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Second-Trimester Miscarriage in a Pregnant Woman With SARS-CoV-2 Infection

Educational Objective
To understand COVID-19 as a possible contributor to a second-trimester miscarriage
1 Credit CME

No data exist regarding the effect on fetuses of maternal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during the first or second trimester of pregnancy, and data are limited regarding infections that occur during the third trimester. However, reports of newborns with fetal distress or requiring admission to the intensive care unit1,2 and a stillbirth after maternal coronavirus disease 2019 (COVID-19)3 in the third trimester suggest the possibility of COVID-19–induced placental pathology.

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Corresponding Author: David Baud, MD, PhD, Materno-fetal and Obstetrics Research Unit, Department of Obstetrics and Gynecology, Centre Hospitalier Universitaire Vaudois (CHUV), 1011 Lausanne, Switzerland (david.baud@chuv.ch).

Accepted for Publication: April 20, 2020.

Published Online: April 30, 2020. doi:10.1001/jama.2020.7233

Author Contributions: Dr Baud had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Baud, Favre, Jaton, Pomar.

Acquisition, analysis, or interpretation of data: Baud, Greub, Favre, Gengler, Dubruc, Pomar.

Drafting of the manuscript: Baud, Favre, Jaton, Pomar.

Critical revision of the manuscript for important intellectual content: Baud, Greub, Favre, Gengler, Dubruc, Pomar.

Administrative, technical, or material support: All authors.

Supervision: Baud, Greub.

Conflict of Interest Disclosures: Dr Greub reported having ongoing research agreements with Resistell and Becton-Dickinson and being medical advisor for Resistell; he also reported being developer of a card game on microbes and funding JeuPro, a start-up company that distributes the game Krobs. No other disclosures were reported.

References
1.
Chen  H , Guo  J , Wang  C ,  et al.  Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records.   Lancet. 2020;395(10226):809-815. doi:10.1016/S0140-6736(20)30360-3PubMedGoogle ScholarCrossref
2.
Zhu  H , Wang  L , Fang  C ,  et al.  Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia.   Transl Pediatr. 2020;9(1):51-60. doi:10.21037/tp.2020.02.06PubMedGoogle ScholarCrossref
3.
Liu  Y , Chen  H , Tang  K , Guo  Y .  Clinical manifestations and outcome of SARS-CoV-2 infection during pregnancy.   J Infect. 2020;S0163-4453(20)30109-2. doi:10.1016/j.jinf.2020.02.028PubMedGoogle Scholar
4.
Kimberlin  DW , Stagno  S .  Can SARS-CoV-2 infection be acquired in utero? more definitive evidence is needed.   JAMA. Published online March 26, 2020. doi:10.1001/jama.2020.4868PubMedGoogle Scholar
5.
Favre  G , Pomar  L , Musso  D , Baud  D .  2019-nCoV epidemic: what about pregnancies?   Lancet. 2020;395(10224):e40. doi:10.1016/S0140-6736(20)30311-1PubMedGoogle Scholar
6.
Wong  SF , Chow  KM , Leung  TN ,  et al.  Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome.   Am J Obstet Gynecol. 2004;191(1):292-297. doi:10.1016/j.ajog.2003.11.019PubMedGoogle ScholarCrossref
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