Objective: A majority of studies evaluating the risk of vertical transmission and adverse outcomes in pregnancies with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are mostly based on third-trimester infections. There is limited data available on pregnancy sequelae of maternal infection in the first or second trimester.
Study Design: We present a patient with monochorionic-diamniotic twins that develops coronavirus disease 2019 infection at 15 weeks of gestation. The pregnancy is further complicated by stage II twin-twin transfusion syndrome. She undergoes laser ablation, which is complicated by development of a subchorionic hematoma. The patient then develops bacteremia, resulting in septic shock and preterm labor followed by previable delivery at 21 weeks of gestation. Amniotic fluid and placenta were negative for SARS-CoV-2 by real-time polymerase chain reaction.
Conclusion: This case of SARS-CoV-2 argues against transplacental transmission after a second-trimester infection but brings attention to the possible downstream complications that may arise following early infection.
Key Points: · Vertical transmission of SARS-CoV-2 is not evident after a second-trimester infection.. · Antepartum coronavirus disease 2019 may cause vascular placental changes and placental insufficiency.. · SARS-CoV-2 is associated with a maternal hypercoagulable state with adverse perinatal outcomes..
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Effect of reduced placental expression of zinc transporters on selective intrauterine growth restriction in monochorionic diamniotic twin pregnancies.
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Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University.; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan 610041, China.. Electronic address:
Zinc is an essential trace element. The regulatory mechanism of zinc and its transporters in fetal growth in monochorionic diamniotic (MCDA) twins with selective intrauterine growth restriction (MCDA-sIUGR) is unclear. A total of 45 MCDA twins were divided into two groups, MCDA (n=37) and MCDA-sIUGR (n=8), to investigate their possible effects on fetal growth.
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Johns Hopkins Center for Fetal Therapy, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Objective: To determine if the resolution of fetal growth discordance after laser surgery in pregnancies with twin-to-twin transfusion syndrome (TTTS) and coexisting selective fetal growth restriction (sFGR) can be predicted by estimated fetal weight (EFW) discordance recorded prior to the development of TTTS (pre-TTTS).
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Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, 00185 Roma, Italy.
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Department of Gynecology and Obstetrics, Center for Fetal Therapy, Johns Hopkins Medicine, Baltimore, Maryland, USA.
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Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, JPN.
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