Hereby, we report a confirmed case of intrauterine SARS-CoV-2 transmission with rapid placental dysfunction and fetal distress.. Intrauterine SARS-CoV-2 transmission

A recent systematic review found that pregnant women were potentially more likely to need intensive care treatment related to coronavirus 2019 disease (COVID-19) as compared to non-pregnant women of reproductive age. In addition, preterm birth rates were higher in pregnant women with COVID-19 2. Neonatal COVID-19 is less investigated and the possibility of maternal-fetal transmission awaits further elucidation. A number of reports have suggested postpartum transmission 3, but to the best of our knowledge, only Vivanti et al have convincingly reported a case of transplacental SARS-CoV-2 transmission 4. The placenta has been found to harbor a significant viral load and is of key interest in understanding perinatal COVID-19 5.Hereby, we report a confirmed case of intrauterine SARS-CoV-2 transmission with rapid placental dysfunction and fetal distress. Interestingly, the neonate displayed no clear symptoms of COVID-19 post-partum. Therefore, early invasive testing was not indicated, and intrauterine transmission of SARS-CoV-2 was instead determined by next generation sequencing of the viral genome. A marked placenta pathology and viral load is shown. Further, maternal-neonatal seroconversion and the role of breastfeeding are discussed.