Intrauterine fetal demise in extensive SARS-CoV-2-associated placental maternal vascular malperfusion in the setting of SARS-CoV-2 placentitis (severe acute respiratory syndrome coronavirus 2)

We report a case of a placenta with extensive maternal vascular malperfusion and chronic histiocytic intervillositis corresponding to SARS-CoV-2 placentitis in the context of fetal demise at 31 weeks of gestation. Placental swamp and PCR of the placental parenchyma, umbilical cord and amnion-chorion membrane showed SARS-CoV-2- and B-betacoronavirus-specific RNA. Maternal vascular malperfusion has been described in cases of SARS-CoV-2 infection; however, the manifested severity of this case in the setting of a severe SARS-CoV-2 placentitis is rare. It emphasizes the need of a maternal prophylactic anticoagulation.