ABSTRACT
BACKGROUND: Several viral infections cause changes in the placenta. Cytomegalovirus, herpes viruses, and HIV cause increased placental thickness; Zika virus induces focal regions of necrosis; parvovirus B19 causes a structural injury. Umbilical flow can be considered a direct measurement of vascular placental function. OBJECTIVE: This study aimed to compare placental ultrasound and umbilical Doppler findings in pregnant women who tested positive or negative for SARS-CoV-2. Our work aimed to confirm the suspicion of placental infection and the consequence in fetal physiopathology. STUDY DESIGN: Fifty-seven pregnant women who tested positive for SARS-CoV-2 at the time of or 1 month before the ultrasound scan were evaluated. Cases included 9 first trimester, 16 second trimester, and 32 third trimester ultrasound scans. For comparison, 110 pregnant women (controls) were evaluated. They included 19 women in their first trimester, 43 in their second trimester, and 48 in the third trimester. Controls were asymptomatic and tested negative for SARS-CoV-2 infection in the last 72 hours before the ultrasound scan. Fetal biometry, placental thickness, placental lakes and Doppler umbilical vein parameters, including venous cross-sectional area (mean transverse diameter and radius of umbilical vein, mean velocity of umbilical vein), and umbilical vein blood flow were evaluated. RESULTS: Placental thickness (in millimeter) was significantly higher in the group of pregnant women with SARS-CoV-2 infection (53.82 [10-115]) than in the control group (33.82 [12-66]; P<.001) in their second and third trimesters. The frequency of >4 placental lakes was significantly higher in the group of pregnant women with SARS-CoV-2 infection (28/57 [50.91%]) than in the control (7/110 [6.36]; P<.001) in all 3 trimesters. The mean velocity of umbilical vein was significantly higher in the group of pregnant women with SARS-CoV-2 infection (12.45 [5.73-21]) than in the control group (10.81 [6.31-18.80]; P=.001) in all 3 trimesters. Umbilical vein blood flow (in milliliter per minute) was significantly higher in the group of pregnant women with SARS-CoV-2 infection (389.9 [6.52-1496.1]) than in the control group (305.05 [3.11-1441]; P=.05) in all 3 trimesters. CONCLUSION: Significant differences in placental and venous Doppler ultrasound were documented. Placental thickness, placental venous lakes, mean velocity of umbilical vein, and umbilical vein flow were significantly higher in the group of pregnant women with SARS-CoV-2 infection in all 3 trimesters.
ABSTRACT
Objectives The aim of our study is to present the impact on maternal and perinatal outcomes of the COVID pandemic in our patients.Methods We retrospectively reviewed the medical records of all pregnant women from March to December 2020 in Infanta Leonor Universitary Hospital, in Madrid. Infected women during the 3rd trimester of pregnancy or at delivery time with SARS-CoV2 diagnosis composed infected group, and non-infected women with SARS-CoV2 composed non-infected group. The infection status was determined via RT-PCR of nasopharyngeal swab specimen.Results 1262 non-infected pregnant women and 86 SARS-CoV2 positive pregnant women were admitted to our clinic during the study period. Within the group of infected pregnant women, they were 49 cases (56.98%) symptomatic and 37 cases (43.02%) asymptomatic. In the group of symptomatic infected women, the majority were mild cases (80.23%). In the group of uninfected pregnant women, the main complication was gestational diabetes 14 (1.09%) We did not find any complications during pregnancy in case group. Cesarean section was performed in 16.67% of the infected pregnant women and in 21.71% of the control group. Mean neonatal birth weight was 3.240 g in case group and 3.210 g in non-infected group. Neonatal admission to NICU was 9.52% in cases while in the control group was 1.19%.Conclusion Infection does not worsen the prognosis of pregnancy in terms of low birth weight of the newborn, but is associated with a greater increase in neonatal admission in NICU.