Foetal Intrapartum Compromise at Term: Could COVID-19 Infection Be Involved? A Case Report.

The impact of the SARS-CoV-2 infection on pregnancy has been studied and many reports have been published, mainly focussing on complications and in utero transmission with neonatal consequences. Although the effects of other viruses on foetuses are well known, the impact of maternal COVID-19 during pregnancy is not completely understood. We report a case of acute foetal intrapartum hypoxia without other risk factors than maternal COVID-19 disease 2 weeks previous to birth at term. Placental histological changes suggested that the viral infection could have been the culprit for the unfavourable outcome during labour. The neonate was promptly delivered by Caesarean section. Neonatal intensive care was started, including therapeutic hypothermia. The procedure was successful, the evolution of the neonate was favourable, and she was discharged after 10 days. Follow-up at 2 months of life indicated a normal neurological development but a drop in head growth. The case raises the idea that pregnancies with even mild COVID-19 symptoms may represent the cause of neonate compromise in a low-risk pregnancy. An important follow-up in the neonatal period and infancy is required to identify and treat any subsequent conditions. Further long-term studies are necessary to identify a cause-effect relationship between COVID-19 pregnancies and the whole spectrum of neonatal and infant consequences.

Vasectomy: subclinical pathologic changes.

The nature of the local histopathologic changes secondary to vasectomy is described in tissue excised at vasovasostomy in 37 secondarily infertile patients. Segments of surgically removed vasa were also studied in four patients with primary infertility who underwent scrotal explorations and subsequent vasoepididymostomy. Except for infertility, all patients were asymptomatic. Three, often concurrent, inflammatory or proliferative changes were found in 50 of 76 segments of vasa deferentia. These included suture granuloma, sperm granuloma, and vasitis nodosa, the last being a ductular proliferation originating from the central vas lumen and extending into the perivasal soft tissues. Vasitis nodosa occurred in 66% of the patients, and although it was often found with a sperm granuloma, it did occur by itself and is a lesion which should be recognized.

Long term effects of IUD on the human endometrium. Histologic, histochemical and ultrastructural studies.

PIP: To evaluate the longterm effects of a IUD on the human endometrium and find the possible contraceptive mechanism of the IUD, histologic, histochemical, and ultrastructural studies of human endometrial biopsies from 44 normal contorls and 178 IUD wearers were made. Histologic findings included interstitial hemorrhage, inflammatory reaction, hyperplasia, atrohy, focal necrosis, and squamous metaplasia. However, all of these findings were either infrequent or insignificant except for inflammatory reaction. Histochemical, enzymatic, and ultrastructural findings were also unremarkable. The most significant finding was asynchronism between cyclic dating and endometrial histologic dating, showing delayed endometrial maturation in the majority of IUD users. In summary, IUD insertion results in mild histologic-alteration in the human endometrium but the inflammatory reaction and asynchronous endometrial maturation may play some role in the antifertility action of an IUD.^ieng

[The effect of the IUD on the endometrial blood vessels: the histochemical changes of enzymes and glycogen].

PIP: 32 endometrial biopsies, 22 of which had used the IUD for 1-20 years or more and 10 cases with normal menstrual cycles used as controls were studied by means of histochemical methods. As compared with controls, the activities of succinic dehydrogenase, alkaline phosphatase, thiamine pyrophosphatase, glucose-6-phosphatase were more or less decreased and the amount of glycogen reduced in most of the endometrial blood vessels in IUD users. However, no significant difference between the activity of acid phosphatase and nonspecific esterases of the IUD users and control groups had been found. Results suggest that the dilatation, defect, and rupture of endometrial microvascularity in IUD-exposed users may be related to the changes of enzymes and glycogen. (author's modified)^ieng

Intra-uterine contraceptive devices (IUDs) in relation to uterine histology and microbiology.

Histological and microbiological examinations were made of 90 uteri taken in association with abdominal hysterectomy. Thirty-one women had an intra-uterine contraceptive device (IUD) in utero at the time of operation, 16 women had previously used an IUD, while 43 had never used one. A chronic inflammatory reaction was seen significantly more often in the fallopian tubes of women with an IUD in situ (21/31, 68%) than in those who had never used an IUD (7/43, 16%). In contrast, non-active post-inflammatory tubal changes were found less frequently in women with an IUD in situ (6%) than in women who had never used an IUD (16%). All tubes were sterile, expect for two with apathogenic microbes. An endometrial inflammatory reaction was found in 4 women with an IUD in situ and in one woman who had never used an IUD. The possibility of tubal infertility must be borne in mind when planning IUD contraception.