The impact of the SARS-CoV-2 infection on pregnancy has been studied and many reports have been published, mainly focussing on complications and in utero transmission with neonatal consequences. Although the effects of other viruses on foetuses are well known, the impact of maternal COVID-19 during pregnancy is not completely understood. We report a case of acute foetal intrapartum hypoxia without other risk factors than maternal COVID-19 disease 2 weeks previous to birth at term. Placental histological changes suggested that the viral infection could have been the culprit for the unfavourable outcome during labour. The neonate was promptly delivered by Caesarean section. Neonatal intensive care was started, including therapeutic hypothermia. The procedure was successful, the evolution of the neonate was favourable, and she was discharged after 10 days. Follow-up at 2 months of life indicated a normal neurological development but a drop in head growth. The case raises the idea that pregnancies with even mild COVID-19 symptoms may represent the cause of neonate compromise in a low-risk pregnancy. An important follow-up in the neonatal period and infancy is required to identify and treat any subsequent conditions. Further long-term studies are necessary to identify a cause–effect relationship between COVID-19 pregnancies and the whole spectrum of neonatal and infant consequences.
Cerebral hemorrhage can affect the fetus. Clinical signs usually suggest the presence of cerebral hemorrhage and it can be confirmed by ultrasound during the fetal or early neonatal period. The first part of this paper investigates the usefulness of neonatal cerebral ultrasound screening in term neonates, in order to detect antenatal/perinatal cerebral hemorrhage. Three newborns with antenatal cerebral hemorrhage are presented. A diagnosis and investigation algorithm consisting of five questions is proposed for each case: 'When did the hemorrhage occur?', 'What is the diagnosis?', 'Are there neonatal consequences?' 'Other lesions?' and 'What is the prognosis?'.
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