Outcome of COVID-19 Contracted in the First and Second Trimester of Pregnancy: A Systematic Review

Abstract Background: Downstream remodeling of the spiral arteries (SpA) decreases utero-placental resistance drastically, allowing sustained and increased blood flow to the placenta at all circumstances. We systematically evaluated available reports to visualize adaptation of spiral arteries throughout pregnancy by ultra-sonographic measurements and evaluated when this process is completed.Methods: A systematic review and meta-analysis of spiral artery flow (pulsatility index (PI), resistance index (RI) and peak systolic velocity (PSV)) was performed. English articles were obtained from Pubmed, EMBASE and Cochrane Library and included articles were assessed on quality and risk of bias. Weighted means of Doppler indices were calculated using a random-effects model. Results: In healthy pregnancies, PI and RI decreased from 0.75 (95% CI: 0.67-0.83) and 0.49 (95% CI: 0.46-0.53) in the first trimester to 0.52 (95% CI: 0.48-0.56, p=0.003) and 0.40 (95% CI: 0.38-0.42, p=0.080) in the second trimester and to 0.49 (95% CI: 0.44-0.53, p=0.510) and 0.36 (95% CI: 0.35-0.37, p=0.307) in the third trimester, respectively. In parallel, PSV altered from 0.24 m/s (95% CI: 0.17-0.31 m/s) to 0.28 m/s (95% CI: 0.22-0.34 m/s, p=0.377) and to 0.25 m/s (95% CI: 0.21-0.28 m/s, p=0.919) in the three trimesters. In absence of second and third trimester Doppler data in complicated gestation, only a difference in PI was observed between complicated and healthy pregnancies during the first trimester (1.49 vs 0.76, p<0.001). Although individual studies have identified differences in PI between SpA located in the central part of the placental bed versus those located at its periphery, this meta-analysis could not confirm this (p=0.349).Conclusions: This review and meta-analysis concludes that an observed decrease of SpA PI and RI from the first towards the second trimester parallels the physiological trophoblast invasion converting SpA during early gestation, a process completed in the midst of the second trimester. Higher PI and RI were found in SpA of complicated pregnancies compared to healthy pregnancies, possibly reflecting suboptimal utero-placental circulation. Longitudinal studies examining comprehensively the predictive value of spiral artery Doppler for complicated pregnancies are yet to be carried out.

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Second-trimester fetal aberrant right subclavian artery: original study, systematic review and meta-analysis of performance in detection of Down syndrome

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.13336 ◽

2014 ◽

Vol 44 (2) ◽

pp. 147-153 ◽

Cited By ~ 23

Author(s):

J. De León-Luis ◽

F. Gámez ◽

C. Bravo ◽

J. M. Tenías ◽

Á. Arias ◽

...

Keyword(s):

Systematic Review ◽

Down Syndrome ◽

Subclavian Artery ◽

Meta Analysis ◽

Original Study ◽

Aberrant Right Subclavian Artery ◽

Second Trimester ◽

Analysis Of Performance

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Systematic review of the clinical prediction rules for the calculation of the risk of Down syndrome based on ultrasound findings in the second trimester of pregnancy

Prenatal Diagnosis ◽

10.1002/pd.4304 ◽

2014 ◽

Vol 34 (3) ◽

pp. 265-272 ◽

Cited By ~ 5

Author(s):

María Moreno-Cid ◽

José María Tenías Burillo ◽

Ana Rubio-Lorente ◽

María José Rodríguez ◽

Gema Bueno-Pacheco ◽

...

Keyword(s):

Systematic Review ◽

Down Syndrome ◽

Second Trimester ◽

Clinical Prediction ◽

Clinical Prediction Rules ◽

Prediction Rules ◽

Ultrasound Findings

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Does Vitamin D Deficiency in Different Periods of Gestation Have the Same Effect on Preterm Birth? A Systematic Review and Meta-Analysis

10.21203/rs.3.rs-15534/v1 ◽

2020 ◽

Author(s):

bin Yi ◽

Rui-han Lian ◽

Ping-an Qi ◽

Tao Yuan ◽

Pei-jing Yan ◽

...

Keyword(s):

Systematic Review ◽

Vitamin D ◽

Preterm Birth ◽

Vitamin D Deficiency ◽

Meta Analysis ◽

Cochrane Library ◽

Second Trimester ◽

Case Control Studies ◽

Cross Sectional ◽

Vitamin D Levels

Abstract Background: Current studies suggest that vitamin D deficiency during pregnancy can produce a certain effect for preterm birth, but there is no research showing whether vitamin D deficiency has a consistent effect in different pregnancies; thus, we conducted a systematic review and meta-analysis of 24 observational studies, grouping them according to the gestational age at the time of serum sampling, to investigate whether vitamin D deficiency in different periods of gestation has different effects on preterm birth and to provide an evidence-based basis for pregnant women to measure and supplement vitamin D. Methods: The databases PubMed-Medline, EMBASE, the Cochrane Library, Web of Science, EBSCO, CBM, and CNKI were searched until July 2019. Two researchers independently assessed the eligibility and quality of studies, and STATA 12.0 software was used for meta-analysis. Result: Seven cohort studies, 13 case-control studies, and four cross-sectional studies were included from 2500 articles by inclusion and exclusion criteria. After adjusting for age, race, and other confounding factors, meta-analysis results showed that vitamin D deficiency in the first trimester, the second trimester and the third trimester did not increase the risk of preterm birth (odds ratio (OR) = 1.01, 95% confidence interval (CI) (0.88, 1.16), P = 0.867; OR = 1.12, 95%CI (0.92, 1.37), P = 0.249; OR = 1.05, 95%CI (0.87, 1.27), P = 0.602). However, there was moderate heterogeneity in the study of vitamin D deficiency in the second trimester, and subgroup analysis suggested that vitamin D deficiency in the second trimester may increase the risk of preterm birth (OR = 1.33, 95%CI (1.15, 1.54), P = 0.000). A sensitivity analysis of the second trimester showed that excluding any one study did not significantly change the results. Conclusions: Vitamin D deficiency in early and late pregnancy may not be associated with preterm birth, while vitamin D deficiency in middle pregnancy is likely to have an important effect on preterm birth. Vitamin D levels should be measured in the second trimester of pregnancy, and vitamin D supplements should be provided if necessary.

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Successful dilation and evacuation for second trimester conjoined twin: A case report and systematic review of the literature

10.22541/au.159819138.80510410 ◽

2020 ◽

Author(s):

Ferid Abbas Abubeker ◽

Tesfaye Tufa ◽

Matiyas Shiferaw ◽

Mekdes Feyssa ◽

Wondimu Gudu ◽

...

Keyword(s):

Systematic Review ◽

Case Report ◽

Second Trimester ◽

Review Of The Literature

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Dorsolumbosacral agenesis: Case report and literature review

Obstetrics & Gynecology International Journal ◽

10.15406/ogij.2021.12.00553 ◽

2021 ◽

Vol 12 (2) ◽

Author(s):

Andrés Mauricio Camacho Montaño ◽

Reinaldo Child Alba Reinaldo ◽

María Camila Cetina Grajales

Keyword(s):

Systematic Review ◽

Case Report ◽

Prenatal Diagnosis ◽

Perinatal Death ◽

Severe Form ◽

Second Trimester ◽

Review Of The Literature ◽

The Third ◽

First Case ◽

Made In

Objetives: To report a case of dorsolumbosacral agenesis and to make a systematic review of the literature focused on prenatal diagnosis. Materials and methods: We report a case of a 32year old pregnant woman, with a 30 week pregnanacy, without prenatal care, the fetus is diagnosed with dorsolumbosacral agenesis. The mother request voluntary termination of pregnancy. A systematic review of the literature focused on prenatal diagnosis of thos condiction is performed. Results: We found 50 papers, 6 met the inclusión critiria. Three of them with prenatal diagnosis. In the first case the diagnosis was made at 13 weeks of gestation and termination of preganancy was requested. In the second case corresponded an biamniotic bicorial twin preganancy. One normal feto and one presented dorsolumbosacral agenesis. The diagnosis was made in the second trimester. The pregnancy continued until 34 week of gestation and the affected neonate had perinatal death. The third case, the diagnosis was made at 18 weeks and a male newborn of 2990gr was born at 37 weeks of gestation. Conclusion: Dorsolumbosacral agenesis is a very severe form of caudal regresión syndrome, with only a few cases reportted in the literature. To the best of our knowladge this is the fourth case reported with prenatal diagnosis.

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Spiral artery blood flow during pregnancy: a systematic review and meta-analysis.

10.21203/rs.2.16611/v3 ◽

2020 ◽

Author(s):

Veronique Schiffer ◽

Laura Evers ◽

Sander de Haas ◽

Chahinda Ghossein ◽

Salwan Al-Nasiry ◽

...

Keyword(s):

Systematic Review ◽

Blood Flow ◽

Meta Analysis ◽

Resistance Index ◽

First Trimester ◽

Trophoblast Invasion ◽

Cochrane Library ◽

Second Trimester ◽

Spiral Artery ◽

Third Trimester

Abstract Background: Downstream remodeling of the spiral arteries (SpA) decreases utero-placental resistance drastically, allowing sustained and increased blood flow to the placenta at all circumstances. We systematically evaluated available reports to visualize adaptation of spiral arteries throughout pregnancy by ultra-sonographic measurements and evaluated when this process is completed. Methods: A systematic review and meta-analysis of spiral artery flow (pulsatility index (PI), resistance index (RI) and peak systolic velocity (PSV)) was performed. English articles were obtained from Pubmed, EMBASE and Cochrane Library and included articles were assessed on quality and risk of bias. Weighted means of Doppler indices were calculated using a random-effects model. Results: In healthy pregnancies, PI and RI decreased from 0.80 (95% CI: 0.70-0.89) and 0.50 (95% CI: 0.47-0.54) in the first trimester to 0.50 (95% CI: 0.45-0.55, p<0.001) and 0.39 (95% CI: 0.37-0.42, p<0.001) in the second trimester and to 0.49 (95% CI: 0.44-0.53, p=0.752) and 0.36 (95% CI: 0.35-0.38, p=0.037) in the third trimester, respectively. In parallel, PSV altered from 0.22 m/s (95% CI: 0.13-0.30 m/s) to 0.28 m/s (95% CI: 0.17-0.40 m/s, p=0.377) and to 0.25 m/s (95% CI: 0.20-0.30 m/s, p=0.560) in the three trimesters. In absence of second and third trimester Doppler data in complicated gestation, only a difference in PI was observed between complicated and healthy pregnancies during the first trimester (1.49 vs 0.80, p<0.001). Although individual studies have identified differences in PI between SpA located in the central part of the placental bed versus those located at its periphery, this meta-analysis could not confirm this (p=0.349). Conclusions: This review and meta-analysis concludes that an observed decrease of SpA PI and RI from the first towards the second trimester parallels the physiological trophoblast invasion converting SpA during early gestation, a process completed in the midst of the second trimester. Higher PI was found in SpA of complicated pregnancies compared to healthy pregnancies, possibly reflecting suboptimal utero-placental circulation. Longitudinal studies examining comprehensively the predictive value of spiral artery Doppler for complicated pregnancies are yet to be carried out.

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