What does the cardiotocography say about SARS-CoV-2 infection? Cardiotocograph monitoring during the pandemic era: a narrative short review

Although emerging data indicate an increased risk of preeclampsia, intra-uterine growth restriction, preterm birth, and stillbirth, several questions remain unsolved in the case of SARS-CoV-2 infection in pregnant wom-en. Cardiotocography (CTG) is the main method for monitoring the foetal well-being during the intrapartum period and is now used worldwide for the early detection of foetal distress during labour and delivery. This literature review aims to assess different intrapartum CTG changes observed in SARS-CoV-2 positive mothers, to understand whether CTG should be specifically interpreted or correlated with the seropositivity of mother to improve their management. We reviewed titles and abstracts of 44 records regarding CTG and SARS-CoV-2, in PubMed and SCOPUS, abstracting the full text for 10. Of these, 6 studies met the eligibility criteria and were included in this narrative short review. Maternal SARS-CoV-2 infection has been associated with changes observed in CTG, such as the increase in the baseline due to fever, inflammatory response and the “cytokine storm”. Moreover, the impact that SARS-CoV-2 had on the placenta has noticed to be still accountable for most of the alterations in CTG. Despite the lack of specificity of CTG alterations in SARS-CoV-2 positive patients, obstetricians are encouraged not to neglect foetal monitoring be-cause of the isolation of positive woman, owing the virus’s harmful effects on placentas and maternal health.