A fetus that contracted COVID-19 died over the weekend, the Health Ministry reported on Tuesday, in what is considered the first such case in Israel and one of only a few reported in the world, with doctors attributing the cause of death to the virus with a high degree of probability.
Two days after having experienced cold symptoms and a fever, and no longer able to feel her fetus move, the 29-year-old woman from southern Israel – who has not yet been vaccinated – underwent a medical examination at which no fetal pulse was found. Doctors at Assuta Medical Center in Ashdod subsequently induced labor to remove the fetus. Tests found that both she and the fetus had contracted the virus.
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It is impossible to rule out other causes of death and therefore difficult to determine with any degree of certainty whether the fetus died from COVID-19, a senior specialist at a different hospital told Haaretz.
Even if it is ultimately proven that the fetus died due to COVID-19 in this case, broader conclusions cannot be drawn based on just one case, the physician noted.
This is the first case in Israel, and among a very few around the world, in which a fetus was found to have been infected with COVID-19 while still in the womb and died.
Because many specialists believe that fetuses are at risk of contracting the virus during birth and not during pregnancy, most natal research focuses on newborn health or the virus' effects on pregnant women, and not the fetuses themselves. Little is therefore known about the risks and possibility of in-utero transmission, with research still sparse and reports from different researchers and practitioners sometimes contradictory.
However, according to research published in August by scientists from the University of Cambridge and Caltech in the Royal Society’s Open Biology journal, a human embryo can contract COVID-19 in utero as of the second week of pregnancy. The researchers noted that embryos are particularly vulnerable, despite their "remarkable plasticitiy," and that 60 percent of pregnancies among women who had contracted the virus during the first 14 days ended in a miscarriage."
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According to the study, transmission is possible at early stages of pregnancy via nutrient exchanges with maternal blood which may carry implications for the success of embryonic implantation, placental health and fetal health, both in utero and post-partum.
Another recent study, published by researchers at the University of Pennsylvania, found that antibodies were efficiently transmitted by women who had contracted and recovered from the coronavirus while pregnant to their fetuses, with women who contracted the virus at an earlier stage transmitting more antibodies to their fetuses. But the researchers do not know whether these antibodies are sufficient to prevent fetal COVID-19 contraction.
On February 1, the Health Ministry revised its position regarding the vaccination of pregnant women, and now recommends that women at every stage of pregnancy get vaccinated. Previously, the ministry recommended that pregnant women get vaccinated only in the second trimester of their pregnancy or later, unless otherwise in an at-risk group for severe coronavirus infection.
Infection rates in Israel being as high as they were, as well as three cases of pregnant women in life-threatening condition after having contracted the virus, fueled the shift in the ministry's policy, said the head of public health services, Dr. Sharon Elrai-Price, at the time, adding that it all comes down to managing risk. She also noted that Israeli and U.S. fertility and gynecologist associations have recommended that pregnant women be vaccinated, and said, "We're talking about a vaccine with safe technology."