Maternal thrombocytopenia precedes fetal death associated with COVID-19
Maternal thrombocytopenia precedes fetal death associated with COVID-19
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母亲血小板减少症先于与 COVID-19 相关的胎儿死亡
DOI：
10.1111/jog.15223
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Kondoh E.
中科院分区：
文献类型：
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作者：
Sagara A;Yamaguchi M;Mikami Y;Motohara T;Ohba T;Kondoh E.
据报道，感染 COVID-19 的孕妇会出现急性凝血功能障碍、特定胎盘病理以及胎儿死亡风险增加；然而，凝血障碍与胎儿死亡之间的关联仍不清楚。我们报告了两名患有 COVID-19 的孕妇，她们在胎儿死亡前表现出急性凝血功能障碍。两名孕妇在 SARS-CoV-2 检测呈阳性后（第 5 天和第 7 天）均出现血小板减少症。他们的症状轻微，但凝血功能障碍不断发展，他们的胎儿在怀孕 27 周和 22 周的第 9 天死亡。分娩后它们的凝血能力得到改善。两例胎盘组织学均显示绒毛间组织细胞浸润、滋养层细胞坏死和绒毛间纤维蛋白沉积，与之前报道的 SARS-CoV-2 相关病理结果一致。在感染 COVID-19 的孕妇的管理中，血小板减少症可能是 SARS-CoV-2 感染引起的凝血障碍和胎盘炎症变化后胎儿死亡的预测标志。
Acute coagulopathy, specific placental pathology, and an increased risk of fetal death have been reported in pregnant women with COVID‐19; however, the association between coagulopathy and fetal death remains unknown. We report two pregnant women with COVID‐19 who showed acute coagulopathy prior to fetal death. Both pregnant women presented with thrombocytopenia after testing positive for SARS‐CoV‐2 (days 5 and 7). They had mild symptoms, but coagulopathy progressed, and their fetuses died on day 9 at 27 and 22 weeks of pregnancy. Their coagulability improved after delivery. Placental histology in both cases showed intervillous infiltration of histiocytes, necrosis of trophoblasts, and intervillous fibrin deposition, which were consistent with previously reported pathological findings related to SARS‐CoV‐2. In the management of pregnant women with COVID‐19, thrombocytopenia may be a predictive marker of fetal death following coagulopathy and placental inflammatory changes due to SARS‐CoV‐2 infection.