Evaluation of Foetal Doppler After Maternal Covid-19 Disease: How Does Foetal Aortic Isthmus Doppler Change?
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Abstract
Objective: We aim to evaluate the foetal aortic isthmus Doppler data after maternal COVID-19 disease.
Material and Methods: Twenty six pregnant patient who recovered from COVID-19 and 43mhealthy patient were included in this prospective case–control study. The study group consisted of those who had COVID-19 disease and completed the quarantine period.
Results: Doppler ultrasound evaluations were performed at the similar gestational week. We observed significantly high pulsatility indices (PI) of umbilical and aortic isthmus in study group than the control group (p=0,02, p=0,02). There was no significant change in cerebroplacental ratio (CPR) between the two groups (p>0.05).
Conclusion: COVID-19 may affect placental function in pregnant women and could deterioration on foetal circulation and Doppler parameters. In particular, changes in aortic isthmus doppler flow indicating foetal circulation and cerebral oxygenation help to reflect the foetal effects of COVID-19.
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Accepted 2022-01-14
Published 2022-01-24
References
Sohrabi C, Alsafi Z, O’Neill N, et al. World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). International Journal of Surgery. 2020;76:71–6. DOI: https://doi.org/10.1016/j.ijsu.2020.02.034
Dey M, Singh S, Tiwari R, et al. Pregnancy Outcome in First 50 SARS-Cov-2 Positive Patients at Our Center. Gynecology Obstetrics & Reproductive Medicine. 2021;27(1):11–6. DOI: https://doi.org/10.21613/GORM.2021.1176
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. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics. 2021;152(3):328–34. DOI: https://doi.org/10.1002/ijgo.13460
Mullins E, Evans D, Viner RM, et al. Coronavirus in pregnancy and delivery: rapid review. Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2020;55(5):586–92. DOI: https://doi.org/10.1002/uog.22014
Brandt JS, Hill J, Reddy A, et al. Epidemiology of coronavirus disease 2019 in pregnancy: risk factors and associations with adverse maternal and neonatal outcomes. ajog.2020;09.04.
Sahin D, Tanacan A, Erol SA, et al. A pandemic center’s experience of managing pregnant women with COVID-19 infection in Turkey: A prospective cohort study. International Journal of Gynecology and Obstetrics [Internet]. 2020;151(1):74–82. DOI: https://doi.org/10.1002/ijgo.13318
Panahi L, Amiri M, Pouy S. Risks of Novel Coronavirus Disease (COVID-19) in Pregnancy; a Narrative Review. Archives of Academic Emergency Medicine. 2020;8(1):1–5. DOI: https://doi.org/10.5812/amh.111598
Lam CM, Wong SF, Leung TN, et al. A case‐controlled study comparing clinical course and outcomes of pregnant and non‐pregnant women with severe acute respiratory syndrome. Bjog. 2004;111(8):771. DOI: https://doi.org/10.1111/j.1471-0528.2004.00199.x
Liu D, Li L, Wu X, et al. Pregnancy and Perinatal Outcomes of Women With Coronavirus Disease (COVID-19) Pneumonia: A Preliminary Analysis. AJR American journal of roentgenology. 2020;215(1):127–32. DOI: https://doi.org/10.2214/AJR.20.23072
Alfirevic Z, Stampalija T, Dowswell T. Foetal and umbilical Doppler ultrasound in high-risk pregnancies. The Cochrane database of systematic reviews. 2017;6(6). DOI: https://doi.org/10.1002/14651858.CD007529.pub4
Vollgraff Heidweiller-Schreurs CA, De Boer MA, Heymans MW, et al. Prognostic accuracy of cerebroplacental ratio and middle cerebral artery Doppler for adverse perinatal outcome: systematic review and meta-analysis. Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2018;51(3):313–22. DOI: https://doi.org/10.1002/uog.18809
Ayhan SG, Tanacan A, Atalay A, et al. Assessment of foetal Doppler parameters in pregnant women with COVID-19 infection: a prospective case-control study. Journal of Perinatal Medicine. 2021;49(6):697–701. DOI: https://doi.org/10.1515/jpm-2020-0512
Anuk AT, Tanacan A, Yetiskin FDY, et al. Doppler assessment of the fetus in pregnant women recovered from COVID‐19. The Journal of Obstetrics and Gynaecology Research. 2021;47(5):1757–62. DOI: https://doi.org/10.1111/jog.14726
Ferraz MM, Araújo FDV, Carvalho PRN, et al. Aortic Isthmus Doppler Velocimetry in Foetuses with Intrauterine Growth Restriction: A Literature Review. Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia. 2020;42(5):289–96. DOI: https://doi.org/10.1055/s-0040-1710301
Hecher K, Campbell S, Doyle P, et al. Assessment of Foetal Compromise by Doppler Ultrasound Investigation of the Foetal Circulation. Circulation. 1995;91(1):129–38 DOI: https://doi.org/10.1161/01.CIR.91.1.129
Acharya G. Technical aspects of aortic isthmus Doppler velocimetry in human foetuses. Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2009;33(6):628–33. DOI: https://doi.org/10.1002/uog.6406
Mulvey JJ, Magro CM, Ma LX, et al. Analysis of complement deposition and viral RNA in placentas of COVID-19 patients. Annals of diagnostic pathology. 2020;46:151530. DOI: https://doi.org/10.1016/j.anndiagpath.2020.151530
Komine-Aizawa S, Takada K, Hayakawa S. Placental barrier against COVID-19. Placenta. 2020;99:45–9. DOI: https://doi.org/10.1016/j.placenta.2020.07.022
Leavitt K, Odibo L, Nwosu O, et al. Comparing the cerebro-placental to umbilico-cerebral Doppler ratios for the prediction of adverse neonatal outcomes in pregnancies complicated by foetal growth restriction. J Matern Foetal Neonatal Med. 2021. DOI: https://doi.org/10.1080/14767058.2021.1901880
Mascio DD, Rizzo G, Buca D, et al. Comparison between cerebroplacental ratio and umbilicocerebral ratio in predicting adverse perinatal outcome at term. European journal of obstetrics, gynecology, and reproductive biology. 2020;252:439–43. DOI: https://doi.org/10.1016/j.ejogrb.2020.07.032
Del Río M, Martínez JM, Figueras F, et al. Doppler assessment of the aortic isthmus and perinatal outcome in preterm foetuses with severe intrauterine growth restriction. Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2008;31(1):41–7. DOI: https://doi.org/10.1002/uog.5237
Figueras F, Benavides A, Del Rio M, et al. Monitoring of foetuses with intrauterine growth restriction: longitudinal changes in ductus venosus and aortic isthmus flow. Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2009;33(1):39–43. DOI: https://doi.org/10.1002/uog.6278
Choudhary P, Malik A, Batra A. Cerebroplacental ratio and aortic isthmus Doppler in early foetal growth restriction. Journal of Clinical Ultrasound. 2021;49(7):754–61. DOI: https://doi.org/10.1002/jcu.23028
Sharma KA, Swami S, Dadhwal V, et al. Aortic isthmus Doppler in normal and small-for-gestational-age foetuses and its association with prediction of adverse perinatal outcome. International Journal of Gynecology & Obstetrics. 2021;153(3):542–8. DOI: https://doi.org/10.1002/ijgo.13489
Unterscheider J, Daly S, Geary MP, et al. Predictable progressive Doppler deterioration in IUGR: does it really exist? American journal of obstetrics and gynecology. 2013;209(6):539.e1-539.e7. DOI: https://doi.org/10.1016/j.ajog.2013.08.039
Villalaín C, Herraiz I, Quezada MS, et al. Prognostic value of the aortic isthmus Doppler assessment on late onset foetal growth restriction. Journal of perinatal medicine [Internet]. 2019 Feb 1 [cited 2021 Aug 14];47(2):212–7. Available from: https://pubmed.ncbi.nlm.nih.gov/30210056/ DOI: https://doi.org/10.1515/jpm-2018-0185
Mascio D di, Sen C, Saccone G, et al. Risk factors associated with adverse foetal outcomes in pregnancies affected by Coronavirus disease 2019 (COVID-19): a secondary analysis of the WAPM study on COVID-19. Journal of Perinatal Medicine. 2020;48(9):950–8. DOI: https://doi.org/10.1515/jpm-2020-0355
Parums D. Editorial: Maternal SARS-CoV-2 Infection and Pregnancy Outcomes from Current Global Study Data. 2021. DOI: https://doi.org/10.12659/MSM.933831
Ranucci M, Ballotta A, di Dedda U, et al. The procoagulant pattern of patients with COVID-19 acute respiratory distress syndrome. Journal of Thrombosis and Haemostasis. 2020;18(7):1747–51. DOI: https://doi.org/10.1111/jth.14854
Ayhan SG, Oluklu D, Sinaci S, et al. Foetal Thymus Size in Pregnant Women with COVID-19 Infection. Gynecology Obstetrics & Reproductive Medicine. 2021;27(2):84–8. DOI: https://doi.org/10.21613/GORM.2021.1222