A Prospective Hospital Based Study of Placental Changes to Identify Antenatal and Perinatal Transmission of Sars CoV2 Infection

Aim: To study the placental changes in mothers exposed to Covid 19 and to identify antenatal and perinatal transmission of SARS CoV2 infection. Method: This is a prospective observational study conducted over 18 months in all pregnant women with history of Covid symptoms and RT-PCR positive for Covid-19 or and SARS CoV Antibodies positive any time during the course of pregnancy or at the time of delivery. Results: A total of 60 cases, 30 Covid positive and 30 Covid negative mothers were included in the study. There was no statistical significance among the gravida or mode of delivery. Preterm deliveries were more in number in Covid positive mothers. Clinical presentation of covid symptoms and history of exposure to cases of covid positive patients was statistically significant (p<0.001 to p=0.0080). Histopathological study of covid positive placenta revealed increased incidence of chorioamnionitis, MVP, decidual arteriopathy, chorangiosis, calcification and hyalinization (p=0.0001 to 0.0003). Sars CoV2 and ACE 2 expression was not statistically significant among the two groups (p=0.5). Conclusion: There is increased incidence of placental changes such as MVP, decidual arteriopathy, increased syncytial knots, calcification in covid infected mothers and thereby affecting the new born. However, the exact association between these changes and ACE 2 & Sars CoV2 expression could not be established, also whether these are true markers for placental infection needs further study.