Lung ultrasound and computed tomographic findings in pregnant woman with COVID‐19

Kalafat, Erkan; Yaprak, Esra; Çınar, Güle; Varlı, Bulut; Özışık, Seçkin; Uzun, Çağlar; Azap, Alpay; Koç, Acar

doi:10.1002/uog.22034

Cited by 140 publications

(175 citation statements)

References 7 publications

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“…Seven (1.9%) women were aged 40 years or older. Presenting symptoms were reported in 55 studies, comprising 515 pregnant women 4,5,7,11–19,21–30,32–57 . Of these, the most common symptoms at presentation were fever (n=273, 53.0%), cough (n=224, 43.5%), myalgia/malaise (n=79, 15.3%), dyspnea (n=64, 12.4%), diarrhea (n=18, 3.5%), and sore throat (n=18, 3.5%), regardless of gestational age.…”

Section: Resultsmentioning

confidence: 99%

Clinical characteristics, prognostic factors, and maternal and neonatal outcomes of SARS‐CoV‐2 infection among hospitalized pregnant women: A systematic review

Turan

Hakim

Dashraath

et al. 2020

Intl J Gynecology & Obste

116

183

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Background Pregnant women represent a potentially high‐risk population in the COVID‐19 pandemic. Objective To summarize clinical characteristics and outcomes among pregnant women hospitalized with COVID‐19. Search strategy Relevant databases were searched up until May 29, 2020. Selection criteria Case series/reports of hospitalized pregnant women with laboratory‐confirmed COVID‐19. Data collection and analysis PRISMA guidelines were followed. Methodologic quality was assessed via NIH assessment tools. Main results Overall, 63 observational studies of 637 women (84.6% in third trimester) with laboratory‐confirmed SARS‐CoV‐2 infection were included. Most (76.5%) women experienced mild disease. Maternal fatality, stillbirth, and neonatal fatality rates were 1.6%, 1.4%, and 1.0%, respectively. Older age, obesity, diabetes mellitus, and raised serum D‐dimer and interleukin‐6 were predictive of poor outcomes. Overall, 33.7% of live births were preterm, of which half were iatrogenic among women with mild COVID‐19 and no complications. Most women underwent cesarean despite lacking a clear indication. Eight (2.0%) neonates had positive nasopharyngeal swabs after delivery and developed chest infection within 48 hours. Conclusions Advanced gestation, maternal age, obesity, diabetes mellitus, and a combination of elevated D‐dimer and interleukin‐6 levels are predictive of poor pregnancy outcomes in COVID‐19. The rate of iatrogenic preterm birth and cesarean delivery is high; vertical transmission may be possible but has not been proved.

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Section: Resultsmentioning

confidence: 99%

Clinical characteristics, prognostic factors, and maternal and neonatal outcomes of SARS‐CoV‐2 infection among hospitalized pregnant women: A systematic review

Turan

Hakim

Dashraath

et al. 2020

Intl J Gynecology & Obste

116

183

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“…Moreover, in emergency situations, such as the current pandemic, performed by appropriately trained gynecologists/obstetricians 1 , it may be incorporated quickly and easily into a routine fetal ultrasound examination. Kalafat et al 8 . described positive LUS findings in a COVID‐19 pregnant woman with an initial negative RT‐PCR result.…”

Section: Discussionmentioning

confidence: 99%

Clinical role of lung ultrasound for diagnosis and monitoring of COVID‐19 pneumonia in pregnant women

Buonsenso

Raffaelli

Tamburrini

et al. 2020

Ultrasound in Obstet & Gyne

138

162

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Lung ultrasound has been suggested recently by the Chinese Critical Care Ultrasound Study Group and Italian Academy of Thoracic Ultrasound as an accurate tool to detect lung involvement in COVID‐19. Although chest computed tomography (CT) represents the gold standard to assess lung involvement, with a specificity superior even to that of the nasopharyngeal swab for diagnosis, lung ultrasound examination can be a valid alternative to CT scan, with certain advantages, particularly for pregnant women. Ultrasound can be performed directly at the bed‐side by a single operator, reducing the risk of spreading the disease among health professionals. Furthermore, it is a radiation‐free exam, making it safer and easier to monitor those patients who require a series of exams. We report on four cases of pregnant women affected by COVID‐19 who were monitored with lung ultrasound examination. All patients showed sonographic features indicative of COVID‐19 pneumonia at admission: irregular pleural lines and vertical artifacts (B‐lines) were observed in all four cases, and patchy areas of white lung were observed in two. Lung ultrasound was more sensitive than was chest X‐ray in detecting COVID‐19. In three patients, we observed almost complete resolution of lung pathology on ultrasound within 96 h of admission. Two pregnancies were ongoing at the time of writing, and two had undergone Cesarean delivery with no fetal complications. Reverse transcription polymerase chain reaction analysis of cord blood and newborn swabs was negative in both of these cases. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.

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“…Finally, 24 studies, including a total of 324 pregnant women with COVID-19, met the eligibility criteria and were included in the review. These comprised nine case series 11,[19][20][21][22][23][24][25][26] , published between 4 March 2020 and 28 April 2020, and 15 case reports [27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] , published between 25 March 2020 and 28 April 2020 ( 35 1 I r a n 2 7 1 0 3 0+ 3 1 1 0 0 0 1 0 Kelly (2020) 36 1 U S A N R 1 0 3 3 1 1 0 0 0 0 0 Lee (2020) 37 1 Korea 28 1 0 37 + 6 1 1 0 0 1 0 0 Lowe (2020) 38 1 Australia 31 1 0 40 + 2 1 1 0 0 0 0 0 Schnettler (2020) 39 1 reported on a total of 295 pregnant patients 11,19,[21][22][23][24][25][26] . Of these, 211 (71.5%) cases had laboratory-confirmed and 84 (28.5%) had clinically diagnosed COVID-19.…”

Section: Figure 1 Summarizes the Selection Of Articles For Inclusionmentioning

confidence: 99%

Effect of coronavirus disease 2019 (COVID‐19) on maternal, perinatal and neonatal outcome: systematic review

Juan

Gil

Zeng

et al. 2020

Ultrasound in Obstet & Gyne

489

470

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Objective To evaluate the effect of coronavirus disease 2019 (COVID‐19) on maternal, perinatal and neonatal outcome by performing a systematic review of available published literature on pregnancies affected by COVID‐19. Methods We performed a systematic review to evaluate the effect of COVID‐19 on pregnancy, perinatal and neonatal outcome. We conducted a comprehensive literature search using PubMed, EMBASE, the Cochrane Library, China National Knowledge Infrastructure Database and Wan Fang Data up to and including 20 April 2020 (studies were identified through PubMed alert after that date). For the search strategy, combinations of the following keywords and medical subject heading (MeSH) terms were used: ‘SARS‐CoV‐2’, ‘COVID‐19’, ‘coronavirus disease 2019’, ‘pregnancy’, ‘gestation’, ‘maternal’, ‘mother’, ‘vertical transmission’, ‘maternal–fetal transmission’, ‘intrauterine transmission’, ‘neonate’, ‘infant’ and ‘delivery’. Eligibility criteria included laboratory‐confirmed and/or clinically diagnosed COVID‐19, patient being pregnant on admission and availability of clinical characteristics, including at least one maternal, perinatal or neonatal outcome. Exclusion criteria were non‐peer‐reviewed or unpublished reports, unspecified date and location of the study, suspicion of duplicate reporting and unreported maternal or perinatal outcomes. No language restrictions were applied. Results We identified a high number of relevant case reports and case series, but only 24 studies, including a total of 324 pregnant women with COVID‐19, met the eligibility criteria and were included in the systematic review. These comprised nine case series (eight consecutive) and 15 case reports. A total of 20 pregnant patients with laboratory‐confirmed COVID‐19 were included in the case reports. In the combined data from the eight consecutive case series, including 211 (71.5%) cases of laboratory‐confirmed and 84 (28.5%) of clinically diagnosed COVID‐19, the maternal age ranged from 20 to 44 years and the gestational age on admission ranged from 5 to 41 weeks. The most common symptoms at presentation were fever, cough, dyspnea/shortness of breath, fatigue and myalgia. The rate of severe pneumonia reported amongst the case series ranged from 0% to 14%, with the majority of the cases requiring admission to the intensive care unit. Almost all cases from the case series had positive computed tomography chest findings. All six and 22 cases that had nucleic‐acid testing in vaginal mucus and breast milk samples, respectively, were negative for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). Only four cases of spontaneous miscarriage or termination were reported. In the consecutive case series, 219/295 women had delivered at the time of reporting and 78% of them had Cesarean section. The gestational age at delivery ranged from 28 to 41 weeks. Apgar scores at both 1 and 5 min ranged from 7 to 10. Only eight neonates had birth weight < 2500 g and nearly one‐third of neonates were transferred to the neonatal intensive care...

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Lung ultrasound and computed tomographic findings in pregnant woman with COVID‐19

Cited by 140 publications

References 7 publications

Clinical characteristics, prognostic factors, and maternal and neonatal outcomes of SARS‐CoV‐2 infection among hospitalized pregnant women: A systematic review

Clinical characteristics, prognostic factors, and maternal and neonatal outcomes of SARS‐CoV‐2 infection among hospitalized pregnant women: A systematic review

Clinical role of lung ultrasound for diagnosis and monitoring of COVID‐19 pneumonia in pregnant women

Effect of coronavirus disease 2019 (COVID‐19) on maternal, perinatal and neonatal outcome: systematic review

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