Placental pathology in COVID-19 infected mothers and its impact on pregnancy and fetal outcome

Background: The placenta serves as the critical maternal–fetal interface and exhibits a relatively attenuated immune response, making it susceptible to various viral infections. Since the emergence of coronavirus disease 2019 (COVID-19), several studies have described placental abnormalities in infected mothers; however, there is no consensus regarding specific or characteristic histopathological findings associated with COVID-19 infection. The present study aimed to evaluate the histopathological changes in placentas from COVID-19–positive women and to assess their potential impact on maternal and fetal outcomes.Methods: This descriptive observational study included 100 COVID-19–positive pregnant women without associated comorbidities who presented to the labor room of our institute over a six-month period. Placentas were collected following delivery and subjected to detailed gross and histopathological examination in accordance with the Amsterdam Placental Workshop Group guidelines. Relevant clinical and pathological data were recorded, and statistical analysis was performed using SPSS software.Results: Among the study population, there were two cases of intrauterine fetal demise, and no maternal mortality was observed. Histopathological examination revealed inflammatory lesions as the most frequent finding, present in 83% of placentas. Maternal vascular malperfusion was identified in 56% of cases, while fetal vascular malperfusion was observed in 21% of placentas.Conclusion: Placental examination in COVID-19–positive pregnancies commonly demonstrates inflammatory changes and features of vascular malperfusion. Despite these histopathological abnormalities, adverse maternal and fetal outcomes were infrequent, suggesting a limited clinical impact in the absence of maternal comorbidities.