Evaluation of the Effect of SARS-COV-2 Infection During Pregnancy on Fetal Doppler Ultrasound Parameters: A Prospective Study

Yıl 2023, Cilt: 5 Sayı: Supplement (1) - Innovations in Medicine and Healthcare in the 100th Year of the Republic, 82 - 6, 19.10.2023

Mehmet Özer , Pınar Tuğçe Özer , Süleyman Cemil Oğlak , Alper İleri , Zübeyde Emiralioğlu Çakır , Barış Sever , Onur Süleyman Aldemir , Sercan Kantarcı , Varol Gülseren , Halil Gürsoy Pala

https://doi.org/10.37990/medr.1345373

Cited By: 1

Öz

Aim: The fetal effects of severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) infection have been the subject of controversy since the beginning of the pandemic. We aimed to investigate the effect of SARS-COV-2 infection on fetal Doppler parameters.
Material and Methods: This prospective case-control study was conducted at İzmir Tepecik Training and Research Hospital between September 1, 2021, and June 1, 2022, on pregnant women confirmed to have SARS-CoV-2 by RT-PCR testing. Pregnant women who had mild to moderate coronavirus disease 2019 (COVID-19) infection during pregnancy were compared with a control group of pregnant women not infected with the COVID-19 virus. All Doppler and fetal biometry ultrasound assessments between 34 and 37 weeks of gestation were performed in our unit.
Results: Pregnant women infected and not infected with COVID-19 were demographically homogeneous. When the groups were compared in terms of fetal Doppler parameters, including left and right uterine artery (UtA) pulsatility index (PI), middle cerebral artery (MCA) PI, and systolic/diastolic ratio (S/D), as well as umbilical artery (UA) S/D and PI, no statistically significant difference was observed (p>0.05).
Conclusion: We consider that mild to moderate COVID-19 does not affect Doppler ultrasound parameters and fetal well-being during pregnancy.

Anahtar Kelimeler

COVID-19 , Doppler ultrasound , Fetal well-being

Kaynakça

• Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497-506.
• Oğlak SC, Obut M. The risk of vicarious trauma among front-line and non-front-line midwives and nurses. Aegean J Obstet Gynecol. 2020;2:19-22.
• Tunç Ş, Göklü MR, Oğlak SC. COVID-19 in pregnant women: an evaluation of clinical symptoms and laboratory parameters based on the 3 trimesters. Saudi Med J. 2022;43:378-85.
• Can E, Oğlak SC, Ölmez F. Abnormal liver function tests in pregnant patients with COVID-19 - a retrospective cohort study in a tertiary center. Ginekol Pol. 2022;93:151-7.
• Zambrano LD, Ellington S, Strid P, et al. CDC COVID-19 response pregnancy and infant linked outcomes team. Update: characteristics of symptomatic women of reproductive age with laboratory-confirmed SARS-CoV-2 infection by pregnancy status - United States, January 22-October 3, 2020. MMWR Morb Mortal Wkly Rep. 2020;69:1641-7.
• Schwartz DA, Graham AL. Potential maternal and infant outcomes from (Wuhan) Coronavirus 2019-nCoV infecting pregnant women: lessons from SARS, MERS, and other human coronavirus infections. Viruses. 2020;12:194.
• Tunç Ş, Oğlak SC, Göklü MR, Gedik Özköse Z. Maternal mortality cases due to COVID-19 pandemic in a tertiary referral hospital. Perinatal Journal. 2022;30:185-94.
• Aktiz Bıçak E, Oğlak SC. Clinical characterisation and management outcome of obstetric patients following intensive care unit admission for COVID-19 pneumonia. J Obstet Gynaecol. 2023;43:2218915.
• Sahin D, Tanacan A, Erol SA, et al. Updated experience of a tertiary pandemic center on 533 pregnant women with COVID-19 infection: a prospective cohort study from Turkey. Int J Gynaecol Obstet. 2021;152:328-34.
• Dubey P, Reddy SY, Manuel S, Dwivedi AK. Maternal and neonatal characteristics and outcomes among COVID-19 infected women: an updated systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2020;252:490-501.
• Agolli A, Agolli O, Velazco DFS, et al. Fetal complications in COVID-19 infected pregnant woman: a systematic review and meta-analysis. Avicenna J Med. 2021;11:200-9.
• Alfirevic Z, Stampalija T, Dowswell T. Fetal and umbilical Doppler ultrasound in high-risk pregnancies. Cochrane Database Syst Rev. 2017;6:CD007529.
• Rizzo G, Pietrolucci ME, Mappa I, et al. Modeling Pulsatility Index nomograms from different maternal and fetal vessels by quantile regression at 24-40 weeks of gestation: a prospective cross-sectional study. J Matern Fetal Neonatal Med. 2022;35:1668-76.
• Salomon LJ, Alfirevic Z, Da Silva Costa F, et al. ISUOG Practice Guidelines: ultrasound assessment of fetal biometry and growth. Ultrasound Obstet Gynecol. 2019;53:715-23.
• Can E, Oğlak SC, Ölmez F, Bulut H. Serum neutrophil gelatinase-associated lipocalin concentrations are significantly associated with the severity of COVID-19 in pregnant patients. Saudi Med J. 2022;43:559-66.
• Göklü MR, Oğlak SC, Gedik Özköse Z, et al. The course of infection with the Delta variant of COVID-19 in pregnancy: analysis of clinical, laboratory, and neonatal outcomes. J Turk Ger Gynecol Assoc. 2023;24:33-41.
• Baergen RN, Heller DS. Placental pathology in COVID-19 positive mothers: preliminary findings. Pediatr Dev Pathol. 2020;23:177-80.
• Spinillo A, Gardella B, Bariselli S, et al. Placental histopathological correlates of umbilical artery Doppler velocimetry in pregnancies complicated by fetal growth restriction. Prenat Diagn. 2012;32:1263-72.
• Todros T, Sciarrone A, Piccoli E, et al. Umbilical Doppler waveforms and placental villous angiogenesis in pregnancies complicated by fetal growth restriction. Obstet Gynecol. 1999;93:499-503.
• Papageorghiou AT, Leslie K. Uterine artery Doppler in the prediction of adverse pregnancy outcome. Curr Opin Obstet Gynecol. 2007;19:103-9.
• Anuk AT, Tanacan A, Yetiskin FDY, et al. Doppler assessment of the fetus in pregnant women recovered from COVID-19. J Obstet Gynaecol Res. 2021;47:1757-62.
• Schenone MH, Mari G. The MCA Doppler and its role in the evaluation of fetal anemia and fetal growth restriction. Clin Perinatol. 2011;38:83-102, vi.
• Jamal A, Marsoosi V, Sarvestani F, Hashemi N. The correlation between the cerebroplacental ratio and fetal arterial blood gas in appropriate-for-gestational-age fetuses: a cross-sectional study. Int J Reprod Biomed. 2021;19:821-6.
• Faure-Bardon V, Isnard P, Roux N, et al. Protein expression of angiotensin-converting enzyme 2, a SARS-CoV-2-specific receptor, in fetal and placental tissues throughout gestation: new insight for perinatal counseling. Ultrasound Obstet Gynecol. 2021;57:242-7.
• Algarroba GN, Rekawek P, Vahanian SA, et al. Visualization of severe acute respiratory syndrome coronavirus 2 invading the human placenta using electron microscopy. Am J Obstet Gynecol. 2020;223:275-8.
• Kotlyar AM, Grechukhina O, Chen A, et al. Vertical transmission of coronavirus disease 2019: a systematic review and meta-analysis. Am J Obstet Gynecol. 2021;224:35-53.e3.
• Fillion A, Guerby P, Menzies D, et al. Pathological investigation of placentas in preeclampsia (the PEARL study). Hypertens Pregnancy. 2021;40:56-62.
• Ding XX, Wu YL, Xu SJ, et al. Maternal anxiety during pregnancy and adverse birth outcomes: a systematic review and meta-analysis of prospective cohort studies. J Affect Disord. 2014;159:103-10.
• Shahhosseini Z, Abedian K, Azimi H. Role of anxiety during pregnancy in preterm delivery. J Adv Med Biomed Res. 2008;16:85-92.
• Lindgren K. Relationships among maternal-fetal attachment, prenatal depression, and health practices in pregnancy. Res Nurs Health. 2001;24:203-17.
• Coelho HF, Murray L, Royal-Lawson M, Cooper PJ. Antenatal anxiety disorder as a predictor of postnatal depression: a longitudinal study. J Affect Disord. 2011;129:348-53.
• Rizzo G, Mappa I, Maqina P, et al. Effect of SARS-CoV-2 infection during the second half of pregnancy on fetal growth and hemodynamics: a prospective study. Acta Obstet Gynecol Scand. 2021;100:1034-9.
• Mappa I, Distefano FA, Rizzo G. Effects of Coronavirus 19 pandemic on maternal anxiety during pregnancy: a prospectic observational study. J Perinat Med. 2020;48:545-50.