Covid-19 And Pregnancy: Clinical Case Of Critical Presentation, Placental Inflammation And Demonstrated Fetal Vertical Transmission

Abstract

On June 20, 2020, a 34-year-old woman, 25 weeks pregnant, is transferred from Hospital de San Bernardo to Clínica Las Condes in Santiago, Chile, with a 10-day history of COVID-19, which is evolving to a critical situation with severe respiratory failure. She is admitted to the intensive care unit for mechanical ventilation. Simple radiology and computed tomography images of the chest demonstrate bilateral lung disease with characteristic images of ground glass opacities, associated with interstitial thickening, images previously described as characteristic for COVID-19. The patient remains in the intensive care unit on mechanical ventilation for seven days, with subsequent favorable evolution, improvement of the septic condition and discharge after 22 days of hospitalization. Delivery occurs spontaneously at 38 weeks, the mother and the newborn evolve in good general condition. The placental histopathological examination shows villous inflammatory involvement and the newborn's blood antibody tests show the presence of IgG and IgM type antibodies. This is one of the few reported proven cases of transplacental blood transmission of SARS-CoV-2 from mother to newborn.