Ultrasound and Doppler findings in pregnant women with SARS‐CoV‐2 infection

• Published in: Ultrasound in obstetrics & gynecology 2021-07, Vol.58 (1), p.111-120
• Main Authors: Soto‐Torres, E., Hernandez‐Andrade, E., Huntley, E., Mendez‐Figueroa, H., Blackwell, S. C.
• Format: Article
• Language: English
• Subjects: Adult; Age; Amniotic fluid; Body mass; Body mass index; Body size; Case-Control Studies; Coronaviruses; COVID-19 - diagnostic imaging; COVID‐19 pandemic; Data analysis; Diabetes mellitus; Doppler effect; Eclampsia; Female; fetus; Fetuses; Gestation; Gestational age; Gynecology; Humans; Infant, Newborn; infection; Infections; Infectious Disease Transmission, Vertical - prevention & control; Neonates; Obesity; Obstetrics; Original Paper; Original Papers; Pandemics; perinatal death; Pre-Eclampsia - epidemiology; Pregnancy; Pregnancy Complications, Infectious - diagnostic imaging; Pregnancy Complications, Infectious - epidemiology; Premature Birth - epidemiology; Prenatal Care - statistics & numerical data; preterm delivery; Respiratory diseases; Retrospective Studies; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; SGA; small‐for‐gestational age; Ultrasonic imaging; Ultrasonography, Prenatal - statistics & numerical data; Ultrasound; Umbilical Arteries - diagnostic imaging; Velocimetry; vertical transmission; Viral diseases; Womens health; Young Adult
• ISSN: 0960-7692; 1469-0705; 1469-0705
• DOI: 10.1002/uog.23642

ABSTRACT Objectives To describe and compare ultrasound and Doppler findings in pregnant women who were positive for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) with findings in those who were SARS‐CoV‐2‐negative, evaluated during the pandemic period. Methods In this retrospective case–control study, we analyzed data from 106 pregnant women who tested positive for SARS‐CoV‐2 at the time of, or within 1 week of, an ultrasound scan between 1 May and 31 August 2020. Scans were either performed for routine fetal evaluation or indicated due to a positive SARS‐CoV‐2 test. Forty‐nine women were symptomatic and 57 were asymptomatic. For comparison, we analyzed data from 103 pregnant women matched for maternal age, parity, body mass index and gestational age at the time of the ultrasound scan. These control women did not report symptoms of SARS‐CoV‐2 infection at the time of the ultrasound scan or at the time of admission for delivery and had a negative SARS‐CoV‐2 test at admission for delivery. Fetal biometry, fetal anatomy, amniotic fluid volume and Doppler parameters, including umbilical and fetal middle cerebral artery pulsatility indices, cerebroplacental ratio and biophysical profile (BPP), were evaluated as indicated. Biometric and Doppler values were converted to Z‐scores for comparison. Our primary outcome, an adverse prenatal composite outcome (APCO) included any one or more of: small‐for‐gestational‐age (SGA) fetus, oligohydramnios, abnormal BPP, abnormal Doppler velocimetry and fetal death. Comorbidities, delivery information and neonatal outcome were compared between the two groups. Results Eighty‐seven (82.1%) women who were positive for SARS‐CoV‐2 had a body mass index > 25 kg/m2. SARS‐CoV‐2‐positive women had a higher prevalence of diabetes (26/106 (24.5%) vs 13/103 (12.6%); P = 0.03), but not of pre‐eclampsia (21/106 (19.8%) vs 11/103 (10.7%); P = 0.08), compared with controls. The prevalence of APCO was not significantly different between SARS‐CoV‐2‐positive women (19/106 (17.9%)) and controls (9/103 (8.7%)) (P = 0.06). There were no differences between SARS‐CoV‐2‐positive women and controls in the prevalence of SGA fetuses (12/106 (11.3%) vs 6/103 (5.8%); P = 0.17), fetuses with abnormal Doppler evaluation (8/106 (7.5%) vs 2/103 (1.9%); P = 0.08) and fetuses with abnormal BPP (4/106 (3.8%) vs 0/103 (0%); P = 0.14). There were two fetal deaths in women who were positive for SARS‐CoV‐2 and these women had a higher rate of preterm de