Impact of Viral Myocarditis on the Course of Pregnancy and Delivery

Background : COVID-19 is mainly a respiratory infection; however, in some cases, it can result in cardiac complications in pregnant women leading to the development of myocarditis. Material and methods : In 2021-2022 we studied the impact of COVID-19-associated myocarditis on the course of pregnancy in the Republican Perinatal Center (Tashkent, Republic of Uzbekistan). We examined a total of 147 pregnant women with myocarditis (of them, 95 women had COVID-19 while pregnant and 52 women had chronic focal myocarditis). The patients underwent electrocardiography, echocardiography, ultrasonography, and laboratory studies (troponin T1). Results : COVID-19 in pregnant women can lead to COVID-19-associated myocarditis with signs of circulatory failure (68%), in contrast to chronic focal myocarditis with impaired circulation and chronic heart failure (84.7%). Metabolic changes on echocardiography were more typical of COVID-19-associated myocarditis (group 1) than indolent focal myocarditis (group 2); however, pathological changes were more common in group 2, indicating more pronounced changes in the myocardium of pregnant women with chronic focal myocarditis. Conclusions: The course of gestation in women with COVID-19-associated myocarditis was characterized by the hypertensive syndrome, increased risk of miscarriage, intrauterine growth restriction, and nonreassuring fetal status, but these complications were less common compared with group 2 with chronic focal myocarditis, in which case operative vaginal delivery is indicated.

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