Radiology Diagnostics of a New Coronavirus Infection in Pregnant Women. Experience of O.M. Filatov Municipal Clinical Hospital No. 15, Moscow

Abstract

Background. The pandemic of coronavirus pneumonia (COVID-19) is spreading globally at an accelerated rate and is a major health problem. The purpose of this study was to assess the possibility of using a combination of radiation diagnostic methods in lung lesions in pregnant women, with confirmed coronavirus infection and suspected COVID-19 pneumonia, hospitalized in O.M. Filatov Municipal Clinical Hospital No. 15, Moscow. Methods. Retrospectively analyzed changes in lung parenchyma and pleura detected by multispiral computed tomography of chest organs and pulmonary ultrasound in 90 pregnant patients with clinical manifestations of viral pneumonia and confirmed coronavirus infection. Results. Examined 90 patients with clinical manifestations of pneumonia and PCR-confirmed COVID-19. Among the clinical manifestations, coughing, fever, shortness of breath prevailed. Most changes detected by lung tomography (performed in 92% of patients), had a polysegmental and bilateral character, were more often localized in the peripheral departments, in 74 (89%) patients were involved in a pathological process of more than two lobes, in 77 (93%) of the patients were determined the centers of pulmonary tissue compaction by the type of ground glass, and the combination of the above manifestations with the presence of foci of consolidation and reticular changes was noted in 23 (28%) cases. Among the complications more common: thickening of the pleura, hydrothorax, less often pneumothorax. In 43 (48%) patients, MSCT was supplemented by ultrasound examination of the lungs and pleura, and in 21 (23%) patients, ultrasound was used in isolation as a dynamic control tool to reduce dose load and comply with the ALARA principle, while in 7 (8%) patients, ultrasound was used as the only diagnostic tool due to refusal to perform MSCT. Conclusion. Radiosemiotics of lung lesions in pregnant women with COVID-19, detected in MSCT of thoracic organs, does not differ from that in non-pregnant patients. The appearance of specific zones of pulmonary tissue compaction in the form of a gound glass, as a manifestation of a unilateral or bilateral, mono- or polyphocal lung lesion, is highly likely to indicate a manifestation of COVID-19. Pulmonary ultrasound also allows detecting characteristic changes in lung parenchyma and pleura in pregnant women, correlating with MSCT data, primarily in patients with medium-severe forms of pneumonia. Use of ultrasonography corresponds to the principle of ALARA in medicine, remaining a choice method with the women refusing the visualization interfaced to beam loading that can be used in the period of COVID-19 pandemic.