Histopathological Evaluation of Placentas from COVID-19-positive Mothers: A Study of 100 Placentas

Aims and background: There is a limited availability of data regarding the consequences of COVID-19 disease on placenta and pregnancy outcome.Pregnant females are more vulnerable to COVID-19 infection.In such case scenario, histological study of the placenta gives the best clue of the undergoing disease process, thus helping in management and improvement of pregnancy outcome.Hence, this study was undertaken to evaluate pathological changes in placentas of COVID-19 mothers.Materials and methods: This is a cohort-based, prospective observational study undertaken in tertiary care center.The duration of study is 6 months (July 2020 to December 2020).The placentas of 100 COVID-19 positive mothers were included in this study.Due to the highly infectious nature of the tissue, the placentas were fixed in 10% neutral buffered formalin for 48 hours, followed by grossing, sectioning as per Amsterdam placental workshop group consensus and subjecting it to standard tissue processing protocol.The data were subjected to analysis by MS Excel and SSPS software version 27.Results: The mean age was 27 years.The majority were asymptomatic.On clinical examination, 42% revealed tachycardia, 4% revealed hypertension.The laboratory parameters revealed anemia in 23%, leukocytosis in 5% and raised neutrophil lymphocyte ratio (NLR) in 46.Fullterm placentas were observed in 87% with mean weight of 473 grams.The most common finding of maternal malperfusion was increased perivillous fibrin deposition while of fetal malperfusion was chorangiosis.The inflammatory changes were chorioamnionitis and villitis.Conclusions: A causal relationship between maternal COVID-19 infection and its consequences in pregnancy is essential for improving the outcome.Hence, detailed histopathological examination of the placenta is essential.Clinical significance: Due to limited research available on the histopathological changes in the placenta of COVID-19 mothers, its consequences on maternal as well as fetal health need to be established.The detailed knowledge of pathology of the placenta will be helpful in unveiling the causal relationship, thus helping the management of COVID-positive pregnant females.