OBJECTIVE

To study the peculiarities of structural and functional reorganization in the placentas of COVID-19 patients in the I and II trimesters of pregnancy.

MATERIAL AND METHODS

Twenty-six patients who had undergone COVID-19 in the first or second trimesters of pregnancy in different forms (the study group) and 20 patients with term physiological pregnancy (the control group) were examined. A morphological study of the placenta was carried out and the results were compared between the study and control groups. To assess structural reorganization in the placentas of both groups, we calculated the relative volume density of villi of different types per conventional unit area and the relative area of syncytial nodules.

RESULTS

Areas with a predominance of intermediate differentiated and undifferentiated villi were found in the placentas of the COVID-19-treated pregnant women in the first trimester and asymptomatic form, which indicated a tendency to delay their maturation. Compared with the results in the control group, the relative area of syncytial nodules was increased in the placentas of women who underwent COVID-19 in the first trimester of pregnancy. The placentas of women who underwent COVID-19 in the second trimester showed the greatest structural abnormalities — the bulk density of the terminal villi decreased, which was possibly associated with the formation of intermediate undifferentiated and differentiated villi between weeks 13 and 28.

CONCLUSION

Study of structural reorganization in the placentas of women who underwent COVID-19 in the first and second trimesters of pregnancy reveals new links in the pathogenesis of the disease depending on its severity and helps to correctly assess the condition of the mother and her newborn.