Hafif semptomları olan gebelikte COVID-19 bulaşmış annelerin fetüslerinde doku doppler türevli miyokard performans indeksinin değerlendirilmesi

Year 2024, Volume: 49 Issue: 2, 407 - 414, 30.06.2024

Cenk Soysal Rahmi Özdemir

https://doi.org/10.17826/cumj.1392668

Abstract

Amaç: Şiddetli akut respiratuar sendromu koronavirüs 2 (SARS-CoV-2) ile enfekte olmuş ve asemptomatik veya hafif semptomları olan hamile kadınların fetüsleri ile enfekte olmamış hamile kadınların fetüslerinin, ekokardiyografi ve doku Doppler (TD) görüntüleme ile değerlendirilen fetal kardiyak fonksiyonlarını karşılaştırmaktır.
Gereç ve Yöntem: Gestasyonel yaşları 20 haftadan fazla olan ve COVID-19 enfekte, hafif ya da asemptomatik gebe kadınların fetüslerinin triküspit ve mitral kapakların lateral anülüslerinde erken diyastolik miyokardiyal hızlar (Em) ve geç miyokardiyal hızlar (Am) ve Em/Am oranları ölçülmüştür (n=45). Aynı gestasyonel yaşa sahip sağlıklı hamile kadınların fetüsleriyle Fetal eko sonuçları (n=43) karşılaştırılmıştır. Ayrıca doku doppler türevli miyokard performans indeksi (MPI) de ölçülmüştür.
Bulgular: Fetüslerin gestasyonel yaşları sırasıyla 26.1 ± 3.3 hafta ve 26.6 ± 3.5 hafta olarak tespit edilmiştir). Araştırma grubunda mitral kapak Em/Am oranı 0.56±0.08 iken, kontrol grubunda 0.61±0.06 olarak bulunmuştur. Araştırma grubunda triküspit kapak Em/Am oranı 0.58±0.11 iken, kontrol grubunda 0.63±0.10 olarak ölçülmüştür. Doku doppler türevli mitral kapak MPI'si araştırma grubunda 0.48±0.07, kontrol grubunda ise 0.40±0.07 olarak belirlenmiştir.
Sonuç: Maternal COVID-19 enfeksiyonu fetal MPI ve diyastolik fonksiyonları etkilemektedir. Eşlik eden maternal komorbidite olmaksızın SARS-CoV-2 ile enfekte olmuş, düşük riskli, hafif semptomatik hamile kadınların antenatal takibinde fetal kardiyak ekokardiyografi yapılmalıdır.

Keywords

COVID-19, E/A oranı, fetal ekokardiyografi, miyokard performans indeksi

Evaluation of the tissue doppler-derived myocardial performance index in fetuses of mothers infected with COVID-19 during pregnancy with mild symptoms

Abstract

Purpose: To compare cardiac functions evaluated with echocardiography and tissue Doppler (TD) imaging between fetuses of pregnant women who were infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and were asymptomatic or had mild symptoms and fetuses of pregnant women who were not infected.
Material and Methods: Early diastolic myocardial velocities (Em) and late myocardial velocities (Am) and Em/Am ratios were measured in the lateral annuli of tricuspid and mitral valves of fetuses of pregnant women with COVID-19 at more than 20 weeks of gestational age who had COVID-19 (n=45) and gestational age-matched healthy pregnant women’s fetuses (n=43). The TD-derived myocardial performance index (MPI) was also measured.
Results: The gestational ages of the fetuses were found as 26.1 ± 3.3 and 26.6 ± 3.5 weeks, respectively. The mitral valve Em/Am ratio was 0.56±0.08 and 0.61±0.06 in the study group and the control group, respectively. The tricuspid valve Em/Am ratio was 0.58±0.11 and 0.63±0.10 in the study group and the control group, respectively. The TD-derived mitral valve MPI was 0.48±0.07 and 0.40±0.07 in the study group and the control group, respectively.
Conclusion: Maternal COVID-19 affects fetal MPI and diastolic function. Fetal cardiac echocardiography should be performed during antenatal follow-up of low-risk, mildly symptomatic pregnant women infected with SARS-CoV-2 without concomitant maternal comorbidity.

Keywords

COVID-19, E/A ratio, fetal echocardiography, myocardial performance index

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