How COVID-19 pandemic is changing the practice of prenatal screening and diagnosis?

Abstract

Objectives To evaluate the impact of the COVID-19 pandemic on prenatal screening and diagnostic tests. Methods We conducted a retrospective study with pregnant women attending to the perinatology department of a tertiary referral center. The pre-COVID-19 period between 11 March 2019 and 10 March 2020 and COVID-19 period between 11 March 2020 and 10 March 2021 were evaluated. Both periods were compared in terms of outpatient visits, ultrasound examinations, prenatal screening and diagnostic tests. The correlation of deaths related to COVID-19 pandemic on these parameters was also assessed. Results A total of 38,918 patients were examined and 28,452 ultrasound examinations, 26,672 prenatal screening tests and 1,471 prenatal diagnostic tests were performed over two years. During COVID-19 pandemic, number of outpatient visits decreased by 25.2%, ultrasound examinations decreased by 44.2%, prenatal screening tests decreased by 36.2% and prenatal diagnostic tests decreased by 30.7%. Statistically significant correlation was not observed between deaths related to COVID-19 and outpatient visits (p=0.210), ultrasound examinations (p=0.265), prenatal screening (p=0.781) and diagnostic tests (p=0.158). Among indications of prenatal diagnostic tests, maternal anxiety was significantly higher in COVID-19 period (p=0.023). There was significant decrease in the detection of fetuses with trisomy 21 (p=0.047) and a significant increase in the detection of fetuses with Turner syndrome (p=0.017) during COVID-19 period. Conclusions The COVID-19 pandemic has severely impacted antenatal care. Prenatal fetal screening and diagnosis was adversely affected by the pandemic in terms of detecting genetic and structural anomalies.

SARS-CoV-2 Infection and Associated Cardiovascular Manifestations and Complications in Children and Young Adults: A Scientific Statement From the American Heart Association

“…130 Prenatal fetal screening and diagnosis with genetic and structural anomalies were adversely affected by the pandemic. 131 Routine vaccination rates temporarily declined in the Unites States and elsewhere, particularly in children >24 months of age. 132 Ambulatory volume declined substantially.…”

Implementation of the Publicly Funded Prenatal Screening Programme in Poland during the COVID-19 Pandemic: A Cross-Sectional Study

“…In a multicentre research trial carried out in Italy from March to May 2020, the average number of procedures performed in four centres decreased by over 20% in comparison with the same period in 2019 [ 19 ]. A similar analysis was conducted in a Turkish centre, in which, from11 March 2020 to 30 June 2020, the number of invasive diagnostic procedures decreased by one third when compared with the same period before the pandemic [ 20 ].…”

First Croatian Case of Double Aneuploidy: A Child With Klinefelter and Edwards Syndrome (48,XXY,+18) – Possible Causes and Contributing Factors

“…Initially, the child was ventilated using synchronized intermittent positive pressure ventilation with volume guarantee (SIPPV + VG) with optimal adjustment of ventilatory parameters. On day 2, inhaled nitric oxide (iNO) at 20 ppm was introduced for bridge, microretrognathism, low set ears, widely spaced nipples, clenched fists with joint contractures, and bilateral clubfoot indicating Trisomy 18 but also had cryptorchidism which is commonly seen in both Trisomy 18 and Klinefelter syndrome (11,12). In Trisomy 18 cardiac abnormalities are commonly seen but not so much in Klinefelter (11); however, in the combination of both trisomies, all the reported cases had cardiac involvement (PDA and VSD in more than 95% of cases) (12)(13)(14).…”

“…While there is limited research on the subject, COVID-19 during pregnancy could result in fetal complications, including intrauterine growth retardation, abortion, preterm delivery, or even stillbirth. (11) The aim of this report is to describe clinical features and management strategies in a patient with double aneuploidy, to review and discuss mechanisms of nondisjunction as a probable underlying cause of aneuploidy, and to discuss the possible influence of COVID-19 parental infection on such chromosomal abnormalities.…”