Decreased Fetal Movements: A Sign of Placental SARS-CoV-2 Infection with Perinatal Brain Injury
2021
Guillaume Favre | Sara Mazzetti | Carole Gengler | Claire Bertelli | Juliane Schneider | Bernard Laubscher | Romina Capoccia | Fatemeh Pakniyat | Inès Ben Jazia | Béatrice Eggel-Hort | Laurence de Leval | Léo Pomar | Gilbert Greub | David Baud | Eric Giannoni
Neonatal COVID-19 is rare and mainly results from postnatal transmission. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), however, can infect the placenta and compromise its function. We present two cases of decreased fetal movements and abnormal fetal heart rhythm 5 days after mild maternal COVID-19, requiring emergency caesarean section at 29 + 3 and 32 + 1 weeks of gestation, and leading to brain injury. Placental examination revealed extensive and multifocal chronic intervillositis, with intense cytoplasmic positivity for SARS-CoV-2 spike antibody and SARS-CoV-2 detection by RT-qPCR. Vertical transmission was confirmed in one case, and both neonates developed extensive cystic peri-ventricular leukomalacia.
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