Expectant Management of Severe COVID-19 Pneumonia in Late Preterm Pregnancy and Subsequent Cholecystitis: Lessons Learned.

IF 0.8 Q4 PEDIATRICS AJP Reports Pub Date : 2021-01-01 Epub Date: 2021-02-12 DOI:10.1055/s-0040-1721672
Neggin B Mokhtari, Daphnie Drassinower, Lindsey A Orr, Nathan K Cobb, Oscar L Mims, Helain J Landy
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Abstract

Introduction  Since the emergence of coronavirus disease 2019 (COVID-19) as a pandemic in March 2020, research and guidance have been published with regard to the management of infection and considerations in pregnancy, but much is still unknown. Pregnant women with COVID-19 infection are more likely to be hospitalized and are at increased risk for intensive care unit admissions and intubation than nonpregnant women with COVID-19 infection. The optimal timing of delivery among pregnant women with COVID-19 infection has not been established at this time, especially when the infection arises in late preterm and early term gestation. It is suggested that COVID-19 infection should not be considered a sole indication for delivery. The risks and benefits of prolonging pregnancy versus delivery should be taken into consideration at any given gestational age in a patient with COVID-19 infection. Case Report  We report a case of a patient in the late third trimester of pregnancy that presented with severe COVID-19 infection and was managed expectantly through her disease course with improvement of respiratory status without necessitating delivery. We also discuss the unique development of cholecystitis in her hospitalization that may represent another clinical association to COVID-19 infection. Conclusion  This case illustrates that delaying delivery is an option even in later gestational ages for maternal stabilization. A multidisciplinary approach and teamwork is needed to manage pregnant women with COVID-19 infection for optimal outcomes for both mother and fetus. Key Points Delaying delivery in severe coronavirus disease 2019 (COVID-19) infection is a reasonable option even in late gestation.A multidisciplinary team is of utmost importance when managing a pregnant woman with COVID-19.Other clinical sequalae such as cholecystitis may arise in the setting of COVID-19 infection.

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早孕晚期重症 COVID-19 肺炎及其后胆囊炎的预期管理:经验教训。
导言:自 2020 年 3 月冠状病毒病 2019(COVID-19)作为大流行病出现以来,有关妊娠期感染管理和注意事项的研究和指南相继发布,但仍有许多情况尚不清楚。与感染 COVID-19 的非孕妇相比,感染 COVID-19 的孕妇更有可能住院治疗,入住重症监护室和插管的风险也更高。感染 COVID-19 的孕妇的最佳分娩时间目前尚未确定,尤其是在早产晚期和足月妊娠早期发生感染时。建议不要将 COVID-19 感染作为分娩的唯一指征。对于 COVID-19 感染者,在任何特定孕龄都应考虑延长妊娠期与分娩的风险和益处。病例报告 我们报告了一例妊娠晚期的重度 COVID-19 感染患者,她在整个病程中接受了预期治疗,呼吸状况有所改善,但无需分娩。我们还讨论了她在住院期间出现胆囊炎的独特情况,这可能代表了 COVID-19 感染的另一种临床关联。结论 本病例说明,即使在孕晚期,推迟分娩也是产妇病情稳定的一种选择。在处理 COVID-19 感染孕妇时,需要多学科方法和团队合作,才能为母亲和胎儿带来最佳结果。多学科团队在管理 COVID-19 孕妇时至关重要。
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来源期刊
AJP Reports
AJP Reports PEDIATRICS-
CiteScore
2.20
自引率
0.00%
发文量
30
审稿时长
12 weeks
期刊最新文献
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