Abstract
Severe acute respiratory syndrome COVID-19 infection has been reported to affect the placenta. There are evidences of increased risk of placental lesions due to hypoperfusion and inflammation in women with COVID-19 infection. On this basis, we hypothesised that placental changes due to COVID-19 infection may lead to impaired umbilical vein blood flow (UVBF) and subsequent fetal cardiac remodelling. The objective to compare the UVBF and fetal cardiac function in pregnancies complicated and in those not complicated by COVID-19 infection. Prospective case-control study of consecutive pregnancies complicated by COVID-19 infection during the second half of pregnancy matched with unaffected women. Measurements of UVBF normalised for fetal abdominal circumference (UVBF/AC), atrial area (AA) and ventricular sphericity indices (SI) was assessed and compared between the two study groups. Data are presented as median and interquartile range (IQR). Fifty-four consecutive pregnancies complicated and 108 not complicated by COVID-19 infection were included. Median gestational age at COVID-19 infection was 30.2 weeks (IQR 28.7-32.4) and 36.5 (IQR 35.3-37.0) at ultrasonographic examination. General baseline and pregnancy characteristics were similar between pregnant women with compared to those without COVID-19 infection. There was no difference in UVBF/AC (study groups z value -0.11 vs 0.14 control p 0.751) values. Likewise, there was no difference in the AA (left 1.30 vs 1.28 p = 0.221 and right 1.33 vs 1.31 p = 0324) and SI (left 1.75 vs 1.77 p = 0.208 and right 1.51 vs 1.54 p = 0.121). Pregnancies complicated by COVID-19 infection did not show a reduction in UBF and are not at higher risk of cardiac remodelling.
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