Research says women in Mumbai suffer miscarriage because of Covid

After the 13th week of pregnancy, a regular ultrasound examination revealed that the fetus had died. (representative)

Early abortion miscarriage in Mumbai residents is associated with the SARS-CoV-2 virus after it has been discovered that the infection may have moved to the umbilical cord, placenta and caused inflammation in the fetus.

“To the best of our knowledge, this is the first case to show that tissue persists SARS-CoV-2 infection a few weeks after clearance of a pharyngeal swab… the virus not only survived in the tissue, but also the placenta. It is replicated in the cell.” Last week, a paper submitted by the National Institute of Reproductive Research (NIRRH), a research unit of the Indian Medical Research Council, in collaboration with the ESIS (Employee State Insurance System) Hospital in Kandy Bali.

The paper was posted on MedRxiv, an online site that publishes preprints for medical and scientific papers on August 22nd.

A woman who is a hospital guard in her late twenties, COVID-19 When you are 2 months pregnant. She was asymptomatic. Five weeks later, when she was 13 weeks pregnant she had a negative nasal swab test. However, after the 13th week of pregnancy, a regular ultrasound examination revealed that the fetus had died.

Evid Hospital suspected it was associated with Covid-19 and asked NIRRH to investigate. The hospital ethics committee approved the test for women.

“I first tested her nasopharynx again with Covid-19, but it was negative. Next, I tested the placenta, amniotic fluid, and fetal membranes. Dr. Dreepak Modi, a placental biologist at NIRRH, said I was surprised to learn that the virus was replicating in the placenta five weeks after infection.

This was the woman’s third pregnancy. Doctors suspect that vertical transmission of the virus caused inflammation in the lungs of the fetus, leading to its death.

Meaning while vertical transmission Coronavirus Although travel from the womb to the mother to the fetus has been recorded, cases of miscarriage due to Covid-19 complications are rare.

In Switzerland, a 28-year-old Covid-19-positive woman gave birth to a stillborn baby in late pregnancy. She was evaluated at the University of Lausanne Hospital on March 20th. A study published in the Journal of the American Medical Association states that samples from the umbilical cord and peripheral margin were positive for Covid-19. The study paper stated that miscarriage “occurs in association with placental infection with SARS-CoV-2” and “no other cause of fetal death was identified”.

Mumbai doctors suspect a similar placental infection that can lead to miscarriage. “The placenta acts as a barrier that protects the baby from infections in the second and third trimesters of pregnancy, but in the first trimester it is still built as a barrier,” Modi said.

He studies the placenta at various stages of his pregnancy. “We found that the placenta had a concentration of the ACE-2 enzyme in early pregnancy. It functions as a reservoir for SARS-CoV-2,” he said. ACE-2 acts as an entry point for coronavirus into human cells and aids replication.

This is the first time a research paper has found that the virus is replicating in the placenta five weeks after infection, and even says it caused an inflammatory response in the fetus.

NIRRH scientist Dr. Rahul Gajbhiye said he maintains a register of pregnant women infected with Covid-19 in Maharashtra, but usually records pregnant or expectant mothers. .. More than 1,000 women are registered.

“Pregnant women infected with Covid-19 are almost asymptomatic. We only diagnose them when they come to delivery and are tested. Because there were no tests in the first two trimesters, Miscarriage may have been overlooked in the first semester associated with Covid-19, “said Gajbhiye.

This study pointed out the need for early universal screening of pregnant women to avoid “adverse fetal outcomes.” Globally, information on the effects of Sars-CoV-2 on the fetus is limited.

Dr. Prajakta Shende, assistant professor of gynecology at ESIS Hospital, said: “This woman came into contact with an infected patient and decided to undergo a test. When she suffered a miscarriage, we wondered if Covid-19 had anything to do with it. So far, we have not begun testing other women in the first trimester of Covid-19.

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