Modified lung ultrasound scoring system to evaluate the feasibility of pregnant women with COVID-19 pneumonia

Abstract

Objective

To investigate whether physicians with short-term training can use a modified lung ultrasound scoring system for coronavirus disease 2019 (COVID-19) pneumonia to assess lung damage in pregnant women.

Methods

Sixteen consecutively hospitalized third-trimester pregnant women with pregnancy-induced hypertension, preeclampsia, rheumatoid arthritis or connective tissue disease were selected as the study subjects for the simulation of COVID-19 pneumonia. Two physicians (imaging and internal medicine) without ultrasonic experience performed lung examinations on pregnant women after six days of lung ultrasound training, and their consistency with examinations by the expert was assessed. In addition, 54 healthy third-trimester pregnant women and 54 healthy nonpregnant women of the same age who were continuously treated in the outpatient clinic of this hospital were selected for comparisons of abnormalities on lung ultrasound.

Results

(1) Third trimester pregnant women with pregnancy-induced hypertension, preeclampsia, rheumatoid arthritis or connective tissue disease had the same lung ultrasound patterns as those associated with COVID-19 pneumonia. (2) There was no statistically significant difference between the scores of the two trained doctors and the expert when the modified ultrasound scoring system was used (p > .05). (3) The evaluations of the two trained doctors and the expert showed good consistency (kappa value = 0.833–0.957). (4) The incidence of abnormal ultrasound manifestations of the pleura and lung parenchyma was higher among healthy third-trimester pregnant women than among healthy women of the same age (p < .001).

Conclusions

After receiving short-term training, imaging and internal medicine physicians can use the modified lung ultrasound scoring system to evaluate pregnant women’s pulmonary damage, but caution is needed to avoid false-positive results among pregnant women with suspected COVID-19 pneumonia.

Keywords:

• Lung ultrasound
• pregnant women
• COVID-19 pneumonia

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was sponsored by the key Clinical Specialty Discipline Construction Program of Fujian, P.R.C, the Research Project of Science and Technology Department of Fujian Province, China [Grant 2018J01288], the Youth Research Project of Health and Family Planning Commission of Fujian Province, China [Grants 2018-1-62 and 2018-2-23], the Quanzhou Science and Technology Project [Grants 2018N012], and the Research Project of Collaborative Innovation Center for Maternal and Infant Health Service Application Technology [Grant XJM1802].