Placental pathology and perinatal risk during the COVID-19 pandemic.

BACKGROUND: Respiratory and immune changes during pregnancy can lead to viral infections. In coronavirus disease 2019 (COVID-19), clinical characteristics and perinatal risks are difficult to assess and are relatively unknown. OBJECTIVE: To review placental pathology in asymptomatic women with COVID-19, and to evaluate effects on perinatal outcomes. MATERIAL AND METHOD: Retrospective, observational, cross-sectional study that included 29 pregnant women in 2020. The women underwent COVID-19 tests and were divided in two groups: 1) control, COVID-19-negative patients, and 2) asymptomatic COVID-19-positive patients; the placentas were studied at the pathology department, and clinical data were retrieved from the electronic medical record; in addition, a literature review was carried out. RESULTS: When the groups were compared, no differences were observed in general data and clinical characteristics. On the day of delivery, patients 2, 4, 5, 6, 8 and 9 of the COVID-19 group were between day 0 and 10.5 after having tested positive; only patients 1, 3 and 7 had overcome the infection. There was a decrease in weeks of gestation in the COVID-19 group (37.8 ± 1.8 vs. 39 ± 0.8; p ≤ 0.05). COVID-19-positive patients' placental histopathology showed a higher prevalence of thrombotic alterations in placental villi (55.5 vs. 0%). CONCLUSIONS: COVID-19 asymptomatic infection potentiates preexisting prothrombotic profile, thus increasing the risk of placental thrombosis and, potentially, of thrombosis in pregnant women.

ANTECEDENTES: Los cambios respiratorios e inmunitarios en el embarazo pueden conducir a infecciones virales. En la enfermedad por coronavirus 2019 (COVID-19) las características clínicas y riesgos perinatales son difíciles de evaluar y son relativamente desconocidos. OBJETIVO: Revisar patología placentaria en mujeres asintomáticas con COVID-19 y evaluar efectos en datos perinatales. MATERIAL Y MÉTODO: Estudio retrospectivo, observacional y transversal, incluye 29 mujeres embarazadas en 2020. Se realizaron prueba COVID-19 y dividieron en dos grupos: 1) control, pacientes COVID-19 negativas y 2) COVID-19 asintomáticas con COVID-19 positivo; las placentas se estudiaron en patología y los datos clínicos se tomaron del expediente electrónico; asimismo, se realizó revisión de literatura. RESULTADOS: Al comparar grupos no se observó diferencia en datos generales y características clínicas. El día del parto, las pacientes 2, 4, 5, 6, 8 y 9 del grupo COVID-19 se encontraban entre día 0 y 10.5 después de positividad; únicamente las pacientes 1, 3 y 7 habían superado la infección. Se presentó disminución de semanas de gestación en el grupo COVID-19 (37.8 ± 1.8 vs. 39 ± 0.8; p ≤ 0.05). La histopatología placentaria en COVID-19 mostró mayor prevalencia de alteraciones trombóticas en vellosidades placentarias (55.5 vs. 0%). CONCLUSIONES: La infección asintomática por COVID-19, potencializa perfil protrombótico preexistente, incrementando riesgo de trombosis placentaria y trombosis en mujeres embarazadas.

[Prevalence of postmenopausal simple ovarian cyst diagnosed by ultrasound]. / Prevalencia de quistes simples de ovario diagnosticados por ultrasonido en mujeres posmenopáusicas.

INTRODUCTION: The high-resolution ultrasound has taken to discover small ovary cysts in postmenopausal asymptomatic women who in another situation would not been detected; these cysts frequently disappear spontaneously and rarely develop cancer; however, they are treated aggressively. OBJECTIVE: To know the prevalence, evolution and treatment of ovary simple cysts in the postmenopausal women in our department, since in our country there are not studies that had analyzed these data. MATERIAL AND METHODS: We made a retrospective and descriptive study in the Service of Biology of the Human Reproduction of the Hospital Juarez de Mexico, in a four-year period (2000-2003) that included 1,010 postmenopausal women. The statistical analysis was made using the SPSS software program with which we obtained descriptive measurements in localization, dispersion and by a graphic analysis. RESULTS: We found a simple cysts prevalence of 8.2% (n = 83); the average of age at the diagnosis time was 50.76 years with a standard deviation of 5.55; the cysts diameter was between 0.614 to 12,883 cm with a mean and standard deviation of 2.542 and 1.91 cm respectively; in 27.71% of the cases (n = 23), the cysts disappear spontaneously in the follow up of 3 to 36 month (mean of 14.1). Surgery was indicated in 16.46% (n = 13), by increase in the size of the cyst in 9 patients (11.64%) and by changes in morphology from simple to complex in 4 (4.82%). Tumor like markers were made only to 37 patients (44.57%), which were in normal ranks; no carcinoma was found in this group. CONCLUSIONS: The prevalence of ovary simple cysts was similar to the reported in literature. Risk of cancer of these cysts is extremely low when a suitable evaluation is made, a reason why the conservative treatment is suggested when these are simple cysts lesser than 5cm with Ca-125 levels within normal ranks. We recommend a follow up every 3-6 months by Doppler color ultrasound and tumor like markers for five years.