Fetal heart rate changes on the cardiotocograph trace secondary to maternal COVID-19 infection
Entidad
UAM. Departamento de Obstetricia y GinecologíaEditor
ElsevierFecha de edición
2020-07-02Cita
10.1016/j.ejogrb.2020.06.049
European Journal of Obstetrics & Gynecology and Reproductive Biology 252 (2020): 286-293
ISSN
0301-2115 (print)DOI
10.1016/j.ejogrb.2020.06.049Versión del editor
https://doi.org/10.1016/j.ejogrb.2020.06.049Materias
COVID-19; CTG; Cardiotocograph; Cytokine storm; Physiological CTG interpretation; ZigZag pattern; MedicinaNota
Elsevier grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains activeDerechos
© 2020 Elsevier B.V. All rights reservedResumen
To determine the cardiotocograph (CTG) changes in women with symptomatic COVID-19
infection.
Study design: 12 anonymised CTG traces from 2 hospitals in Spain were retrospectively analysed by 2
independent assessors. CTG parameters were studied based on fetal pathophysiological responses to
inflammation and hypoxia that would be expected based on the pathogenesis of COVID-19 patients.
Correlation was made with perinatal outcomes (Apgar score at 5 min and umbilical cord pH).
Results: All fetuses showed an increased baseline FHR > 10 percent compared to the initial recording, in
addition to absence of accelerations. 10 out of 12 CTG traces (83.3 percent) demonstrated late or
prolonged decelerations and 7 out of 12 fetuses (58.3 percent) showed absence of cycling. Not a single
case of sinusoidal pattern was observed. ZigZag pattern was found in 4 CTG traces (33 percent). Excessive
uterine activity was observed in all CTG traces where uterine activity was monitored (10 out of 12). Apgar
scores at 5 min were normal (>7) and absence of metabolic acidosis was found in the umbilical cord
arterial pH (pH > 7.0) in the cases that were available (11 and 9, respectively).
Conclusion: Fetuses of COVID-19 patients showed a raised baseline FHR (>10 percent), loss of
accelerations, late decelerations, ZigZag pattern and absence of cycling probably due to the effects of
maternal pyrexia, maternal inflammatory response and the “cytokine storm”. However, the perinatal
outcomes appear to be favourable. Therefore, healthcare providers should optimise the maternal
environment first to rectify the reactive CTG changes instead of performing an urgent operative
intervention
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Google Scholar:Gracia-Perez-Bonfils, Anna
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Martínez Pérez, Óscar
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Llurba, Elisa
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Chandraharan, Edwin
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