三维动力多普勒能否检测 COVID-19 孕妇的胎盘受累情况?一项观察研究

Nehal El-Demiry, S. Elsirgany, M. Moussa, A. Wahba
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摘要

目的:许多研究通过产后组织病理学检查证实,即使胎儿没有感染,感染 covid-19 的孕妇的胎盘也会受累。至于这种胎盘受累是否可在产前通过超声波检查发现,目前尚未进行研究。材料与方法:这是一项横断面研究,包括 40 名接受第二孕期扫描的孕妇,分为两组:A 组(轻度 Covid-19 感染的孕妇,需要在家隔离)和 B 组(对照组)。使用 VOCAL 技术对胎盘进行三维(3-D)动力多普勒超声检查,计算胎盘体积和胎盘血管指数,包括血流指数(FI)、血管指数(VI)和血管血流指数(VFI)。还测量了子宫动脉的脉动指数(PI)。结果两组的基线特征相似。Covid 组的胎盘体积明显高于对照组。Covid组的平均FI明显低于对照组,而VI和VFI则高于对照组。子宫动脉多普勒在两组之间未显示任何差异。结论:轻度 Covid-19 感染会影响三维超声造影观察到的胎盘容积、胎盘血管和灌注。在轻度病例中,这些变化是短暂的还是永久的,以及是否会对妊娠结局产生影响,都需要在今后的研究中加以探讨。
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Can Three-Dimensional Power Doppler Detect Placental Involvement in pregnant women with COVID-19? An observational study
Objective: Placental involvement in pregnant women with covid–19 has been proved by postnatal histopathological examination in many studies even in absence of fetal infection. Whether this placental involvement can be detected prenatally using ultrasonography has not been investigated. Materials and Methods: This is a cross-sectional study including 40 women attending for second trimester scan divided into two groups; Group A (pregnant women with mild Covid-19 infection requiring home isolation), Group B (control group). Three-dimensional (3-D) power Doppler ultrasonography of the placenta using VOCAL technique, calculating the placental volume and placental vascular indices including Flow Index (FI), VI (Vascularity index), VFI (Vascularity flow index). The Pulsatility index (PI) of the uterine artery was also measured. Results: Baseline characteristics were similar between both groups. Placental volume was significantly higher in Covid group than control group. Mean FI was significantly less while VI and VFI were higher in Covid group compared to control group. Uterine artery doppler did not show any differences between both groups. Conclusion : Mild Covid-19 infection can have an impact on placental volume and placental vascularity and perfusion observed by three-dimensional ultrasonography. In mild cases, whether these changes are transient or permanent, and whether it can have an impact on pregnancy outcomes need to be investigated in future research.
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