Fetal Diaphragmatic Excursion Is Decreased in Hospitalized Pregnant Women Infected with COVID-19 during the Second and Third Trimesters

Abstract

Introduction: In the present study, we aimed to evaluate COVID-19 infection effects on fetal diaphragm thickness and diaphragmatic excursion, which together show the quality of diaphragmatic contractions. Materials and Methods: One hundred and ninety-two pregnant women were included in this prospective case-control study. Patients were divided into four groups according to their COVID-19 infection history in their second or third trimester: hospitalized COVID-19 infected pregnant women group (n=48), outpatient COVID-19 infected pregnant women group (n=48), common cold (COVID-19 PCR negative) pregnant women group (n=48) and non-infected healthy controls (n=48). The number of patients was determined by power analysis following the pilot study. All participants underwent an ultrasound examination to determine fetal diaphragm parameters at 32-37 weeks of gestation. Results: Demographic characteristics were similar among the four groups. The gestational age at ultrasound examination and gestational ages at delivery were similar among groups. Neonatal Intensive Care Unit (NICU) admission rate was significantly higher in the hospitalized COVID-19 infected pregnant women group than the other group. The fetal diaphragm thickness during inspiration, expiration and fetal costophrenic angles at inspiration and expiration were similar among groups. Fetal diaphragmatic excursion was significantly decreased in the hospitalized COVID-19 infected pregnant women group compared to the other group. Conclusion: Our results indicated that moderate maternal COVID-19 infection decreased fetal diaphragmatic excursion and ultrasonographic evaluation of fetal diaphragmatic excursion before delivery can provide critical information to predict whether infants will require NICU admission.