Research

13 pages, 1706 KiB

Open AccessArticle

Pregnancy Outcomes, Immunophenotyping and Immunohistochemical Findings in a Cohort of Pregnant Patients with COVID-19—A Prospective Study

by Ana-Maria Adam, Radu-Florin Popa, Cristian Vaduva, Costinela Valerica Georgescu, Gigi Adam, Alina-Sinziana Melinte-Popescu, Cristina Popa, Demetra Socolov, Aurel Nechita, Ingrid-Andrada Vasilache, Elena Mihalceanu, AnaMaria Harabor, Marian Melinte-Popescu, Valeriu Harabor, Anca Neagu and Razvan Socolov

Diagnostics 2023, 13(7), 1345; https://doi.org/10.3390/diagnostics13071345 - 04 Apr 2023

Cited by 4 | Viewed by 2409

Abstract

(1) Background: SARS-CoV-2 infection during pregnancy could determine important maternal and fetal complications. We aimed to prospectively assess placental immunohistochemical changes, immunophenotyping alterations, and pregnancy outcomes in a cohort of patients with COVID-19; (2) Methods: 52 pregnant patients admitted to a tertiary maternity [...] Read more.

(1) Background: SARS-CoV-2 infection during pregnancy could determine important maternal and fetal complications. We aimed to prospectively assess placental immunohistochemical changes, immunophenotyping alterations, and pregnancy outcomes in a cohort of patients with COVID-19; (2) Methods: 52 pregnant patients admitted to a tertiary maternity center between October 2020 and November 2021 were segregated into two equal groups, depending on the presence of SARS-CoV-2 infection. Blood samples, fragments of umbilical cord, amniotic membranes, and placental along with clinical data were collected. Descriptive statistics and a conditional logistic regression model were used for data analysis; (3) Results: Adverse pregnancy outcomes such as preterm labor and neonatal intensive care unit admission did not significantly differ between groups. The immunophenotyping analysis indicated that patients with moderate–severe forms of COVID-19 had a significantly reduced population of T lymphocytes, CD4+ T cells, CD8+ T cells (only numeric), CD4+/CD8+ index, B lymphocytes, and natural killer (NK) cells. Our immunohistochemistry analysis of tissue samples failed to demonstrate positivity for CD19, CD3, CD4, CD8, and CD56 markers; (4) Conclusions: Immunophenotyping analysis could be useful for risk stratification of pregnant patients, while further studies are needed to determine the extent of immunological decidual response in patients with various forms of COVID-19. Full article

(This article belongs to the Special Issue Infectious Disease in Pregnancy)

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10 pages, 2218 KiB

Open AccessArticle

Ultrasound Placental Remodeling Patterns and Pathology Characteristics in Patients with History of Mild SARS-CoV-2 Infection during Pregnancy

by Adelina Staicu, Camelia Albu, Georgiana Nemeti, Cosmina Ioana Bondor, Dan Boitor-Borza, Andreia Paraschiva Preda, Andreea Florian, Iulian Gabriel Goidescu, Diana Sachelaru, Nelida Bora, Roxana Constantin, Mihai Surcel, Florin Stamatian, Ioana Cristina Rotar, Gheorghe Cruciat and Daniel Muresan

Diagnostics 2023, 13(6), 1200; https://doi.org/10.3390/diagnostics13061200 - 22 Mar 2023

Viewed by 1638

Abstract

Introduction: This research aims to describe a progressive pattern of ultrasound placental remodeling in patients with a history of SARS-CoV-2 infection during pregnancy. Materials and Methods: This was a longitudinal, cohort study which enrolled 23 pregnant women with a history of former mild [...] Read more.

Introduction: This research aims to describe a progressive pattern of ultrasound placental remodeling in patients with a history of SARS-CoV-2 infection during pregnancy. Materials and Methods: This was a longitudinal, cohort study which enrolled 23 pregnant women with a history of former mild SARS-CoV-2 infection during the current pregnancy. Four obstetricians analyzed placental ultrasound images from different gestational ages following COVID infection and identified the presence and degree of remodeling. We assessed the inter-rater agreement and the interclass correlation coefficients. Pathology workup included placental biometry, macroscopic and microscopic examination. Results: Serial ultrasound evaluation of the placental morphology revealed a progressive pattern of placental remodeling starting from 30–32 weeks of gestation towards term, occurring approximately 8–10 weeks after the SARS-CoV-2 infection. Placental changes—the “starry sky” appearance and the “white line” along the basal plate—were identified in all cases. Most placentas presented normal subchorionic perivillous fibrin depositions and focal stem villi perivillous fibrin deposits. Focal calcifications were described in only 13% of the cases. Conclusions: We identified two ultrasound signs of placental remodeling as potential markers of placental viral shedding following mild SARS-CoV-2. The most likely pathology correspondence for the imaging aspect is perivillous and, respectively, massive subchorionic fibrin deposits identified in most cases. Full article

(This article belongs to the Special Issue Infectious Disease in Pregnancy)

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13 pages, 2394 KiB

Open AccessArticle

Do NAAT-Based Methods Increase the Diagnostic Sensitivity of Streptococcus agalactiae Carriage Detection in Pregnant Women?

by Agnieszka Sroka-Oleksiak, Wojciech Pabian, Joanna Sobońska, Kamil Drożdż, Tomasz Bogiel and Monika Brzychczy-Włoch

Diagnostics 2023, 13(5), 863; https://doi.org/10.3390/diagnostics13050863 - 23 Feb 2023

Viewed by 2155

Abstract

The aim of the study was to evaluate particular polymerase chain reaction primers targeting selected representative genes and the influence of a preincubation step in a selective broth on the sensitivity of group B Streptococcus (GBS) detection by nucleic acid amplification techniques (NAAT). [...] Read more.

The aim of the study was to evaluate particular polymerase chain reaction primers targeting selected representative genes and the influence of a preincubation step in a selective broth on the sensitivity of group B Streptococcus (GBS) detection by nucleic acid amplification techniques (NAAT). Research samples were vaginal and rectal swabs collected in duplicate from 97 pregnant women. They were used for enrichment broth culture-based diagnostics, bacterial DNA isolation, and amplification, using primers based on species-specific 16S rRNA, atr and cfb genes. To assess the sensitivity of GBS detection, additional isolation of samples preincubated in Todd-Hewitt broth with colistin and nalidixic acid was performed and then subjected to amplification again. The introduction of the preincubation step increased the sensitivity of GBS detection by about 33–63%. Moreover, NAAT made it possible to identify GBS DNA in an additional six samples that were negative in culture. The highest number of true positive results compared to the culture was obtained with the atr gene primers, as compared to cfb and 16S rRNA primers. Isolation of bacterial DNA after preincubation in enrichment broth significantly increases the sensitivity of NAAT-based methods applied for the detection of GBS from vaginal and rectal swabs. In the case of the cfb gene, the use of an additional gene to ensure the appropriate results should be considered. Full article

(This article belongs to the Special Issue Infectious Disease in Pregnancy)

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29 pages, 6538 KiB

Open AccessArticle

Microbial Diversity and Pathogenic Properties of Microbiota Associated with Aerobic Vaginitis in Women with Recurrent Pregnancy Loss

by Karima Ncib, Wael Bahia, Nadia Leban, Abdelkarim Mahdhi, Fatma Trifa, Ridha Mzoughi, Anis Haddad, Chédia Jabeur and Gilbert Donders

Diagnostics 2022, 12(10), 2444; https://doi.org/10.3390/diagnostics12102444 - 09 Oct 2022

Cited by 7 | Viewed by 2304

Abstract

Recurrent pregnancy loss (RPL) is a major reproductive problem that affects approximately 5% of couples. The objective of this study was to assess vaginal flora dysbiosis in women suffering from unexplained RPL and to investigate the pathogenic properties of the microbiota associated with [...] Read more.

Recurrent pregnancy loss (RPL) is a major reproductive problem that affects approximately 5% of couples. The objective of this study was to assess vaginal flora dysbiosis in women suffering from unexplained RPL and to investigate the pathogenic properties of the microbiota associated with aerobic vaginitis (AV). The study included one hundred fifteen women, 65 with RPL and 50 controls. The diversity of vaginal microbiota isolated was evaluated by molecular sequencing. Then, pathogenic factors, such as acid-resistance, antibiotics susceptibility, and biofilm formation were evaluated. The prevalence of AV was five-fold higher in the RPL group than in the controls (64.6% vs. 12.0%). The most prevalent isolates in the case group were Enterococcus spp. (52%) and Staphylococcus spp. (26%). All bacterial strains tolerate low pH. The prevalence of multidrug resistance (MDR) among all bacteria was 47.7%. Of all strains, 91.0% were biofilm producers. The presence of MDR was found to be related to biofilm formation. The results provide evidence supporting an increased presence of dysbiosis of the vaginal flora, especially AV, in women with RPL in Tunisia. The viability of the AV-associated bacteria and their persistence in the genitals may be due to their ability to resist low pH and to produce a biofilm. Full article

(This article belongs to the Special Issue Infectious Disease in Pregnancy)

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10 pages, 4300 KiB

Open AccessArticle

Placenta, the Key Witness of COVID-19 Infection in Premature Births

by Tina-Ioana Bobei, Romina-Marina Sima, Gabriel-Petre Gorecki, Mircea-Octavian Poenaru, Octavian-Gabriel Olaru, Anca Bobirca, Catalin Cirstoveanu, Radu Chicea, Oana-Maria Topirceanu-Andreoiu and Liana Ples

Diagnostics 2022, 12(10), 2323; https://doi.org/10.3390/diagnostics12102323 - 26 Sep 2022

Cited by 2 | Viewed by 1309

Abstract

Adverse perinatal outcomes, such as increased risks of pre-eclampsia, miscarriage, premature birth, and stillbirth have been reported in SARS-CoV-2 infection. For a better understanding of COVID-19 complications in pregnancy, histopathological changes in the placenta, which is the interface between mother and foetus, could [...] Read more.

Adverse perinatal outcomes, such as increased risks of pre-eclampsia, miscarriage, premature birth, and stillbirth have been reported in SARS-CoV-2 infection. For a better understanding of COVID-19 complications in pregnancy, histopathological changes in the placenta, which is the interface between mother and foetus, could be the place to look at. The aim of this study was to determine placental histopathological changes and their role in preterm birth in pregnant women with SARS-CoV-2 infection. We performed a prospective, observational study in a COVID-only hospital, which included 39 pregnant women with SARS-CoV-2 infection and preterm birth compared with a control group of 39 women COVID-19 negative with preterm birth and a placental pathology exam available. The microscopic examination of all placentas revealed placental infarction (64.1% vs. 30.8%), decidual arteriopathy (66.7% vs. 23.1%), intervillous thrombi (53.8% vs. 38.5%), perivillous fibrin deposits (59% vs. 46.2%), inflammatory infiltrate (69.2% vs. 46.2%), chorangiosis (17.9% vs. 10.3%), and accelerated maturation of the villi (23.1% vs. 28.2%). Full article

(This article belongs to the Special Issue Infectious Disease in Pregnancy)

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11 pages, 1330 KiB

Open AccessArticle

SARS-CoV-2 Infection during Pregnancy and Histological Alterations in the Placenta

by Irina Pacu, George-Alexandru Roșu, Giorgia Zampieri, Anca Rîcu, Alexandra Matei, Ana-Maria Davițoiu, Teodora Vlădescu and Crîngu Antoniu Ionescu

Diagnostics 2022, 12(9), 2258; https://doi.org/10.3390/diagnostics12092258 - 19 Sep 2022

Cited by 3 | Viewed by 1677

Abstract

(1) Background: Despite the high number of cases of COVID-19 during pregnancy, SARS-CoV-2 congenital infection is rare. The role of the placenta as a barrier preventing the transmission of SARS-CoV-2 from the mother to the fetus is still being studied. This study aimed [...] Read more.

(1) Background: Despite the high number of cases of COVID-19 during pregnancy, SARS-CoV-2 congenital infection is rare. The role of the placenta as a barrier preventing the transmission of SARS-CoV-2 from the mother to the fetus is still being studied. This study aimed to evaluate the impact of SARS-CoV-2 infection on placental tissue. (2) Methods: This was a transversal monocentric observational study. In the study, we included pregnant women with COVID-19 who delivered at “Sfântul Pantelimon” Clinical Emergency Hospital between 1 April 2020 and 30 March 2022. Histological analyses, both macroscopic and microscopic, were performed for placentas that came from these cases. (3) Results: To date, a characteristic placental lesion has not been clearly demonstrated, but most findings include features of maternal and fetal vascular malperfusion, which probably reflect the reduction in placental blood flow due to low oxygen level from the hypoxic respiratory disease and underlying hypercoagulable state induced by the COVID-19 infection. (4) Conclusions: The histopathological aspects found in placentas that came from COVID-19-positive pregnant women are common for many other diseases, but when they are found together, they are highly suggestive for viral infectious involvement of the placenta. Full article

(This article belongs to the Special Issue Infectious Disease in Pregnancy)

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Review

Jump to: Research, Other

16 pages, 1585 KiB

Open AccessReview

An Overview of Cytomegalovirus Infection in Pregnancy

by Mihaela Plotogea, Al Jashi Isam, Francesca Frincu, Anca Zgura, Xenia Bacinschi, Florica Sandru, Simona Duta, Razvan Cosmin Petca and Antoine Edu

Diagnostics 2022, 12(10), 2429; https://doi.org/10.3390/diagnostics12102429 - 07 Oct 2022

Cited by 4 | Viewed by 4546

Abstract

The objective of this review was to bring to attention cytomegalovirus (CMV) infection during pregnancy, taking into consideration all relevant aspects, such as maternal diagnosis, fetal infection and prevention, prenatal diagnosis, and postnatal prognosis. A literature review was performed regarding adult and congenital [...] Read more.

The objective of this review was to bring to attention cytomegalovirus (CMV) infection during pregnancy, taking into consideration all relevant aspects, such as maternal diagnosis, fetal infection and prevention, prenatal diagnosis, and postnatal prognosis. A literature review was performed regarding adult and congenital infection. General information regarding this viral infection and potential related medical conditions was provided, considering the issues of maternal infection during pregnancy, transmission to the fetus, and associated congenital infection management. Prenatal diagnosis includes maternal serum testing and the confirmation of the infection in amniotic fluid or fetal blood. Additionally, prenatal diagnosis requires imaging techniques, ultrasound, and complementary magnetic resonance to assess cortical and extracortical anomalies. Imaging findings can predict both fetal involvement and the postnatal prognosis of the newborn, but they are difficult to assess, even for highly trained physicians. In regard to fetal sequelae, the early diagnosis of a potential fetal infection is crucial, and methods to decrease fetal involvement should be considered. Postnatal evaluation is also important, because many newborns may be asymptomatic and clinical anomalies can be diagnosed when sequelae are permanent. Full article

(This article belongs to the Special Issue Infectious Disease in Pregnancy)

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Other

Jump to: Research, Review

17 pages, 1332 KiB

Open AccessSystematic Review

Maternal HPV Infection and the Estimated Risks for Adverse Pregnancy Outcomes—A Systematic Review

by Simona Daniela Popescu, Andreea Gratiana Boiangiu, Romina-Marina Sima, Liviu Bilteanu, Simona Vladareanu and Radu Vladareanu

Diagnostics 2022, 12(6), 1471; https://doi.org/10.3390/diagnostics12061471 - 15 Jun 2022

Cited by 5 | Viewed by 2812

Abstract

Background: Human Papilloma Virus (HPV) represents the most prevalent genital infection in young women of reproductive age. Objective: This systematic review aims to estimate the effect of HPV infection during pregnancy and assess the correlation between HPV and adverse pregnancy outcomes. Materials and [...] Read more.

Background: Human Papilloma Virus (HPV) represents the most prevalent genital infection in young women of reproductive age. Objective: This systematic review aims to estimate the effect of HPV infection during pregnancy and assess the correlation between HPV and adverse pregnancy outcomes. Materials and methods: The search strategy has been developed based on the PICOS framework: Population (pregnant women infected with HPV), Intervention (HPV infection confirmed by molecular tests), Comparator (pregnant women without HPV infection), Outcomes (adverse pregnancy outcomes) and Study design (observational studies). We searched PubMed, Web of Science, and Scopus databases on 8 January 2022 by using the following keywords: “HPV”, “prematurity”, “preterm birth”, “miscarriage”, “premature rupture of membranes”, “adverse pregnancy outcome”, “low birth weight”, “fetal growth restriction”, “pregnancy-induced hypertensive disorders”, “preeclampsia”. Selection criteria were HPV infection confirmed within maximum 2 years before pregnancy with a molecular test and adverse pregnancy outcomes. (Results: Although numerous studies are conducted on this topic, data are still controversial regarding identifying maternal HPV infection as a risk factor for adverse pregnancy outcomes. More prospective large cohort studies are needed to prove a causative relationship. Full article

(This article belongs to the Special Issue Infectious Disease in Pregnancy)

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