Pune doctors have confirmed that a pregnant woman infected with COVID-19 can transmit the infection to the foetus through the placenta.

Several studies around the world had directed the possibility of the vertical transmission (i.e. through the placental route) of the virus in the past. But, excluding anecdotal findings, there wasn’t any confirmatory evidence that could definitely establish that the route of infection through the womb (in utero) before the onset of labour and delivery.

Doctors at the state-run Sassoon hospital in Pune, attached to the B J Medical College, had registered a case of a pregnant woman with a history of fever one week before her delivery. On investigations, her baby’s nasal swab, placenta along with the umbilical stump tested positive for COVID-19 after birth by the RT-PCR method. The mother was tested negative by RT-PCR but was found to have increased levels of the virus specific antibodies in her blood. This confirms that she had the coronavirus infection in the recent past.

Hospital’s paediatrician Aarti Kinikar told TOI that as per the hospital protocol, they separated the newborn from the mother immediately after birth as it was suspected that the mother had contracted the infection. The baby too had fever and was lethargic with signs of severe coronavirus infection. The baby also had abnormal blood parameters indicating severe inflammation. The baby was kept in an intensive care unit with high flow oxygen support for one week but completely recovered by three weeks. Both the mother and baby were discharged after 21 days after the delivery.

The newborn’s nasopharyngeal sample had a higher viral load of coronavirus. Also, its placenta and umbilical stump tested positive for the Sars-CoV-virus particles with the molecular RT-PCR. The mother had fever one week before the delivery was found to have sufficient amount of virus specific antibodies concentration in her blood at 3 weeks after delivery by using the ICMR approved antibody test. This indicates that the mother had mild coronavirus infection in the past.

Kinikar further explained that the raised virus specific antibodies level in the mother’s blood signifies that the newborn was infected in utero (through the placenta). The newborn too tested positive for the virus specific antibodies along with the mother three weeks after the delivery. The findings confirm that transplacental transmission is certainly possible in the last weeks of pregnancy, thoughit cannot exclude a possible transmission and foetal concerns earlier in the pregnancy.

The woman aged 22 years, resident of Hadapsar, had delivered a baby girl normally at 9 months of pregnancy in the last week of May and both were discharged in the 3rd week of June.

Hospital dean Madhukar Tambe said that their doctors are working very hard to treat these patients. The research paper on the case findings is accepted for publication by a prestigious peer-reviewed international journal. Mother’s breast milk has not been found to be a source of the Sars-CoV-2 virus transmission as yet. It is safe for the baby.

10 years back too, the hospital had reported intrauterine transmission of the H1N1 virus from mother to child.

Source: ET Healthworld