新型冠状病毒感染孕妇三例临床特点及胎盘病理学分析  

Pregnancy with new coronavirus infection:clinical characteristics and placental pathological analysis of three cases

作　　者：陈烁 黄博 罗丹菊 李想 杨帆[2] 赵茵[3] 聂秀[1] 黄邦杏[1] Chen Shuo;Huang Bo;Luo Danju;Li Xiang;Yang Fan;Zhao Yin;Nie Xiu;Huang Bangxing(Department of Pathology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China;Department of Radiology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China;Department of Obstetrics and Gynecology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China)

机构地区：[1]华中科技大学同济医学院附属协和医院病理科,武汉430022 [2]华中科技大学同济医学院附属协和医院放射科,武汉430022 [3]华中科技大学同济医学院附属协和医院妇产科,武汉430022

出　　处：《中华病理学杂志》2020年第5期418-423,共6页Chinese Journal of Pathology

摘　　要：目的探讨新型冠状病毒(2019-nCoV)感染孕妇的临床特点及胎盘病理学变化,并评估有无宫内垂直传播的可能。方法回顾性分析华中科技大学同济医学院附属协和医院病理科2020年2月4日接收的3例确诊2019-nCoV感染孕妇的患者资料,收集胎盘组织、肺部CT及实验室检查结果,同时采用逆转录-聚合酶链反应(RT-PCR)方法检测胎盘组织内2019-nCoV病毒核酸序列。结果3例确诊2019-nCoV感染孕妇均为妊娠晚期,急诊入院行剖宫产手术分娩。3例均伴有发热(1例产前发热,2例产后发热),不伴有明显的白细胞减少及淋巴细胞减少;3例新生儿咽拭子2019-nCoV核酸检测均为阴性,仅1例因早产儿低体重转入新生儿科;截至2020年2月25日,3例产妇均未进展为重症或死亡(2例治愈出院,1例转至方舱医院隔离治疗)。胎盘组织病理学分析显示1例合并绒毛膜血管瘤,另1例伴有多灶性梗死;3例镜下均有不同程度的绒毛间质内或绒毛周围纤维蛋白沉积,局部合胞体小结增多;未查见绒毛炎或绒毛膜羊膜炎。3例胎盘组织2019-nCoV核酸检测均阴性。结论该组3例妊娠晚期2019-nCoV感染孕妇的临床表现与非妊娠期患者相似,未发现严重不良妊娠结局;病理学分析提示胎盘组织缺乏病毒感染相关形态学改变,未发现宫内母胎垂直传播。Objective To investigate the clinical characteristics and placental pathology of 2019-nCoV infection in pregnancy,and to evaluate intrauterine vertical transmission potential of 2019-nCoV infection.Methods The placentas delivered from pregnant women with confirmed 2019-nCoV infection which were received in the Department of Pathology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology by February 4,2020 were retrospectively studied.Their clinical material including placental tissue and lung CT,and laboratory results were collected,meanwhile,nucleic acid detection of 2019-nCoV of the placentas were performed by RT-PCR.Results Three placentas delivered from pregnant women with confirmed 2019-nCoV infection,who were all in their third trimester with emergency caesarean section.All of the three patients presented with fever(one before caesarean and two in postpartum),and had no significant leukopenia and lymphopenia.Neonatal throat swabs from three newborns were tested for 2019-nCoV,and all samples were negative for the nucleic acid of 2019-nCoV.One premature infant was transferred to Department of Neonatology due to low birth weight.By the end of February 25,2020,none of the three patients developed severe 2019-nCoV pneumonia or died(two patients had been cured and discharged,while another one had been transferred to a square cabin hospital for isolation treatment).There were various degrees of fibrin deposition inside and around the villi with local syncytial nodule increases in all three placentas.One case of placenta showed the concomitant morphology of chorionic hemangioma and another one with massive placental infarction.No pathological change of villitis and chorioamnionitis was observed in our observation of three cases.All samples from three placentas were negative for the nucleic acid of 2019-nCoV.Conclusions The clinical characteristics of pregnant women with 2019-nCoV infection in late pregnancy are similar to those of non-pregnant patients,and no severe adverse pregnancy o

关 键 词：新型冠状病毒 孕妇 肺炎 临床特点 胎盘病理 垂直传播 

分 类 号：R714[医药卫生—妇产科学]