Maternal COVID-19 causing intrauterine foetal demise with microthrombotic placental insufficiency: a case report


  • O. Nonn
  • L. Bonstingl
  • K. Sallinger
  • L. Neuper
  • J. Fuchs
  • M. Gauster
  • B. Huppertz
  • D. Brislinger
  • A. El-Heliebi
  • H. Fluhr
  • E. Kampelmühler
  • P. Klaritsch


  • BMC pregnancy and childbirth


  • BMC Pregnancy Childbirth 23 (1): 653


  • BACKGROUND: Pregnant women have an increased risk of getting infected with SARS-CoV-2 and are more prone to severe illness. Data on foetal demise in affected pregnancies and its underlying aetiology is scarce and pathomechanisms remain largely unclear. CASE: Herein we present the case of a pregnant woman with COVID-19 and intrauterine foetal demise. She had no previous obstetric or gynaecological history, and presented with mild symptoms at 34 + 3 weeks and no signs of foetal distress. At 35 + 6 weeks intrauterine foetal death was diagnosed. In the placental histopathology evaluation, we found inter- and perivillous fibrin depositions including viral particles in areas of degraded placental anatomy without presence of viral entry receptors and SARS-CoV-2 infection of the placenta. CONCLUSION: This case demonstrates that maternal SARS-CoV-2 infection in the third trimester may lead to an unfavourable outcome for the foetus due to placental fibrin deposition in maternal COVID-19 disease possibly via a thrombogenic microenvironment, even when the foetus itself is not infected.