Amaç: İn vitro fertilizasyon (İVF) ve embriyonik manipülasyonlar yoluyla gebe kalan kadınlarda hormon kullanımı, pulmoner hipertansiyon olasılığı da dahil olmak üzere yenidoğanların sağlığıyla ilgili endişeleri artırmıştır. Bu nedenle bu çalışma, term İVF yenidoğanlarında pulmoner arter basıncını değerlendirmeyi amaçlamıştır. Gereç ve Yöntemler: Bu prospektif kesitsel çalışma Mart 2013 ile Ekim 2017 arasında gerçekleştirilmiştir ve 160 İVF yenidoğanı (grup 1) 160 doğal yolla olan yenidoğanla (grup 2) karşılaştırmaktadır. Her iki gruptaki yenidoğanlar, gebelik ve yenidoğan yaşı açısından eşleştirilmiş sezaryen ile doğan yenidoğanlardı. Yenidoğanlar üç-yedi günlük idi, 37-39 hafta ve 6 günlük tam dönem gebelik yaşına sahipti ve yenidoğanların doğum ağırlığı normal sınırlarda (2500-4000 g) idi. Sistolik pulmoner arter basıncı (SPAB), triküspit yetersizlik jetinin pik akış hızını temel alan gerçek zamanlı ekokardiyografi kullanılarak tahmin edildi. Bulgular: İki grup arasındaki ortalama SPAB açısından anlamlı bir fark gözlendi (p<0,001). Her ne kadar gestasyonel yaşın SPAB'yi düşürücü etkisi grup 1'de daha fazla ve istatistiksel olarak anlamlı olsa da, doğumdan sonra PAB'de kademeli azalma bu grupta daha yavaş gözlenmiştir. Ayrıca, her iki grupta da gebelik yaşının SPAB'yi düşürücü etkisi yenidoğan yaşına göre daha belirgindi. Ayrıca, her iki grupta da SPAB ile yenidoğan ağırlığı arasında anlamlı bir ters korelasyon gözlendi; ancak bu korelasyonun grup 1'de daha kuvvetli olduğu görüldü. Sonuç: Çalışmamız, İVF'yi yenidoğanlarda pulmoner hipertansiyon insidansında artış ile ilişkili bulmuştur. Bu nedenle, İVF yenidoğanlarında pulmoner
Tug (2020) Outcomes of universal SARS-CoV-2 testing program in pregnant women admitted to hospital and the adjuvant role of lung ultrasound in screening: a prospective cohort study,
Letters to the Editor Utility of lung ultrasound assessment for probable SARS-CoV-2 infection during pregnancy and universal screening of asymptomatic individuals Pregnant women are a risk group for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, which has been shown to be associated with increased rates of preterm delivery and Cesarean section 1. Despite reassuring safety profile, imaging modalities, such as computed tomography, are used scarcely in pregnancies with suspected SARS-CoV-2 infection due to concerns about undue exposure of the fetus to ionizing radiation. However, false-positive and false-negative results are not uncommon in reverse transcription polymerase chain reaction (RT-PCR) testing. Anecdotal reports suggest that the adjunct use of imaging modalities can help manage cases in which molecular testing results and the clinical presentation are conflicting 2. Furthermore, use of imaging modalities is suggested for the preoperative screening of emergency cases 3. Lung ultrasound (LUS) is an ionizing-radiation-free, reproducible imaging modality for evaluating lung lesions, and its results are readily available, well in advance of the RT-PCR results 4. However, the added benefit of LUS for managing symptomatic and asymptomatic patients with SARS-CoV-2 infection during pregnancy remains unclear. This was a retrospective cohort study conducted in two large SARS-CoV-2 pandemic hospitals in Turkey (
Objective:
Evidence for the use of lung ultrasound scan (LUS) examinations in coronavirus 2019 pneumonia is rapidly growing. The safe and non-ionizing nature of LUS drew attention, particularly for pregnant women. This study aimed to contribute to the interpretation of LUS findings in pregnant women for the obstetricians.
Materials and Methods:
LUS was performed to pregnant women suspected of or diagnosed as having Severe Acute Respiratory syndrome coronavirus-2 (SARS-CoV-2) in the first 24 hours of admission. Fourteen areas (3 posterior, 2 lateral, and 2 anterior) were scanned per patient for at least 10 seconds along the indicated anatomical landmarks. The scan was performed in supine, right-sided and left-sided positions, respectively. Each area was given a score between 0 and 3 according to the specific pattern.
Results:
In this study, 21 still images and 21 videoclips that enabled dynamic and real-time evaluation were provided. Pleural line assessment, physiologic A-lines, pathologic B-lines, light beam pattern, white lung pattern, and specific patterns for quick recognition and evaluation are described.
Conclusion:
The potential advantages and limitations of LUS and its areas of use for obstetricians are discussed. LUS is a promising supplementary imaging tool during the SARS-CoV-2 pandemic. It is easy to perform and may be feasible in the hands of obstetricians after a brief didactic course. It may be a firstline imaging modality for pregnant women.
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