Impact of Gestational COVID-19 on Neonatal Outcomes: Is Vertical Infection Possible?

BACKGROUND: The vertical transmission of severe acute respiratory coronavirus-2 (SARS-CoV-2) remains highly debated. Here, we evaluated SARS-CoV-2-transmission in newborns with intrauterine conditions. METHODS: This was a prospective, observational and multicentric study involving 13 Spanish hospitals included in the GEStational and NEOnatal-COVID cohort. Pregnant women with microbiologically confirmed SARS-CoV-2 infection during any trimester of pregnancy or delivery and their newborns were included from March to November 2020. Demographic, clinical and microbiological data were also obtained. Viral loads were analyzed in different maternal and newborn biological samples (placenta, breast milk and maternal blood; urine, meconium and newborn blood). RESULTS: A total of 177 newborns exposed to SARS-CoV-2 were included. Newborns were tested by reverse transcriptase-polymerase chain reaction using nasopharyngeal swabs within the first 24-48 hours of life and at 14 days of life. In total 5.1% were considered to have SARS-CoV-2 infection in the neonatal period, with 1.7% considered intrauterine and 3.4% intrapartum or early postnatal transmission cases. There were no differences in the demographic and clinical characteristics of the pregnant women and their newborns' susceptibility to infections in their perinatal history or background. CONCLUSIONS: Intrauterine transmission of SARS-CoV-2 is possible, although rare, with early postnatal transmission occurring more frequently. Most infected newborns remained asymptomatic or had mild symptoms that evolved well during follow-up. We did not find any maternal characteristics predisposing infants to neonatal infection. All infected newborn mothers had acute infection at delivery.Although there was no presence of SARS-CoV2 in cord blood or breast milk samples, SARS-CoV-2 viral load was detected in urine and meconium samples from infected newborns.

[Mammary ductal ectasia child. Diagnostic and therapeutic approach]. / Ectasia ductal mamaria infantil. Aproximación diagnóstica y terapéutica.

Mammary duct ectasia in childhood is a rare disease. It appears typically as a periareolar mammary mass and/or nipple discharge. Even though in the adult age is an acquired disease, its occurrence in children suggests it may constitute a development mammary gland anomaly. Sonography is highly useful in the diagnosis. Differential diagnosis must include other nipple discharge and mammary mass causes as the juvenile fibroadenoma or malignant pathology. This usually is a self-limited process, so that a conservative approach is recommended, even though occasionally surgical treatment is required. We report the case of a 13 years old girl with nipple discharge who finally was diagnosed bilateral mammary duct ectasia.

Síndrome de Meckel. Diagnóstico prenatal y diagnóstico diferencial / Meckel syndrome. Prenatal diagnosis and differential diagnosis

El síndrome de Meckel es un infrecuente y letal síndrome polimalformativo de herencia autosómica recesiva. Su incidencia oscila entre 1:1.300 y 1:140.000 nacimientos. Las malformaciones que se observan con más frecuencia son a nivel del sistema nervioso central (frecuentemente meningoencefalocele occipital), displasia renal multiquística bilateral, fibrosis hepática y polidactilia. La alteración genómica que lo produce puede localizarse en diversos loci. El diagnóstico prenatal es posible mediante sospecha ecográfica y, en muchos casos, mediante estudio del ADN fetal. Presentamos el caso de una paciente que tuvo 2 embarazos consecutivos en los que se diagnosticó dicho síndrome (AU)

Meckel syndrome is an infrequent and lethal syndrome characterized by multiple malformations. Inheritance is autosomal recessive. The incidence of this syndrome ranges from 1:1,300 to 1:140,000 births. The most common malformations are those affecting the central nervous system (usually occipital meningoencephalocele), bilateral renal cystic dysplasia, fibrotic changes of the liver and polydactyly. The associated genomic alteration can involve distinct loci. Prenatal diagnosis is feasible with ultrasound findings and, in numerous cases, with fetal DNA analysis. We present the case of a woman who had two consecutive pregnancies with a diagnosis of Meckel syndrome (AU)