Placental histopathology after SARS-CoV-2 infection in pregnancy: a systematic review and meta-analysis.
Placental histopathology after SARS-CoV-2 infection in pregnancy: a systematic review and meta-analysis.
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DOI：
10.1016/j.ajogmf.2021.100468
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发表时间：
2021-11
影响因子：
6.3
通讯作者：
D'Antonio F
中科院分区：
文献类型：
--
作者：
Di Girolamo R;Khalil A;Alameddine S;D'Angelo E;Galliani C;Matarrelli B;Buca D;Liberati M;Rizzo G;D'Antonio F
本研究旨在报告妊娠合并SARS-CoV-2感染的胎盘病理学表现谱。检索了MEDLINE、Embase、Google Scholar和Web of Science数据库，截止日期为2021年8月11日。组织学异常包括母体血管灌注不良、胎儿血管灌注不良、急性炎症病理、慢性炎症病理、绒毛周纤维蛋白增加和绒毛间血栓形成。此外，仅对有症状的妇女和高危妊娠进行了亚组分析。方法：胎盘组织学分析包括大体检查、苏木精-伊红组织病理学、免疫组织化学、荧光原位杂交、定量逆转录-聚合酶链反应和透射电镜。随机效应荟萃分析被用来分析数据。共纳入56项研究（1008例妊娠）。在30.7%的胎盘中报告了母体血管灌注不良（95%置信区间，20.3-42.1），而在27.08%的病例中观察到胎儿血管灌注不良（95%置信区间，19.2-35.6）。分别有22.68%（95%置信区间，16.9-29.0）和25.65%（95%置信区间，18.4-33.6）的病例报告了急性和慢性炎症病理。在32.7%（95%置信区间，24.1-42.0）的胎盘中观察到绒毛周围纤维蛋白增加，而在14.6%的病例中观察到绒毛间血栓形成（95%置信区间，9.7-20.2）。37.5%的病例报告了其他胎盘发现，包括附着有子宫肌纤维的基板、显微镜下增生、绒毛水肿、循环有核红细胞增加或膜出血（95%置信区间，28.0-47.5），而只有17.5%的病例（95%置信区间，10.9-25.2）没有出现任何异常的组织学结果。根据SARS-CoV-2感染或高危妊娠引起的母体症状进行的亚组分析显示，不同组织病理学异常的分布与主要分析中报告的分布相似。此外，当仅考虑病例对照研究比较SARS-CoV-2感染妇女与健康对照时，胎盘组织病理学异常的风险更高。在SARS-CoV-2感染的孕妇中，相当比例的胎盘显示出组织病理学结果，表明胎盘灌注不足和炎症。未来需要进行多中心前瞻性盲法研究，以确定这些胎盘病变与妊娠结局的相关性。
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. METHODS: 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, 16.9–29.0) and 25.65% (95% confidence interval, 18.4–33.6) of cases, respectively. Increased perivillous fibrin was observed in 32.7% (95% confidence interval, 24.1–42.0) of placentas undergoing histopathologic analysis, whereas intervillous thrombosis was observed in 14.6% of cases (95% confidence interval, 9.7–20.2). Other placental findings, including a basal plate with attached myometrial fibers, microscopic accretism, villous edema, increased circulating nucleated red blood cells, or membranes with hemorrhage, were reported in 37.5% of cases (95% confidence interval, 28.0–47.5), whereas only 17.5% of cases (95% confidence interval, 10.9–25.2) did not present any abnormal histologic findings. The subanalyses according to maternal symptoms owing to SARS-CoV-2 infection or the presence of a high-risk pregnancy showed a similar distribution of the different histopathologic anomalies to that reported in the main analysis. Moreover, the risk of placental histopathologic anomalies was higher when considering only case-control studies comparing women with SARS-CoV-2 infection with healthy controls. In pregnant women with SARS-CoV-2 infection, a significant proportion of placentas showed histopathologic findings, suggesting placental hypoperfusion and inflammation. Future multicenter prospective blinded studies are needed to correlate these placental lesions with pregnancy outcomes.
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影响因子：
9.8
作者：
Gurol-Urganci I;Jardine JE;Carroll F;Draycott T;Dunn G;Fremeaux A;Harris T;Hawdon J;Morris E;Muller P;Waite L;Webster K;van der Meulen J;Khalil A
通讯作者：
Khalil A
影响因子：
6.3
作者：
D'Antonio F;Sen C;Mascio DD;Galindo A;Villalain C;Herraiz I;Arisoy R;Ovayolu A;Eroğlu H;Canales MG;Ladella S;Cojocaru L;Turan O;Turan S;Hadar E;Brzezinski-Sinai NA;Dollinger S;Uyaniklar O;Ocakouglu SR;Atak Z;Premru-Srsen T;Kornhauser-Cerar L;Druškovič M;Ples L;Gündüz R;Ağaçayak E;Schvartzman JA;Malbran MN;Liberati M;Sebastiano FD;Oronzi L;Cerra C;Buca D;Cagnacci A;Ramone A;Barra F;Carosso A;Benedetto C;Cosma S;Pintiaux A;Daelemans C;Costa E;Özel A;Muhçu M;Lopez JSJ;Alvarado C;Piqueras AL;Oliva DE;Schera GBL;Volpe N;Frusca T;Samardjiski I;Simeonova S;Papestiev IA;Hojman J;Turkcuoglu I;Cromi A;Laganà AS;Ghezzi F;Sirico A;Familiari A;Scambia G;Sukhikh ZKGT;Gorina KA;de Sa RAM;Vaz M;Feuerschuette OHM;Gatta AND;Youssef A;Donna GD;Martinez-Varea A;Loscalzo G;Morales Roselló J;Stefanovic V;Nupponen I;Nelskylä K;Ayala R;Molpeceres RG;Vázquez AP;Sandri F;Cataneo I;Lenzi M;Haberal ET;Huertas E;Sanchez A;Arango P;Bermejo A;Alcantara MMG;Göynümer G;Okuyan E;Madalina C;Guisan AC;Schulte AM;Esposito V;De Robertis V;Zdjelar S;Lackovic M;Mihajlovic S;Jekova N;Saccone G;Aslan MM;Dedda MCD;Chalid M;Canache JEM;Daskalakis G;Antsaklis P;Vega EC;Cueto E;Taccaliti C;Aykanat Y;Özlem Genç Ş;Froessler B;Radulova PA;Morano D;Bianchi B;Marino MGL;Meccariello G;Rohatgi B;Schiattarella A;Morlando M;Colacurci N;Villasco A;Biglia N;Marques ALS;Gatti A;Luvero D;Angioli R;Pittaro A;Lila A;Zlatohlávková B;On the behalf of the World Association of Perinatal Medicine working group on coronavirus disease 2019
通讯作者：
On the behalf of the World Association of Perinatal Medicine working group on coronavirus disease 2019
Covid-19的胎盘病理学：社区医院环境中的病例系列。
DOI：
10.7759/cureus.12522
发表时间：
2021-01-06
期刊：
Cureus
影响因子：
--
作者：
Singh N;Buckley T;Shertz W
通讯作者：
Shertz W
影响因子：
3.3
作者：
Debelenko L;Katsyv I;Chong AM;Peruyero L;Szabolcs M;Uhlemann AC
通讯作者：
Uhlemann AC
DOI：
10.1080/14767058.2020.1791817
发表时间：
2020-07-14
影响因子：
1.8
作者：
Algeri, Paola;Stagnati, Valentina;Ciammella, Massimo
通讯作者：
Ciammella, Massimo