ON THE HISTOPATHOLOGICAL PATTERNS OF THE PLACENTA IN WOMEN WITH COVID-19 DURING PREGNANCY: CROSS-SECTIONAL STUDY

Abstract

Background. The COVID-19 pandemic has led to an active surge of studies devoted to the course of pregnancy under conditions of this infection, perinatal outcomes and long-term results, morphohistological features of the placental complex. In case of COVID-19, the placenta can be both a target organ for damage and a barrier between the mother and the fetus. Materials and methods. 58 women with a confirmed (real-time PCR) moderately severу COVID-19 during pregnancy (the main group) and 40 healthy pregnant women (the control group) took part in a case-control study. The study was conducted from November 1, 2021 to December 31, 2022 from on the basis of the Communal Non-Profit Enterprise “Maternity Hospital No. 2” (Odesa). Socio-demographic data and perinatal outcomes have been analyzed. The placentas were subjected to histological examination and described in accordance with the recommendations of the Amsterdam Consensus of the Placental Working Group. Statistical analysis was performed on the platform https://www.socscistatistics.com/tests/. Results. The study and control groups were comparable in terms of demographic and anthropometric data. The incidence of COVID-19 was higher in the 2nd and 3rd trimesters of pregnancy (F=148.38358, p<0.00001). Significantly more often in “post-COVID” placentas, hemodynamic disorders were detected in the form of plethora and hemorrhages (53.45% vs 15%, OR= 6.506, 95% CI 2.370 17.858), maternal vascular malperfusion – villi infarctions (53.45% vs 12.5%, OR=8.037, 95% CI 2.758 23.423), agglutination of villi with an increase in the number of syncytial nodules (79.31% vs 15%, OR=21.722, 95% CI 7.409 63.684), vascular malperfusion of the fetus – hypovascularisation of the villi (only in 8.62% in the main group), and lymphoid infiltration of fetal membranes (17.24% vs 12.5%, OR=1.458, 95% CI 0.458 81.777). Conclusion. The histopathological patterns found in post-COVID placentas indicate a significant impact of coronavirus infection on placental structure, but these changes are not specific and further research is needed to provide an evidence base.