VP45.10: COVID‐19 in 14 pregnant women: maternal, placental, fetal and neonatal outcomes

Abstract

During the SARS-CoV2 pandemic, possible vertical transmission of SARS-CoV2 has been suspected. Recent publications confirm the presence of the virus in the placenta after birth by PCR test and possible vertical transmission. The aim of this research is to present a case series of pregnant women with COVID-19 infection, describing placental findings, rate of vertical transmission, maternal and neonatal outcome. This is a retrospective review of all pregnant patients with SARS-CoV2 infection during pregnancy admitted to Lausanne University Hospital for delivery, from 1 April until 6 May 2020. We included all pregnant patients who delivered after 14 weeks, with a positive RT-PCR nasopharyngeal swab for SARS-CoV2, or positive serology (IgG) for SARS-CoV2. 13 patients infected during the third trimester and 1 in the second trimester were identified. Two of 14 (14%) had a severe course of COVID-19 infection and needed inpatient care, 7 had a mild course (50%) and 5 were asymptomatic (36%). 2 out of 14 patients had a labour induction or emergency Caesarean section (CS) for a reason related to COVID-19 infection. One neonate was hospitalised due to iatrogenic prematurity caused by the elective CS at 32 weeks because of maternal severe infection. No birthweight under the 5th percentile was observed. The rate of live birth was 100% among these neonates. None of the placental, cord blood, and neonate nasopharyngeal swabs were positive for SARS-CoV2. One patient had a late miscarriage at 17 weeks of gestation with positive PCR on placenta. We did not find evidence of placental infection nor vertical transmission in patients infected in the 3rd trimester of pregnancy. Except one neonate exposed to prematurity related to severe maternal infection, no adverse neonatal outcomes were observed. However, a case of miscarriage during the second trimester of pregnancy in a woman with COVID-19 could be related to placental infection with SARS-CoV2, supported by virological findings in the placenta.