Decreased Fetal Movements: A Sign of Placental SARS-CoV-2 Infection with Perinatal Brain Injury
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, Éric Giannoni
Abstract
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.