Covid-19 appears to cause injury in placenta during pregnancy, experts call for additional monitoring
Sixteen Covid-19 positive pregnant women in a Chicago hospital developed an injury to their placenta, an organ that nourishes and maintains the fetus. Researchers in a new study speculate that the new coronavirus is behind the damage. The placenta supplies oxygen to the fetus and removes wastes. The injury recorded in the study leads to insufficient blood flow between the mother and the fetus, which may hamper its functioning. Despite the damage, babies born to these mothers appeared healthy and have not tested positive for the virus.
"Most of these babies were delivered full-term after otherwise normal pregnancies, so you wouldn’t expect to find anything wrong with the placentas, but this virus appears to be inducing some injury in the placenta,” senior author Dr Jeffrey Goldstein, assistant professor of pathology at Northwestern University Feinberg School of Medicine and a Northwestern Medicine pathologist, says. According to previous data, four infected women had a miscarriage, three of whom showed severe inflammation in the placenta. Goldstein said that he does not know whether the virus was the culprit behind the injury, adding that he needs to see more data before pinning the blame on the disease.
In this study, the team looked at 16 pregnant women with Covid-19 infection. Fifteen of them delivered a baby during the third trimester. But one patient, who showed no symptoms, suffered a miscarriage. As for the damage, the researchers found it in 12 of the 16 women. And six of them developed blood clots in the organ. Blood clots are also reportedly common among a few other Covid-19 patients. “Our findings support that there might be something clot-forming about coronavirus, and it’s happening in the placenta," Goldstein explains.
“Not to paint a scary picture, but these findings worry me. I don’t want to draw sweeping conclusions from a small study, but this preliminary glimpse into how Covid-19 might cause changes in the placenta carries some pretty significant implications for the health of a pregnancy. We must discuss whether we should change how we monitor pregnant women right now," co-author Dr Emily Miller, assistant professor of obstetrics and gynecology at Feinberg and a Northwestern Medicine obstetrician, says.
The data is scant at the moment. And because damage to the placenta can be an issue, the experts are calling for increased monitoring of pregnant women with Covid-19. They propose additional screening through a type of tool that monitors the blood flow to the placenta or through ultrasound that measures the growth of the fetus, But one expert thinks additional screening tools can be risky. "There are all sorts of risks in doing additional screening and testing, which can result in unanticipated outcomes," Dr Denise Jamieson, from the Emory University School of Medicine in Atlanta, who was not involved in the study, tells CNN.
"This study raises more questions than it answers. Looking at the placenta will help us understand what's going on in pregnancy, but I think we need to be careful about jumping to what that means clinically in terms of care of pregnant women with Covid-19," Jamieson adds.