance and care on the neonatal intensive care unit (NICU) were required, despite being negative for SARS-CoV-2. This highlights the need for awareness of adverse fetal and neonatal outcomes during the current coronavirus disease 2019 pandemic, especially considering that the majority of pregnant women appear asymptomatic.

Massive Perivillous Fibrin Deposition and Chronic Histiocytic Intervillositis a Complication of SARS-CoV-2 Infection

2021 ◽  
pp. 109352662110207
Author(s):  
T Marton ◽  
B Hargitai ◽  
K Hunter ◽  
M Pugh ◽  
P Murray
Keyword(s):  
Placental Insufficiency ◽  
Intrauterine Death ◽  
Fibrin Deposition ◽  
Fetal Demise ◽  
Trophoblastic Cells ◽  
Stage Disease ◽  
Villous Trophoblast ◽  
Fetal Movements ◽  
Active Viral Replication ◽  
End Stage

An emerging complication of COVID-19 (SARS-CoV-2) infection is reported. A 23-year-old patient presented with high temperature and reduced fetal movements at 25 + 5/40 weeks of gestation. RT-PCR proved maternal COVID-19 infection. Ultrasound examination confirmed intrauterine death. Placenta histology showed necrosis of the villous trophoblast, associated with Chronic Histiocytic Intervillositis (CHI) and Massive Perivillous Fibrin Deposition (MPFD) with up to 90% - of the intervillous spaces being involved. Immunohistochemistry showed CD68 positive histiocytes in the intervillous spaces and the villous trophoblast was positive for the COVID-19 spike protein. RNA scope signal was indicative of the presence of the viral genome and active viral replication in the villous trophoblastic cells, respectively. MPFD is a gradually developing end-stage disease with various etiology, including autoimmune and alloimmune maternal response to antigens expressed at the feto-maternal interface and frequently accompanies chronic alloimmune villitis or histiocytic intervillositis. Covid-19 infection is associated with similar pattern of histological changes of the placenta leading to placental insufficiency and fetal death. This case report supports maternal- fetal vertical transmission of SARS-CoV-2 virus leading to placental insufficiency and fetal demise. MPFD and CHI appear to be the typical placental histology for SARS-CoV-2 virus infection associated fetal demise.

Extensive Perivillous Fibrin and Intervillous Histiocytosis in a SARS-CoV-2 Infected Placenta From an Uninfected Newborn: A Case Report Including Immunohistochemical Profiling

2021 ◽  
pp. 109352662110251
Author(s):  
James Roberts ◽  
Jeanette D Cheng ◽  
Elizabeth Moore ◽  
Carla Ransom ◽  
Minhui Ma ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Report ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Immunohistochemical Staining ◽  
Placental Pathology ◽  
Fibrin Deposition ◽  
Placental Infection ◽  
Fetal Infection

Placental infection by SARS-CoV-2 with various pathologic alterations reported. Inflammatory findings, such as extensive perivillous fibrin deposition and intervillous histiocytosis, have been postulated as risk factors for fetal infection by SARS-CoV-2. We describe the placental findings in a case of a 31-year-old mother with SARS-CoV-2 infection who delivered a preterm female neonate who tested negative for SAR-CoV2 infection. Placental examination demonstrated a small for gestational age placenta with extensive intervillous histiocytosis, syncytiotrophoblast karyorrhexis, and diffuse intervillous fibrin deposition. Immunohistochemical staining demonstrated infection of the syncytiotrophoblasts by SARS-CoV-2 inversely related to the presence of intervillous histiocytes and fibrin deposition. Our case demonstrates that despite extensive placental pathology, no fetal transmission of SARS-CoV-2 occurred, as well as postulates a relationship between placental infection, inflammation, and fibrin deposition.

scholarly journals Critical Ebstein’s anomaly with circular shunt: from successful fetal therapy with non-steroidal anti-inflammatory drugs to biventricular repair using Da Silva cone technique

2021 ◽  
pp. 1-4
Author(s):  
Lilian M. Lopes ◽  
Rodrigo F. Bezerra ◽  
Jose Pedro da Silva ◽  
Luciana da Fonseca da Silva
Keyword(s):  
Single Ventricle ◽  
Ductus Arteriosus ◽  
Ebstein’S Anomaly ◽  
Biventricular Repair ◽  
Fetal Demise ◽  
Ebstein's Anomaly ◽  
Gestational Week ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Single Ventricle Palliation

Abstract We report an innovative treatment strategy for fetal Ebstein’s anomaly with a circular shunt. We used transplacental non-steroidal anti-inflammatory drugs, at the 29th gestational week, to constrict the ductus arteriosus avoiding fetal demise. We addressed the critical neonate with an urgent Starnes procedure. Finally, instead of following the usual single-ventricle palliation pathway after the Starnes procedure, we achieved successful two-ventricle repair with the cone technique at 5 month old.

Sign in / Sign up

Export Citation Format

Share Document