Prenatal ultrasound evaluation in the current era of COVID-19 – looking only for major congenital defects or subtle sonographic and echocardiographic findings, as well?

Introduction
In December 2019 a novel coronavirus emerged. COVID-19 disease varies in severity. Pregnancy implicates special susceptibility to pathogens and severe pneumonia. It is rational to compare accessible literature and discuss possible prenatal ultrasound monitoring in cases of COVID-19 among gravidas.

Material and methods
A PubMed search was conducted, utilising the terms ‘covid 19’ and ‘pregnancy’. Only original source materials were used for comparison. Collected data included: author, date of study, region of study, number of cases, gravidas’ age, trimester of pregnancy during examination, chronic, concomitant diseases, symptoms of infection, type of delivery, Apgar score range, fetal problems, perinatal outcome, and the possibility of vertical transmission.

Results
From a total of 39 results initially identified, six matched our search criteria. Mothers’ ages ranged from 22 to 40 years. Mostly they were healthy women, previously with COVID-19 infection, and without chronic diseases. Symptoms of COVID-19 were similar to those presented in the general population: fever, cough, sneezing, nasal congestion, sore throat, myalgia, malaise, dyspnoea, and diarrhoea. Caesarean section constituted 93% of all deliveries. Twenty of 48 (41%) fetuses were delivered preterm. Apgar scores ranged from 7 to 10 points; only one neonate received 7 points. There is no evidence of SARS-CoV-2 vertical transmission until now.

Conclusions
Current literature does not allow for more precise description of fetal functional changes in the course of maternal COVID-19. More extensive studies are needed with special consideration of fetal cardiovascular system examination and further postnatal monitoring and more extensive epidemiological evaluation.