Evaluation of the tissue doppler-derived myocardial performance index in fetuses of mothers infected with COVID-19 during pregnancy with mild symptoms

Abstract

Purpose: To compare cardiac functions evaluated with echocardiography and tissue Doppler (TD) imaging between fetuses of pregnant women who were infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and were asymptomatic or had mild symptoms and fetuses of pregnant women who were not infected. Material and Methods: Early diastolic myocardial velocities (Em) and late myocardial velocities (Am) and Em/Am ratios were measured in the lateral annuli of tricuspid and mitral valves of fetuses of pregnant women with COVID-19 at more than 20 weeks of gestational age who had COVID-19 (n=45) and gestational age-matched healthy pregnant women’s fetuses (n=43). The TD-derived myocardial performance index (MPI) was also measured. Results: The gestational ages of the fetuses were found as 26.1 ± 3.3 and 26.6 ± 3.5 weeks, respectively. The mitral valve Em/Am ratio was 0.56±0.08 and 0.61±0.06 in the study group and the control group, respectively. The tricuspid valve Em/Am ratio was 0.58±0.11 and 0.63±0.10 in the study group and the control group, respectively. The TD-derived mitral valve MPI was 0.48±0.07 and 0.40±0.07 in the study group and the control group, respectively. Conclusion: Maternal COVID-19 affects fetal MPI and diastolic function. Fetal cardiac echocardiography should be performed during antenatal follow-up of low-risk, mildly symptomatic pregnant women infected with SARS-CoV-2 without concomitant maternal comorbidity.