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Abstrakt
Impact of SARS-CoV-2 on Intrapartum Cardiotocography: A Retrospective Cohort Study
Nelson Rabbachin, Maria Breugelmans, Monika Laubach, Gilles Faron, Michel Boulvain, Leonardo Gucciardo
The objective of this retrospective cohort study was to evaluate the frequency of abnormal intrapartum CTG (Cardiotocography) patterns in women infected with SARS-CoV-2. Conducted at a tertiary hospital center, the study compared a group of women who tested positive for SARS-CoV-2, including both symptomatic and asymptomatic infections, with a control group of randomly selected SARS-CoV-2 negative women. CTG anomalies were blindly identified according to the physiological interpretation of cardiotocography traces, RCOG-classification and 3-tier system. We compared the frequency of CTG anomalies between SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2) positive women and controls, and between symptomatic and asymptomatic infections. The main outcome measures were the frequency of CTG abnormalities, according to the used CTG-classification systems.
A total of 119 women were included in the case group, of whom 31 were symptomatic (26%), and 116 women in the control group. We found no significant differences in maternal and labor characteristics between groups. Perinatal outcomes were similar in the two groups. Major CTG abnormalities were present in 27% of cases versus 27% of controls. No significant differences between cases and controls were found using the RCOG-classification or 3 tier fetal heart rate system. Abnormal patterns 1 h before delivery were present during <10 min (29% vs. 31%), 10 min-30 min (24% vs. 20%) and >30 min (47% vs. 49%) in cases and controls, respectively. CTG characteristics were similar between SARS-CoV-2 positive asymptomatic and symptomatic women, with no significant differences in the rate of abnormalities.
In conclusion, CTG abnormalities do not seem more frequent in maternal SARS-CoV-2 infection, unlike suggested in earlier case-series. No specific pattern was found in these fetuses.