Covid-19 appears to attack the placenta during pregnancy, study finds

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Pathological examinations done immediately after birth revealed signs of insufficient blood flow from the mother to the fetus and blood clots in the placenta.

This could interfere with the role of the placenta in providing oxygen and nutrients from the mother’s blood stream to the growing baby and removing waste products from the baby’s blood.

“Not to paint a scary picture, but these results worry me,” said Northwestern Medicine obstetrician Dr. Emily Miller, co-author of the study published Friday in the American Journal of Clinical Pathology, in a statement. .

Although it only followed 16 women, the authors said the study was the largest placental health review in women who tested positive for Covid-19 to date.

“I don’t want to draw sweeping conclusions from a small study, but this preliminary overview of how Covid-19 could cause changes in the placenta has fairly significant health implications for pregnancy,” said Miller , assistant professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine.

“We need to discuss if we need to change the way we monitor pregnant women right now,” said Miller, which could be done by testing the oxygen supply to the placenta during pregnancy and monitoring babies’ growth. by ultrasound.

“I was surprised that the author started talking about changes in care based on this study,” said Dr. Denise Jamieson, who co-wrote the medical opinion for the American College of Obstetricians and Gynecologists and was not involved in the new study.

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“There are all kinds of risks in screening and additional testing, which can lead to unintended results,” said Jamieson, who heads the department of gynecology and obstetrics at Emory University School of Medicine in Atlanta.

“I don’t think we should jump the gun,” added Jamieson. “This study raises more questions than it answers. Looking at the placenta will help us understand what happens during pregnancy, but I think we need to be careful before we get to what it means clinically in terms of caring for pregnant women with Covid-19. “

No harm to babies

While research on infants born to mothers infected with Covid-19 is just beginning, so far the virus does not seem to create “terribly disturbing pregnancy outcomes as we have seen with other viral infections. Said Jamieson.

The same was true in this new study, where the newborns were “healthy babies, full-term, and beautifully normal babies,” said Miller, although blood flow was blocked and “many placentas were more as small as they should have been. “

However, placentas are built with “a huge amount of redundancy,” said Miller. “Even with only half of it working, babies are often fine. “

What you need for a safe home birth

The lead author, Dr. Jeffrey Goldstein, an assistant professor of pathology at Northwestern University Feinberg School of Medicine, agreed.

“It does not appear to induce negative results in infants born alive, based on our limited data,” said Goldstein.

Fourteen of the children born alive in the study were born at term and with normal Apgar weights and scores. A child born alive was premature.

One patient suffered a miscarriage in the second trimester, but it “was asymptomatic, so we don’t know if the virus caused the miscarriage or if it was not related,” said Goldstein.

What should a future mother do?

Discuss your concerns with your personal obstetrician-gynecologist, experts said. Take the same precautions as those recommended for everyone: wash your hands, do not touch your face, wear a mask when you go out.

“Besides, I think this is the perfect time for pregnant women to ask family members to shop, to fill up on gas, to shop,” said Jamieson. “I think there are a lot of good reasons to pamper pregnant women – and I think now is a better time than ever for pregnant women to ask for and receive help. “

And don’t worry unnecessarily.

“There is growing evidence that pregnant women cannot be more severely affected by Covid-19 than we do, which worried us at the start of the pandemic,” said Jamieson.

“But Covid-19 is still a serious illness during pregnancy that needs to be taken seriously and studied carefully. “

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