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We report a case of a pregnant woman with COVID‐19 who developed coagulopathy in the absence of severe clinical symptoms. A polymerase chain reaction test of a vaginal swab was positive for SARS‐CoV‐2 RNA, suggesting a possibility of perinatal transmission. Cesarean delivery was performed because of a non‐reassuring fetal heart rate; the placenta showed increased perivillous fibrin deposition and intervillositis. Moreover, placental infection with SARS‐CoV‐2 was demonstrated by placental immunostaining. The findings suggest a possible relationship between placental fibrin deposition and chronic and acute intervillositis, non‐reassuring fetal heart rate and coagulopathy in pregnant women with COVID‐19. © 2020 The Authors.  Ultrasound in Obstetrics & Gynecology  published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

COVID ‐19 during pregnancy: non‐reassuring fetal heart rate, placental pathology and coagulopathy