Decreased fetal cardiac output in pregnant women with severe SARS‐Cov‐2 infection

Turgut, Ezgi; Sakcak, Bedri; Hendem, Derya Uyan; Oluklu, Deniz; Ayhan, Şule Göncü; Uygur, Dilek

doi:10.1111/echo.15367

Cited by 11 publications

(13 citation statements)

References 50 publications

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“…A prospective study conducted by Rizzo et al [ 68 ] on 54 infected and 108 non-infected pregnant women indicated no statistically important difference in umbilical vein blood flow/abdominal circumference (UVBF/AC) ( p = 0.07) in the left and right Atrial Area (AA) (left 1.30 vs. 1.28 p = 0.221 and right 1.33 vs. 1.31 p = 0.324), as well as in the ventricular sphericity indices (SI) (left 1.75 vs. 1.77 p = 0.208 and right 1.51 vs. 1.54 p = 0.121) between the two groups. Fetal cardiac output (CO) was evaluated in 48 pregnant women with severe COVID-19 and 50 controls by Turgut et al [ 69 ]. They demonstrated that fetal left CO dramatically decreased in women with severe disease after recovery compared to the controls (285.1 ± 114.7 vs. 246.7 ± 109.0 p = 0.058).…”

Section: Resultsmentioning

confidence: 99%

Cardiovascular Complications of COVID-19 among Pregnant Women and Their Fetuses: A Systematic Review

Yaghoobpoor

Fathi

Vakili

et al. 2022

JCM

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Background: COVID-19 is a viral infectious disease leading to a spectrum of clinical complications, especially cardiovascular. Evidence shows that this infection can potentially accompany a worse outcome in pregnant women. Cardiovascular complications in mothers and their fetuses are reported by previous studies. Objective: In this systematic review, we aim to investigate the cardiovascular complications of COVID-19 during pregnancy in the mothers and fetus, according to the published literature. Method: We systematically searched the online databases of PubMed, Scopus, Web of Science, and Google Scholar, using relevant keywords up to April 2022. We included all observational studies reporting cardiovascular complications among COVID-19-affected pregnant women and their fetuses. Results: We included 74 studies containing 47582 pregnant COVID-19 cases. Pre-eclampsia, hypertensive disorders, cardiomyopathy, heart failure, myocardial infarction, thrombosis formation, alterations in maternal–fetal Doppler patterns, and maternal and fetal arrhythmia were reported as cardiovascular complications. The highest incidences of pre-eclampsia/eclampsia among COVID-19 pregnant cases, reported by studies, were 69% and 62%, and the lowest were 0.5% and 3%. The highest and lowest incidences of fetal bradycardia were 20% and 3%, and regarding fetal tachycardia, 5.4% and 1%, respectively. Conclusion: SARS-CoV-2 infection during pregnancy can potentially be associated with cardiovascular complications in the mother, particularly pre-eclampsia and heart failure. Moreover, SARS-CoV-2 infection during pregnancy can potentially cause cardiovascular complications in the fetus, particularly arrhythmia.

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Section: Resultsmentioning

confidence: 99%

Cardiovascular Complications of COVID-19 among Pregnant Women and Their Fetuses: A Systematic Review

Yaghoobpoor

Fathi

Vakili

et al. 2022

JCM

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“…We attributed this result to the fact that SARS‐COV‐2 infection affects the fetoplacental and fetal circulation either by maternal hypoxia‐related fetal hypoxemia or by infection‐related inflammatory processes and so probably affects the fetal organs such as the fetal heart. Two studies from our center that evaluated the fetal cardiac effects of SARS‐COV‐2 in pregnant women who recovered from the infection concluded that fetal cardiac output was significantly decreased in pregnant women who recovered from severe infection, and therefore placental dysfunction and inflammation related to SARS‐COV‐2 infection might cause fetal cardiac changes 26,27 . These changes can be both functional, such as changes in cardiac output, or biochemical, such as changes in pro‐BNP levels.…”

Section: Discussionmentioning

confidence: 99%

“…Two studies from our center that evaluated the fetal cardiac effects of SARS-COV-2 in pregnant women who recovered from the infection concluded that fetal cardiac output was significantly decreased in pregnant women who recovered from severe infection, and therefore placental dysfunction and inflammation related to SARS-COV-2 infection might cause fetal cardiac changes. 26,27 These changes can be both functional, such as changes in cardiac output, or biochemical, such as changes in pro-BNP levels.…”

Section: Is Cord Pro-bnp Level Different In Newborns Born From Sars-c...mentioning

confidence: 99%

Comparison of cord blood pro‐BNP levels in newborns of SARS‐COV‐2‐positive and ‐negative women, and its association with adverse perinatal outcomes

Besimoğlu

Akgün

Ayhan

et al. 2023

Intl J Gynecology & Obste

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Objective: To compare umbilical cord blood pro-B-type natriuretic peptide (BNP) levels in newborns of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) positive pregnancies to those of SARS-COV-2 negative pregnancies. Methods:Prospectively cord blood samples from newborns of 42 SARS-COV-2 positive women, and 42 negative pregnant were collected at birth and analyzed for pro-BNP levels. Results:The mean cord blood pro-BNP level was significantly higher in newborns of SARS-COV-2 positive women than in controls. Furthermore, the pro-BNP level was an independent predictor of NİCU admission in both SARS-COV-2 positive and control patients. Conclusion:Cord blood pro-BNP level may be a parameter that can predict the understress fetus and adverse perinatal outcomes especially, in cases where placental involvement is present as in SARS-COV-2 infection.

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“…Fetal assessment of the CO is important as fetal well‐being is associated the cardiac functions. In recent studies, changes in CO have been demonstrated in diabetic mother fetuses, intrauterine growth restriction, and SARS‐Cov‐2‐infected mother fetuses 9–11 . However, the relationship between fetal cardiac function and maternal hypothyroidism, and levothyroxine replacement in pregnant women with hypothyroidism is unclear 12,13 .…”

Section: Introductionmentioning

confidence: 99%

“…In recent studies, changes in CO have been demonstrated in diabetic mother fetuses, intrauterine growth restriction, and SARS-Cov-2-infected mother fetuses. [9][10][11] However, the relationship between fetal cardiac function and maternal hypothyroidism, and levothyroxine replacement in pregnant women with hypothyroidism is unclear. 12,13 We hypothesized that hypothyroidism might affect fetoplacental circulation even though the F I G U R E 1 Left ventricular outflow tract (LVOT), the aortic valve velocity waveform.…”

Section: Introductionmentioning

confidence: 99%

The assessment of fetal cardiac output in maternal hypothyroidism under levothyroxine treatment

et al. 2022

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Objective In this study, we investigated whether maternal hypothyroidism has a role in the cardiac output (CO) of the fetus or not. Methods Pregnant women between 33 and 37 gestational weeks known to have hypothyroidism and using levothyroxine were accepted as the case group. Gestational age‐matched healthy euthyroid pregnant women constituted the control group. Fetal echocardiography was performed. Diameters and the velocity waveform of the pulmonary artery (PA) and aortic valves were measured. Velocity time integral (VTI) was also measured from the ventricular outflow tract. CO was calculated using VTI × π (Aortic Valve or Pulmonary Valve diameter/2) 2 × heart rate formula. Results The aortic and PA annulus were measured larger in the control group. (p = .003, p = .005, respectively). Furthermore, the right and left CO of the case group were lower than the control group. Whereas the mean combined CO (ml/min) of the case group was 674.8 ± 146.2, it was 827.8 ± 167.9 in the control group (p < .001). Additionally, a negative correlation was observed between thyroid‐stimulating hormone and aortic VTI (r:−.480; p:.006). Conclusion The findings of our study suggest that the CO of the fetus may be affected by maternal hypothyroidism

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Decreased fetal cardiac output in pregnant women with severe SARS‐Cov‐2 infection

Cited by 11 publications

References 50 publications

Cardiovascular Complications of COVID-19 among Pregnant Women and Their Fetuses: A Systematic Review

Cardiovascular Complications of COVID-19 among Pregnant Women and Their Fetuses: A Systematic Review

Comparison of cord blood pro‐BNP levels in newborns of SARS‐COV‐2‐positive and ‐negative women, and its association with adverse perinatal outcomes

The assessment of fetal cardiac output in maternal hypothyroidism under levothyroxine treatment

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