The July issue of Ultrasound in Obstetrics & Gynecology includes a systematic review on the effect of COVID-19 on maternal, perinatal and neonatal outcome, a randomized controlled trial on the effect of pelvic floor muscle training on pelvic floor muscle contraction and symptomatic and anatomical pelvic organ prolapse after surgery, a study on the effectiveness of a rapid lung ultrasound training program for gynecologists and obstetricians managing pregnant women with suspected COVID-19, and ISUOG Practice Guidelines on the role of ultrasound in congenital infection.
Effect of coronavirus disease 2019 (COVID-19) on maternal, perinatal and neonatal outcome: systematic review
Data on the impact of COVID-19 in vulnerable populations, such as pregnant women, are limited. Juan et al. performed a systematic review to evaluate the effect of COVID-19 on maternal, perinatal and neonatal outcome. When reviewing the many published case reports from China, they observed that duplicate reporting occurred in subsequent published cohorts, so they opted to exclude Chinese case reports from their analysis. Of the 324 pregnant women included, seven maternal deaths were reported in a series of nine non-consecutive cases with severe COVID-19 and two amongst the case reports. COVID-19 did not appear to increase the risk of adverse pregnancy outcome, such as pre-eclampsia, and only a few cases of spontaneous miscarriage or termination have been reported. Among the consecutive case series, there were three reported cases of neonates testing positive for SARS-CoV-2 and among the case reports, two neonates tested positive. The authors conclude that, despite the increasing number of published studies on COVID-19 in pregnancy, there are insufficient good-quality data to draw unbiased conclusions with regard to complications of COVID-19 in pregnant women, as well as vertical transmission and perinatal complications.
Effect of preoperative pelvic floor muscle training on pelvic floor muscle contraction and symptomatic and anatomical pelvic organ prolapse after surgery: randomized controlled trial
Pelvic floor muscle training (PFMT) has been shown to be effective for the prevention and treatment of mild to moderate pelvic organ prolapse (POP). In a randomized controlled trial, Nyhus et al. evaluated the effect of preoperative PFMT on pelvic floor muscle (PFM) contraction, POP symptoms and anatomical POP, 6 months after prolapse surgery, and assessed the overall changes in PFM contraction, POP symptoms and pelvic organ descent after surgery. They found no effect of preoperative PFMT on PFM contraction, POP symptoms or anatomical prolapse after surgery. In all patients, PFM contraction and POP symptoms were improved at the 6-month follow-up, most likely due to the anatomical correction of POP. The findings therefore do not provide evidence to support the introduction of PFMT as a standard supplement to POP surgery. View the accompanying video abstract:
Effectiveness of rapid lung ultrasound training program for gynecologists and obstetricians managing pregnant women with suspected COVID-19
Lung ultrasound examination has been suggested as a useful tool with which to detect lung involvement during the COVID-19 pandemic, desirable particularly for pregnant women. Buonsenso et al. evaluated the feasibility and effectiveness of a specific single-day training program providing gynecologists and obstetricians who are already skilled in ultrasound examination with the theoretical background required for recognition of normal and the main abnormal lung ultrasound patterns. The median number of correct answers among the trainees was 6/10 at the pretraining test and 9/10 at the post-training test. This preliminary experience suggests that a rapid teaching program is sufficient to provide gynecologists and obstetricians who are already skilled in obstetric and/or gynecological ultrasound examination with the theoretical skills necessary to recognize specific lung ultrasound patterns.
ISUOG Practice Guidelines: role of ultrasound in congenital infection
Ultrasound examination is key in the diagnosis and management of congenital infection. New ISUOG Practice Guidelines on the role of ultrasound in congenital infection discuss the ultrasound signs and the prognostic value of ultrasound findings. Six types of infection and their causative agents are looked at in detail: cytomegalovirus, toxoplasma, parvovirus B19, rubella virus, varicella-zoster virus (which causes chickenpox) and Zika virus. For each, the ultrasound signs, timing of infection in relation to gestational age and diagnosis of maternal and fetal infection are discussed, and a brief outline of appropriate management is provided.
Coming up next month…
- ISUOG Practice Guideline on the diagnosis of small-for-gestational-age fetuses and fetal growth restriction
- A study from Nicolaides’ team on the development and validation of a new model for prediction of SGA. Preview the Accepted Article.
- A series of articles on the theme of fetal cerebral Doppler assessment in the context of fetal growth restriction, including the TRUFFLE-2 feasibility study, reference ranges of CPR and UCR and a systematic review examining the clinical impact of such Doppler reference charts.