COVID-19 infection during pregnancy is associated with premature rupture of membranes, preterm delivery, and low birth weight. It has also been associated with hypercoagulability and vasculitis in certain patients. This article reports two premature twins born from a COVID-19 mother who presented with an unusual pattern of ileal ischemia and perforation within 24 hours of each other. We suggest that maternal infection with the novel coronavirus might lead to this atypical distribution of intestinal pathology.

Objective: To correlate hypotension and cerebral saturation from near-infrared spectroscopy (cNIRS) in neonates on dopamine. Study Design: Retrospective review of neonates receiving dopamine between August 2018-2019 was performed. Hypotension thresholds included mean arterial pressure (MAP) of postmenstrual age (PMA) ± 5mmHg, 30mmHg, and gestational age (GA) ± 5mmHg. Time below threshold MAP was compared to time with cerebral hypoxia (cNIRS <55%). Results: Hypotension occurred 6-33% of time on dopamine in 59 cases. Hypotension did not correlate with abnormal cNIRS overall, within PMA subgroups, or by outcomes. Hypotensive periods with MAP<GA had fewer corresponding percent time with abnormal cNIRS events (3.7±1.3%) compared to MAP <PMA (11.9±4.9%, p<0.003) or 30 mm Hg thresholds (12.2±4.7%, p<0.0001). In the most premature infants, mean cNIRS values during hypotension were still within normal range (57±6%). Conclusion: cNIRS may be a more clinically relevant measure than MAP for assessment of neonatal hypotension.