Does Lung Ultrasound Have a Role in the Clinical Management of Pregnant Women with SARS COV2 Infection?

Abstract

Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) infection is a major health threat. Pregnancy can lead to an increased susceptibility to viral infections. Although chest computed tomography (CT) represents the gold standard for the diagnosis of SARS-CoV-2 pneumonia, lung ultrasound (LUS) could be a valid alternative in pregnancy. The objectives of this prospective study were to assess the role of LUS in the diagnosis of lung involvement and in helping the physicians in the management of affected patients. Thirty pregnant women with SARS-CoV-2 infection were admitted at the obstetrical ward of our Hospital. Mean age was 31.2 years, mean gestational age 33.8 weeks. Several LUS were performed during hospitalization. The management of the patients was decided according to the LUS score and the clinical conditions. Mean gestational age at delivery was at 37.7 weeks, preterm birth was induced in 20% of cases for a worsening of the clinical conditions. No neonatal complications occurred. In 9 cases with a high LUS score, a chest CT was performed after delivery. CT confirmed the results of LUS, showing a significant positive correlation between the two techniques. LUS seems a safe alternative to CT in pregnancy and may help in the management of these patients.

Lung Ultrasound Signs and Their Correlation With Clinical Symptoms in COVID-19 Pregnant Women: The “PINK-CO” Observational Study

“…Our data agree with those presented in the study of Moro et al, which first noted that the greater was the parenchymal involvement, the greater was the severity of COVID-19 pneumonia (16). Porpora et al also found a positive correlation between LUS score and CT scan score (17). They proposed to manage patients with COVID-19 based on the clinical status and the pulmonary involvement with LUS.…”

Lung ultrasound in COVID-19 pregnancies: a literature review

“…Last year, M.G. Porpora et al evaluated the role of LUS in the decision-making process, studying the correlation between LUS score and CT score carried out after delivery, which strengthens the reliability of LUS as an alternative diagnostic method to CT in pregnant women [20]. Chest CT was performed after delivery in patients with high LUS score or persistent respiratory symptoms and showed a score up to 4 with an involvement <10% in five cases, a score between 5 and 8 with involvement of 10-25% in three women, while in the patients with a LUS score of 23, CT showed 60-70% lung involvement with a score of 16.…”

“…Chest CT was performed after delivery in patients with high LUS score or persistent respiratory symptoms and showed a score up to 4 with an involvement <10% in five cases, a score between 5 and 8 with involvement of 10-25% in three women, while in the patients with a LUS score of 23, CT showed 60-70% lung involvement with a score of 16. Even if the CT findings were more precise than LUS in defining pulmonary impairment, these results suggest a positive correlation between LUS and CT [20]. CT and LUS images of 39 pregnant patients were retrospectively collected and compared by Q. Deng et al [21].…”

Management of COVID-19 Patients in the Emergency Department

“…In conclusion, lung US could serve as a valuable tool for the detection and follow-up of lung lesions in COVID-19 pneumonia and also provide supplemental imaging information for currently recommended radiological examinations, with the advantages of being radiation-free, flexibility, and cost effective [ 30 ], as an alternative to chest CT. Although lung US cannot replace CT, which is the gold standard for lung evaluation, lung US may be considered a reliable tool in pregnancy [ 41 ].…”