Lung Sonography in Obstetrics during COVID-19

Abstract

In the current coronavirus SARS-CoV-2 pandemic, certain patients are becoming seriously ill. Lung pathologies are common, and some patients even go on to develop acute respiratory distress syndrome (ARDS), which requires intubation and artificial respiration of the critically ill patient. Imaging of the lung is absolutely necessary to obtain a diagnosis, assess the course of disease and for treatment. Particularly in gynecology and obstetrics (OBGYN), ultrasound scans of the lung can be a useful additional tool when caring for pregnant patients in the delivery room. As obstetricians use ultrasound imaging a lot in routine clinical practice, in the current pandemic setting, routine prenatal imaging screening could be expanded by the addition of ultrasound scans of the lung. Lung sonography can offer important additional information, particularly in obstetrics where the indications for radiation-emitting imaging are particularly restrictive. If there is a sonographic suspicion of lung involvement, then, depending on the symptoms and the morphological extent of the ultrasound findings, it may be necessary to consider admitting the patient to hospital for close fetal and maternal monitoring.

Impact of the COVID-19 Pandemic on Delivery of Gynecology and Obstetrics Services at a Maximum Care University Hospital in Germany

“…Moreover, this arrangement represented an absolute exception in the inpatient setting; in all other departments, such as ICU units, exceptions to allow visitors were only made in the case of end-of-life care. One year after the pandemic outbreak of the novel coronavirus with its single-stranded RNA genome, the consequences of a COVID-19 infection for pregnancies during the prenatal, perinatal and postnatal stages remain unclear; possible effects relating to an increase in pregnancy complications in the presence of COVID-19 infection are still being discussed, and to date, there is no standardized, scientifically proven treatment regime for pregnant women infected with COVID-19 1 2 3 4 5 . Accordingly, in our opinion, there are two factors responsible for the positive trend in case numbers in the obstetrics department.…”

“…Darüber hinaus stellte diese Regelung eine absolute Ausnahme für den stationären Aufenthalt dar, während in allen übrigen Abteilungen, wie beispielsweise der intensivmedizinischen Versorgung, nur Ausnahmen im Rahmen der Sterbebegleitung getroffen wurden. Der Einfluss einer COVID-19-Infektion auf den prä-, peri- und postnatalen Verlauf von Schwangerschaften bleibt ein Jahr nach dem pandemischen Ausbruch des neuartigen einzelsträngigen RNA-Virus der Coronavirusfamilie weiterhin undurchsichtig, etwaige Effekte auf eine Zunahme an Schwangerschaftskomplikationen im Rahmen einer COVID-19-Erkrankung werden diskutiert und bis dato existiert kein einheitliches wissenschaftlich fundiertes Therapieregime für infizierte Gravida 1 2 3 4 5 . Ursächlich für die Positiventwicklung der geburtshilflichen Abteilung sind dementsprechend aus unserer Sicht 2 Faktoren.…”

The Association of Serum Electrolytes with Disease Severity and Obstetric Complications in Pregnant Women with COVID-19: a Prospective Cohort Study from a Tertiary Reference Center

“…Maternal age, pre-pregnancy body mass index (BMI), gravidity, parity, comorbid conditions, gestational age at diagnosis, pregnancy trimester at diagnosis, oxygen support rate, admission to intensive care unit (ICU), radiologic findings consistent with COVID-19 19 , COVID-19 specific medications, antenatal corticosteroid prophylaxis rate, maternal mortality rate, obstetric complications (miscarriage, preterm labor, gestational hypertension, gestational diabetes mellitus, preeclampsia, fetal growth restriction, preterm premature rupture of membranes and intrahepatic cholestasis of pregnancy), and serum electrolyte values were compared between the groups. Obesity was defined as pre-pregnancy BMI ≥ 30 kg/m 2 20 .…”

“…Coronavirus disease 2019 (COVID- 19) is an emerging and rapidly evolving health problem. It has caused a global crisis since the beginning of the pandemic and it has forced states to take extraordinary measures [1].…”