Abstract
Keywords
References
- Goddijn M, Leschot NJ. Genetic aspects of miscarriage. Baillieres Best Pract Res Clin Obstet Gynaecol 2000; 14: 855-65.
- Regan L, Rai R. Epidemiology and the medical causes of miscarriage. Baillieres Best Pract Res Clin Obstet Gynaecol 2000; 14: 839-54.
- Frazier T, Hogue CJR, Bonney EA, Yount KM, Pearce BD. Weathering the storm; a review of pre-pregnancy stress and risk of spontaneous abortion. Psychoneuroendocrinology 2018; 92: 142-54.
- Xiong YQ, Tan J, Liu YM, et al. The risk of maternal parvovirus B19 infection during pregnancy on fetal loss and fetal hydrops: A systematic review and meta-analysis. J Clin Virol 2019; 114: 12-20.
- Gomez GB, Kamb ML, Newman LM, Mark J, Broutet N, Hawkes SJ. Untreated maternal syphilis and adverse outcomes of pregnancy: a systematic review and meta-analysis. Bull World Health Organ 2013; 91: 217-26.
- Rasti S, Ghasemi FS, Abdoli A, Piroozmand A, Mousavi SG, Fakhrie-Kashan Z. ToRCH "co-infections" are associated with increased risk of abortion in pregnant women. Congenit Anom (Kyoto) 2016; 56: 73-8.
- Wedi CO, Kirtley S, Hopewell S, Corrigan R, Kennedy SH, Hemelaar J. Perinatal outcomes associated with maternal HIV infection: a systematic review and meta-analysis. Lancet HIV 2016; 3: e33-48.
- Ghasemi FS, Rasti S, Piroozmand A, Bandehpour M, Kazemi B, Mousavi SG, et al. Toxoplasmosis-associated abortion and stillbirth in Tehran, Iran. J Matern Fetal Neonatal Med 2016; 29: 248-51.
- Favre G, Pomar L, Musso D, Baud D 2019-nCoV epidemic: what about pregnancies? Lancet 2020; 395: e40.
- Baud D, Greub G, Favre G, et al. Second-Trimester Miscarriage in a Pregnant Woman With SARS-CoV-2 Infection. JAMA 2020; 323: 2198-2200.
- Shanes ED, Mithal LB, Otero S, Azad HA, Miller ES, Goldstein JA. Placental Pathology in COVID-19. Am J Clin Pathol 2020; 154: 23-32.
- la Cour Freiesleben N, Egerup P, Hviid KVR, et al. SARS-CoV-2 in first trimester pregnancy: a cohort study. Hum Reprod 2021; 36: 40-7.
- Penfield CA, Brubaker SG, Limaye MA, et al. Detection of severe acute respiratory syndrome coronavirus 2 in placental and fetal membrane samples. Am J Obstet Gynecol MFM 2020; 2: 100133.
- Hamming I, Timens W, Bulthuis ML, Lely AT, Navis G, van Goor H. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol 2004; 203: 631-7.
- Chadchan SB, Popli P, Maurya VK, Kommagani R. The SARS-CoV-2 receptor, angiotensin-converting enzyme 2, is required for human endometrial stromal cell decidualizationdagger. Biol Reprod 2021; 104: 336-43.
- Chadchan SB, Maurya VK, Popli P, Kommagani R. The SARS-CoV-2 receptor, Angiotensin converting enzyme 2 (ACE2) is required for human endometrial stromal cell decidualization. Preprint. bioRxiv. 2020;2020.06.23.168252.
- Bellos I, Pandita A, Panza R. Maternal and perinatal outcomes in pregnant women infected by SARS-CoV-2: A meta-analysis. Eur J Obstet Gynecol Reprod Biol 2021; 256: 194-204.
- Wei SQ, Bilodeau-Bertrand M, Liu S, Auger N. The impact of COVID-19 on pregnancy outcomes: a systematic review and meta-analysis. CMAJ 2021; 193: E540-E8.
- Schwartz DA, Dhaliwal A. Infections in pregnancy with covid-19 and other respiratory rna virus diseases are rarely, if ever, transmitted to the fetus: experiences with coronaviruses, hpiv, hmpv rsv, and influenza. Arch Pathol Lab Med 2020;10.5858/arpa.2020-0211-SA.
- Di Toro F, Gjoka M, Di Lorenzo G, et al. Impact of COVID-19 on maternal and neonatal outcomes: a systematic review and meta-analysis. Clin Microbiol Infect 2021; 27: 36-46.
- Wu D, Fang D, Wang R, Deng D, Liao S. Management of pregnancy during the COVID-19 Pandemic. Glob Chall 2021; 5: 2000052.
- Elshafeey F, Magdi R, Hindi N, et al. A systematic scoping review of COVID-19 during pregnancy and childbirth. Int J Gynaecol Obstet 2020; 150: 47-52.
Abstract
Aim: The probability of spontaneous abortion is known to increase (15%) in the pregnant women who develop symptomatic and even “Severe Acute Respiratory Syndrome (SARS)” due to maternal infections. It is known that the SARS-CoV-2 virus, one of these infectious agents, enters host cells by binding to angiotensin-converting enzyme 2 (ACE2). New literature data have shown the increased ACE2 receptor in the endometrium during the decidualization phase and the ability of SARS-CoV-2 to enter endometrial stromal cells through ACE2 proteins. This shows that the COVID-19 infection can cause many pathologies such as early pregnancy loss. The aim of this study is to investigate the effects of SARS-CoV-2 virus which are positive in the uterine samples on pregnancy loss.
Material and Method: 13 women who had first trimester pregnancy loss were included in this cross-sectional study. None of these pregnant women had any known symptoms of SARS-CoV-2 infection. SARS-CoV-2 infection was screened in uterus and naso-oropharynx samples by real-time polymerase chain reaction (RT-PCR) test in these pregnant women. Women with positive RT-PCR results will be evaluated for pneumonia by lung tomography. It is planned to evaluate the sample taken from the naso-oropharynx in the partners of these women for SARS-CoV-2 infection by RT-PCR. In addition, in positive cases, RT-PCR was planned from the uterus and naso-oropharynx samples at 7-day intervals until the case turned negative.
Results: RT-PCR test for SARS-CoV-2 was positive only in a sample taken from the uterus of one woman (7.6%). The naso-oropharyngeal sample of the same patient was negative, and the patient had no symptoms of COVID-19. No COVID-19-related lesion was observed in the lung tomography of this patient. The results of the RT-PCR test performed 7 days later with samples taken from the uterus and naso-pharynx were also negative. After the patient's positive RT-PCR result, a naso-oropharyngeal sample was taken from his partner. The RT-PCR test result for SARS-CoV-2 in the patient's partner was negative.
Conclusion: The fact that the SARS-CoV-2 virus was negative in the naso-oropharyngeal sample and positive in the uterine sample in a pregnant woman who had a miscarriage suggests that the endometrium may be an entry route for the virus. These data suggest that the virus can lead to adverse pregnancy outcomes, including early pregnancy loss, even without known symptoms. A large number of studies are needed to evaluate the effects of common viruses on pregnancy beyond the expected and defined symptoms.
Keywords
References
- Goddijn M, Leschot NJ. Genetic aspects of miscarriage. Baillieres Best Pract Res Clin Obstet Gynaecol 2000; 14: 855-65.
- Regan L, Rai R. Epidemiology and the medical causes of miscarriage. Baillieres Best Pract Res Clin Obstet Gynaecol 2000; 14: 839-54.
- Frazier T, Hogue CJR, Bonney EA, Yount KM, Pearce BD. Weathering the storm; a review of pre-pregnancy stress and risk of spontaneous abortion. Psychoneuroendocrinology 2018; 92: 142-54.
- Xiong YQ, Tan J, Liu YM, et al. The risk of maternal parvovirus B19 infection during pregnancy on fetal loss and fetal hydrops: A systematic review and meta-analysis. J Clin Virol 2019; 114: 12-20.
- Gomez GB, Kamb ML, Newman LM, Mark J, Broutet N, Hawkes SJ. Untreated maternal syphilis and adverse outcomes of pregnancy: a systematic review and meta-analysis. Bull World Health Organ 2013; 91: 217-26.
- Rasti S, Ghasemi FS, Abdoli A, Piroozmand A, Mousavi SG, Fakhrie-Kashan Z. ToRCH "co-infections" are associated with increased risk of abortion in pregnant women. Congenit Anom (Kyoto) 2016; 56: 73-8.
- Wedi CO, Kirtley S, Hopewell S, Corrigan R, Kennedy SH, Hemelaar J. Perinatal outcomes associated with maternal HIV infection: a systematic review and meta-analysis. Lancet HIV 2016; 3: e33-48.
- Ghasemi FS, Rasti S, Piroozmand A, Bandehpour M, Kazemi B, Mousavi SG, et al. Toxoplasmosis-associated abortion and stillbirth in Tehran, Iran. J Matern Fetal Neonatal Med 2016; 29: 248-51.
- Favre G, Pomar L, Musso D, Baud D 2019-nCoV epidemic: what about pregnancies? Lancet 2020; 395: e40.
- Baud D, Greub G, Favre G, et al. Second-Trimester Miscarriage in a Pregnant Woman With SARS-CoV-2 Infection. JAMA 2020; 323: 2198-2200.
- Shanes ED, Mithal LB, Otero S, Azad HA, Miller ES, Goldstein JA. Placental Pathology in COVID-19. Am J Clin Pathol 2020; 154: 23-32.
- la Cour Freiesleben N, Egerup P, Hviid KVR, et al. SARS-CoV-2 in first trimester pregnancy: a cohort study. Hum Reprod 2021; 36: 40-7.
- Penfield CA, Brubaker SG, Limaye MA, et al. Detection of severe acute respiratory syndrome coronavirus 2 in placental and fetal membrane samples. Am J Obstet Gynecol MFM 2020; 2: 100133.
- Hamming I, Timens W, Bulthuis ML, Lely AT, Navis G, van Goor H. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol 2004; 203: 631-7.
- Chadchan SB, Popli P, Maurya VK, Kommagani R. The SARS-CoV-2 receptor, angiotensin-converting enzyme 2, is required for human endometrial stromal cell decidualizationdagger. Biol Reprod 2021; 104: 336-43.
- Chadchan SB, Maurya VK, Popli P, Kommagani R. The SARS-CoV-2 receptor, Angiotensin converting enzyme 2 (ACE2) is required for human endometrial stromal cell decidualization. Preprint. bioRxiv. 2020;2020.06.23.168252.
- Bellos I, Pandita A, Panza R. Maternal and perinatal outcomes in pregnant women infected by SARS-CoV-2: A meta-analysis. Eur J Obstet Gynecol Reprod Biol 2021; 256: 194-204.
- Wei SQ, Bilodeau-Bertrand M, Liu S, Auger N. The impact of COVID-19 on pregnancy outcomes: a systematic review and meta-analysis. CMAJ 2021; 193: E540-E8.
- Schwartz DA, Dhaliwal A. Infections in pregnancy with covid-19 and other respiratory rna virus diseases are rarely, if ever, transmitted to the fetus: experiences with coronaviruses, hpiv, hmpv rsv, and influenza. Arch Pathol Lab Med 2020;10.5858/arpa.2020-0211-SA.
- Di Toro F, Gjoka M, Di Lorenzo G, et al. Impact of COVID-19 on maternal and neonatal outcomes: a systematic review and meta-analysis. Clin Microbiol Infect 2021; 27: 36-46.
- Wu D, Fang D, Wang R, Deng D, Liao S. Management of pregnancy during the COVID-19 Pandemic. Glob Chall 2021; 5: 2000052.
- Elshafeey F, Magdi R, Hindi N, et al. A systematic scoping review of COVID-19 during pregnancy and childbirth. Int J Gynaecol Obstet 2020; 150: 47-52.
Details
| Primary Language | English |
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| Subjects | Health Care Administration |
| Journal Section | Original Article |
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| Publication Date | March 27, 2023 |
| Published in Issue | Year 2023 Volume: 6 Issue: 2 |
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