Lung Ultrasound Patterns in Multisystem Inflammatory Syndrome in Children (MIS-C)-Characteristics and Prognostic Value.

Objective and design: Following COVID-19 infection, children can develop an hyperinflammatory state termed Multisystem Inflammatory Syndrome in Children (MIS-C). Lung Ultrasound (LUS) features of COVID-19 in children have been described, but data describing the LUS findings of MIS-C are limited. The aim of this retrospective observational study conducted between 1 March and 31 December 2020, at a tertiary pediatric hospital in Milano, is to describe LUS patterns in patients with MIS-C and to verify correlation with illness severity. The secondary objective is to evaluate concordance of LUS with Chest X-ray (CXR). Methodology: Clinical and laboratory data were collected for all patients (age 0−18 years) admitted with MIS-C, as well as LUS and CXR patterns at admission. PICU admission, needed for respiratory support and inotrope administration, hospital, and PICU length of stay, were considered as outcomes and evaluated in the different LUS patterns. An agreement between LUS and CXR evaluation was assessed with Cohen' k. Results: 24 children, who had a LUS examination upon admission, were enrolled. LUS pattern of subpleural consolidations < or > 1 cm with or without pleural effusion were associated with worse Left Ventricular Ejection Fraction at admission and need for inotropes. Subpleural consolidations < 1 cm were also associated with PICU length of stay. Agreement of CXR with LUS for consolidations and effusion was slight. Conclusion: LUS pattern of subpleural consolidations and consolidations with or without pleural effusion are predictors of disease severity; under this aspect, LUS can be used at admission to stratify risk of severe disease.

Transabdominal uterine arteries Doppler at 12-14th and 20-24th week of gestation and pregnancy outcome: a prospective study.

OBJECTIVE: To identify women at actual risk of pre-eclampsia and poor pregnancy outcome in a selected group of high risk patients. STUDY DESIGN: Prospective study of women with previous pre-eclampsia and/or intra uterine growth retardation, intra uterine death (> or =20th week), chronic hypertension, three or more previous spontaneous abortions. All subjects were followed-up till pregnancy outcome. Gestational week at delivery and birth weight were recorded. Other outcome measures were: intra uterine growth retardation, pregnancy-induced hypertension, pre-eclampsia, abruptio placenta, admission in neonatal intensive care unit. RESULTS: 139 patients were enrolled and followed-up until the end of pregnancy. Abnormal Doppler results at 12-14th week examination were associated with intra uterine growth retardation, fetal death/spontaneous abortion and small for gestational age birth. CONCLUSIONS: This study indicates that early evaluation of arterial uterine RI and presence of notches may be predictive of low birth weight and intra uterine growth retardation in a high risk population.