Ultrasound characteristics of perinatal complications in newborns from mothers who had COVID-19 during pregnancy

Abstract

Aim - to study ultrasound signs of perinatal complications in newborns born to mothers who suffered from COVID-19 during pregnancy.

Materials and methods. All pregnant women (140 women with a positive test for COVID-19 gave birth, from whom 142 children were born (2 dichorionic, diamniotic twins) of the main group and 103 children (3 dichorionic, diamniotic twins)  of the control group) underwent a full ultrasound of the fetus with fetal echocardiography, as well as an assessment of the state of the uteroplacental and fetal blood flow in different vascular pools in the period of 11-39 weeks of pregnancy to determine the presence of signs of intrauterine infection, detection of accompanying pathology, structural changes in the placenta, the amount of amniotic fluid and the degree of hemodynamic disturbances in the fetoplacental system.

Results. 20 (14%) newborns required treatment in the intensive care unit and intensive care unit after delivery. Significant changes were registered in the structure of the placenta, vessels of the subchorionic space, which was accompanied by an increase in the amount of amniotic fluid (17.1% versus 8.0% in the control group). There was an increase in the percentage of fetuses with distress (18.6% vs. 8.0%) and fetal growth retardation syndrome  (11.4% vs. 3.0%) compared to the control group. It should be noted that the risk of premature birth increased in the presence of fever, hypoxemia, severe respiratory disorders and increased amounts of amniotic fluid. In the main group of newborns, in comparison with the control group, respiratory distress syndrome, pneumonia, damage to the cardiovascular system were more often noted. At the same time, the percentage of congenital malformations practically did not differ in the main and control groups, on the basis of which it can be concluded that the SARS-CoV-2 virus does not cause the formation of congenital malformations associated with this disease. Thus, detection of ventriculodilatation, pyeloectasia , and expansion of intestinal loops  were the basis for urgent ultrasound of newborns. Features detected during fetal echocardiography in fetuses from mothers of the main group, namely: dilatation of the right parts of the fetal heart, thickening of the walls of the ventricles due to the endocardium with an increase in its echogenicity, disturbances of the heart rhythm and conduction, hydropericardium indicated the probability of the presence of myocarditis.

Conclusions. A complex non-invasive ultrasound examination  of fetuses and newborns, when mothers are infected with COVID-19, reveals manifestations of damage to the cardiovascular, digestive, urinary systems and brain structures. The most threatening condition is myocarditis of newborns.

The study was conducted in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent was obtained from the patients for conducting the study.

The authors declare no conflict of interest.