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Vall d’Hebron describes two cases of fetuses with edema in pregnant women with COVID-19

Tuesday, 18 August, 2020

The researchers observed that when the pregnant women recovered from COVID-19, the fetal edema disappeared.

A Vall d’Hebron team has described two cases of fetuses with skin edema in pregnant women with SARS-CoV-2 infection. The appearance of edema during the second trimester of pregnancy could be a complication related to COVID-19, although it is necessary to continue monitoring pregnant women to understand this relationship in depth. The study, published in Obstetrics & Gynecology, involved the Maternal Fetal Medicine and the Pediatric Critical Care Units and the Microbiology and Infectious Disease Departaments at Vall d’Hebron University Hospital.

Some viral infections, such as cytomegalovirus or Zika virus, are associated with problems in pregnancy or abnormalities in the fetus. In the case of SARS-CoV-2, the risk of fetal complications when the mother is infected is still unknown. To study this risk, the researchers followed 31 women with COVID-19 who were pregnant. In two of them (6.5% of the total), skin edema was observed in the fetus. 

One of the cases was a 50-year-old woman who was admitted to the ICU due to bilateral COVID-19 pneumonia. At week 23 of gestation, skin edema was observed in the fetus, without other complications appearing. The other woman, 30, was diagnosed with mild COVID-19, which did not require hospital admission. In this case, fetal edema appeared at week 21 of gestation.

In both women, fetal edema was maintained during the disease. “We see a correlation between edema and SARS-CoV-2 infection, because when the women recovered from COVID-19, the edema also disappeared and the fetuses had no other complications”, explains Dr. Carlota Rodó, physician at the Obstetrics-Maternal-Fetal Medicine Departament at Vall d’Hebron Hospital and researcher at the Maternal and Fetal Medicine research group at Vall d’Hebron Institut de Recerca (VHIR).

In order to determine wheter there was SARS-CoV-2 infection in the fetuses, the researchers performed PCR test son the amniotic fluid. Inflammation-related factors such as IL-6 were also checked. Viral infection was not detected in any of the fetuses and their IL-6 values were normal, regardless of the woman’s inflammatory profile.

The results of the study are not sufficient to conclude that fetal edema is a complication related to COVID-19. Even so, according to Dr. Rodó, taking into account these findings, “it is advisable to monitor pregnant women that are infected with SARS-CoV-2 to understand the impact that the virus may have on the fetus”.

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