Pub Date : 2020-04-27DOI: 10.3760/CMA.J.CN113903-20200403-00311
Chao Tong, Lin Wang, Yalan Liu, Jing Tan, Qiong Li, Yan Chen
We report a female infant born preterm to a woman at 35 gestational weeks and four days in a normal pregnancy prior to delivery, with normal liquor volume and good maternal and infant outcomes. The baby was transferred to the neonatal department 30 min after birth at Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, on March 21, 2020. The infant weighed 2 800 g with 7 and 9 Apgar scores respectively at 1 and 5 min. The mother had been diagnosed with COVID-19 at 26+6 weeks of pregnancy and the maternal serum level of IgM was negative and that of IgG was 20.77 AU/ml (normal reference <10 AU/ml) before delivery. The baby had hypoglycemia on admission, and the blood sugar stabilized after treatment. Though early mild feeding intolerance occurred, the baby was able to feed normal by eight days after birth. The baby was in good condition during hospitalization and discharged. Throat swab specimens obtained from the infant on the 2nd, 3rd and 8th day after birth for SARS-Cov-2 RNA detection were all negative. On the 2nd and 8th day after birth, SARS-Cov-2 IgM in the neonatal serum were negative, while elevated IgG levels of 30.2 AU/ml and 25.3 AU/ml (normal reference value <10 AU/ml) were observed, suggesting that the infant's IgG antibody of SARS-CoV-2 may have come from the mother. According to this case report, no intrauterine vertical transmission was found in the pregnancy with SARS-CoV-2 infection in the second trimester, while further follow-up is still needed. Key words: Coronavirus infections; Pregnancy complications, infectious; Infectious disease transmission, vertical; Infant, premature; Pregnancy trimester, second
{"title":"Premature infant born to a convalescent mother with COVID-19 in mid-term pregnancy","authors":"Chao Tong, Lin Wang, Yalan Liu, Jing Tan, Qiong Li, Yan Chen","doi":"10.3760/CMA.J.CN113903-20200403-00311","DOIUrl":"https://doi.org/10.3760/CMA.J.CN113903-20200403-00311","url":null,"abstract":"We report a female infant born preterm to a woman at 35 gestational weeks and four days in a normal pregnancy prior to delivery, with normal liquor volume and good maternal and infant outcomes. The baby was transferred to the neonatal department 30 min after birth at Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, on March 21, 2020. The infant weighed 2 800 g with 7 and 9 Apgar scores respectively at 1 and 5 min. The mother had been diagnosed with COVID-19 at 26+6 weeks of pregnancy and the maternal serum level of IgM was negative and that of IgG was 20.77 AU/ml (normal reference <10 AU/ml) before delivery. The baby had hypoglycemia on admission, and the blood sugar stabilized after treatment. Though early mild feeding intolerance occurred, the baby was able to feed normal by eight days after birth. The baby was in good condition during hospitalization and discharged. Throat swab specimens obtained from the infant on the 2nd, 3rd and 8th day after birth for SARS-Cov-2 RNA detection were all negative. On the 2nd and 8th day after birth, SARS-Cov-2 IgM in the neonatal serum were negative, while elevated IgG levels of 30.2 AU/ml and 25.3 AU/ml (normal reference value <10 AU/ml) were observed, suggesting that the infant's IgG antibody of SARS-CoV-2 may have come from the mother. According to this case report, no intrauterine vertical transmission was found in the pregnancy with SARS-CoV-2 infection in the second trimester, while further follow-up is still needed. \u0000 \u0000Key words: \u0000Coronavirus infections; Pregnancy complications, infectious; Infectious disease transmission, vertical; Infant, premature; Pregnancy trimester, second","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"23 1","pages":"321-323"},"PeriodicalIF":0.0,"publicationDate":"2020-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44429176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-15DOI: 10.3760/CMA.J.CN113903-20200402-00301
Chen Wang, Yihua Zhou, Huixia Yang
Whether 2019 novel coronavirus can be vertically transmitted to fetuses is a major concern, while how to obtain evidence of vertical transmission in viral infected pregnant women is the key. Virological and serological evidence is valuable to clarify this issue. However, longitudinal follow-up of infants for at least 3-6 months after birth and dynamic changes of specific antibodies of the mothers is essential when serological results are used to confirm or exclude vertical transmission. Key words: Coronavirus infections; Infectious disease transmission, vertical; Immunoglobulin M; Immunoglobulin G
{"title":"How to obtain evidence of vertical transmission of coronavirus according to serological test of specific IgM and IgG antibodies","authors":"Chen Wang, Yihua Zhou, Huixia Yang","doi":"10.3760/CMA.J.CN113903-20200402-00301","DOIUrl":"https://doi.org/10.3760/CMA.J.CN113903-20200402-00301","url":null,"abstract":"Whether 2019 novel coronavirus can be vertically transmitted to fetuses is a major concern, while how to obtain evidence of vertical transmission in viral infected pregnant women is the key. Virological and serological evidence is valuable to clarify this issue. However, longitudinal follow-up of infants for at least 3-6 months after birth and dynamic changes of specific antibodies of the mothers is essential when serological results are used to confirm or exclude vertical transmission. \u0000 \u0000Key words: \u0000Coronavirus infections; Infectious disease transmission, vertical; Immunoglobulin M; Immunoglobulin G","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70010932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We present a case report of a healthy neonate born by vaginal delivery to a woman who had recovered from COVID-19 after 37 days of discharge. The pregnant woman had fever, cough, and chills at 33+1 gestational weeks and was diagnosed with COVID-19 by coronavirus nucleic acid test one day later. She recovered and was discharged after a series of treatments, and the 2019 novel coronavirus nucleic acid test was negative and pulmonary CT was normal at the 2nd and 4th week after being discharged. The patient was admitted due to threatened labor at 38+4 gestational weeks and delivered a healthy newborn vaginally on that day. Both the mother and the baby were in good condition. All the maternal or neonatal specimens taken in the delivery room for 2019 novel coronavirus nucleic acid tests were negative, including the maternal pharynx, rectal and cervical secretions before delivery, amniotic fluid, and colostrum neonatal pharynx and rectal swabs after birth. The qualitative examination of 2019 novel coronavirus antibodies in the maternal venous blood test before delivery showed that both IgG and IgM were positive. While the same test for neonatal cord blood and femoral vein blood showed negative results. No inflammatory reaction was found in the placenta and immunohistochemistry detection of novel coronavirus N protein was negative. The mother and newborn were observed and treated postnatally in the same ward; neither of them had fever, cough, or fatigue, and were discharged three days after delivery. The qualitative examination of 2019 novel coronavirus antibodies (IgM and IgG) in the femoral vein blood of the neonate at 27 days old showed negative results. Key words: Coronavirus infections; Pregnancy complications, infectious; Parturition
{"title":"Vaginal delivery after 37 days of a convalescent pregnant woman with COVID-19: a case report/ 中华围产医学杂志","authors":"X. Xiong, Qiumei Pang, Hong Wei, Xiaopeng Ma, Zhihong Zhang, Xiang Gao","doi":"10.3760/CMA.J.CN113903-20200321-00254","DOIUrl":"https://doi.org/10.3760/CMA.J.CN113903-20200321-00254","url":null,"abstract":"We present a case report of a healthy neonate born by vaginal delivery to a woman who had recovered from COVID-19 after 37 days of discharge. The pregnant woman had fever, cough, and chills at 33+1 gestational weeks and was diagnosed with COVID-19 by coronavirus nucleic acid test one day later. She recovered and was discharged after a series of treatments, and the 2019 novel coronavirus nucleic acid test was negative and pulmonary CT was normal at the 2nd and 4th week after being discharged. The patient was admitted due to threatened labor at 38+4 gestational weeks and delivered a healthy newborn vaginally on that day. Both the mother and the baby were in good condition. All the maternal or neonatal specimens taken in the delivery room for 2019 novel coronavirus nucleic acid tests were negative, including the maternal pharynx, rectal and cervical secretions before delivery, amniotic fluid, and colostrum neonatal pharynx and rectal swabs after birth. The qualitative examination of 2019 novel coronavirus antibodies in the maternal venous blood test before delivery showed that both IgG and IgM were positive. While the same test for neonatal cord blood and femoral vein blood showed negative results. No inflammatory reaction was found in the placenta and immunohistochemistry detection of novel coronavirus N protein was negative. The mother and newborn were observed and treated postnatally in the same ward; neither of them had fever, cough, or fatigue, and were discharged three days after delivery. The qualitative examination of 2019 novel coronavirus antibodies (IgM and IgG) in the femoral vein blood of the neonate at 27 days old showed negative results. \u0000 \u0000Key words: \u0000Coronavirus infections; Pregnancy complications, infectious; Parturition","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"23 1","pages":"280-282"},"PeriodicalIF":0.0,"publicationDate":"2020-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49392816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-17DOI: 10.3760/CMA.J.CN113903-20200228-00171
Shu-min He, Dongna Wang, Rui Chi, D. Ding, Yanping Yu, M. He, Weidong Li, Chunxin Chi, M. Shi
We report a critically ill pregnant woman in the third trimester with severe pneumonia due to COVID-19 who presented to Xiaolan People's Hospital of Zhongshan in February 2020. The 32-year-old patient was admitted at 35+2 gestational weeks with a 4-day history of a sore throat and a fever for three hours. The patient had been to Xiaogan City, Hubei Province, and the symptoms occurred during a period of self-isolation after back home. The condition of the patient deteriorated rapidly, with left-sided chest and back pain, shortness of breath, dizziness, progressing to respiratory failure and septic shock 7 hours after her admission. In view of her critical condition and a history of two previous cesarean sections, an emergency cesarean section was performed. Blood gas analysis of the mother before the operation suggested respiratory failure, respiratory acidosis, and metabolic acidosis. During the operation, a baby boy was born. The Apgar score of the boy, birth weight of 2 700 g, was one at 1, 5 and 10 minutes despite the resuscitation efforts. The neonate died after withdrawing treatment. The patient was treated with tracheal intubation ventilator and other supportive treatments after the operation. The result of the new coronavirus nucleic acid test, taken on admission, but which was reported after delivery, was positive. The patient was transferred to the designated hospital for further treatment and was recovering with the withdrawal of extracorporeal membrane oxygenation and ventilation support at 26 and 36 days after surgery, respectively. Key words: Pregnancy complications, infectious; Coronavirus; Pneumonia, viral; Pregnancy trimester, third; Perinatal death
{"title":"Death of a neonate born to a critically ill mother with COVID-19: a case report","authors":"Shu-min He, Dongna Wang, Rui Chi, D. Ding, Yanping Yu, M. He, Weidong Li, Chunxin Chi, M. Shi","doi":"10.3760/CMA.J.CN113903-20200228-00171","DOIUrl":"https://doi.org/10.3760/CMA.J.CN113903-20200228-00171","url":null,"abstract":"We report a critically ill pregnant woman in the third trimester with severe pneumonia due to COVID-19 who presented to Xiaolan People's Hospital of Zhongshan in February 2020. The 32-year-old patient was admitted at 35+2 gestational weeks with a 4-day history of a sore throat and a fever for three hours. The patient had been to Xiaogan City, Hubei Province, and the symptoms occurred during a period of self-isolation after back home. The condition of the patient deteriorated rapidly, with left-sided chest and back pain, shortness of breath, dizziness, progressing to respiratory failure and septic shock 7 hours after her admission. In view of her critical condition and a history of two previous cesarean sections, an emergency cesarean section was performed. Blood gas analysis of the mother before the operation suggested respiratory failure, respiratory acidosis, and metabolic acidosis. During the operation, a baby boy was born. The Apgar score of the boy, birth weight of 2 700 g, was one at 1, 5 and 10 minutes despite the resuscitation efforts. The neonate died after withdrawing treatment. The patient was treated with tracheal intubation ventilator and other supportive treatments after the operation. The result of the new coronavirus nucleic acid test, taken on admission, but which was reported after delivery, was positive. The patient was transferred to the designated hospital for further treatment and was recovering with the withdrawal of extracorporeal membrane oxygenation and ventilation support at 26 and 36 days after surgery, respectively. \u0000 \u0000Key words: \u0000Pregnancy complications, infectious; Coronavirus; Pneumonia, viral; Pregnancy trimester, third; Perinatal death","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45222793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-06DOI: 10.3760/CMA.J.CN113903-20200304-00192
Xue-lian Gao, Yihua Zhou, Huixia Yang
During the COVID-19 epidemic, there have been many misconceptions concerning vertical transmission between the mother and fetus/baby, which has caused much discussion and controversy. However, there is no strong evidence to indicate that this novel coronavirus could be vertically transmitted from infected mothers to their fetuses/infants. Several easily confused concepts are clarified in this paper, including vertical transmission, intrauterine transmission, mother-to-infant transmission, intrapartum or postpartum transmission. Well-designed protocols and a disciplined research team are essential for both basic and clinical research, in order to contribute to obtaining more scientific evidence for better understanding of the characteristics of this novel coronavirus. Proper handling and disposal of the body fluids and tissue are critical for safety. We highlight the significant value of relevant research, and suggest future research directions, such as investigating the impact of COVID-19 in different trimesters. Furthermore, China has the most experience of treating pregnant women exposed to the COVID-19 virus, and it would be a great service to the rest of the world, for all centers in China to collaborate to report this collective experience. Key words: Pregnancy complications, infectious; Coronavirus infections; COVID-19; Infectious disease transmission, vertical
{"title":"How to obtain evidence of vertical transmission in viral infected pregnant women: Reflection on COVID-19 epidemic/ 中华围产医学杂志","authors":"Xue-lian Gao, Yihua Zhou, Huixia Yang","doi":"10.3760/CMA.J.CN113903-20200304-00192","DOIUrl":"https://doi.org/10.3760/CMA.J.CN113903-20200304-00192","url":null,"abstract":"During the COVID-19 epidemic, there have been many misconceptions concerning vertical transmission between the mother and fetus/baby, which has caused much discussion and controversy. However, there is no strong evidence to indicate that this novel coronavirus could be vertically transmitted from infected mothers to their fetuses/infants. Several easily confused concepts are clarified in this paper, including vertical transmission, intrauterine transmission, mother-to-infant transmission, intrapartum or postpartum transmission. Well-designed protocols and a disciplined research team are essential for both basic and clinical research, in order to contribute to obtaining more scientific evidence for better understanding of the characteristics of this novel coronavirus. Proper handling and disposal of the body fluids and tissue are critical for safety. We highlight the significant value of relevant research, and suggest future research directions, such as investigating the impact of COVID-19 in different trimesters. Furthermore, China has the most experience of treating pregnant women exposed to the COVID-19 virus, and it would be a great service to the rest of the world, for all centers in China to collaborate to report this collective experience. \u0000 \u0000Key words: \u0000Pregnancy complications, infectious; Coronavirus infections; COVID-19; Infectious disease transmission, vertical","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"23 1","pages":"145-148"},"PeriodicalIF":0.0,"publicationDate":"2020-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44442209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-04DOI: 10.3760/CMA.J.CN113903-20200220-00134
Ren-bin Zhou, Yixiang Chen, Chuang-xing Lin, Heida Li, Xiao-ying Cai, Zhi-wei Cai, G. Lin
We report a case of maternal asymptomatic COVID-19 in a patient with typical CT image of pneumonia in the third trimester, and both the mother and baby were well. The patient, a 30-year-old female, was transferred to Yichun People's Hospital at 37+3 gestational weeks because of a positive 2019 novel coronavirus nucleic acid result over seven hours. Her husband and mother-in-law were diagnosed with COVID-19 eight days before her admission and on the same day, respectively. The patient reported no discomfort before admission, and there were no abnormalities in the prenatal course during her pregnancy. On February 13 (the second day of admission), a patchy blurred shadow was observed in the lower lobe of the right lung in chest CT scan, and a live baby girl was delivered by a precaution-based emergent cesarean section because of suspected fetal distress shown in electrical fetal heart monitoring. Both the mother and the newborn were isolated separately after the operation without etiological examination of amniotic fluid, umbilical cord blood, placenta, etc. All the medical staff involved in the cesarean section were isolated as well. The mother was healthy and remained asymptomatic after delivery, while antiviral and anti-inflammatory treatment was offered. COVID-19 nucleic acid tests of pharyngeal swab were negative on the 4th and 6th day after operation. Chest CT on the 5th day after delivery showed inflammation in the lower lobe of the right lung, and reexamination on the 8th day showed a slight absorption of the inflammation. Samples of peripheral blood and pharynx swab were obtained from the newborn on the day of birth and four and seven days after birth and novel coronavirus nucleic acid test were all negative. The mother and baby dyad were discharged nine days after operation. And novel coronavirus nucleic acid tests were all negative in all medical staff involved. Key words: Coronavirus; Coronavirus infections; COVID-19; Pregnancy complications, infectious
{"title":"Asymptomatic COVID-19 in pregnant woman with typical chest CT manifestation: a case report/ 中华围产医学杂志","authors":"Ren-bin Zhou, Yixiang Chen, Chuang-xing Lin, Heida Li, Xiao-ying Cai, Zhi-wei Cai, G. Lin","doi":"10.3760/CMA.J.CN113903-20200220-00134","DOIUrl":"https://doi.org/10.3760/CMA.J.CN113903-20200220-00134","url":null,"abstract":"We report a case of maternal asymptomatic COVID-19 in a patient with typical CT image of pneumonia in the third trimester, and both the mother and baby were well. The patient, a 30-year-old female, was transferred to Yichun People's Hospital at 37+3 gestational weeks because of a positive 2019 novel coronavirus nucleic acid result over seven hours. Her husband and mother-in-law were diagnosed with COVID-19 eight days before her admission and on the same day, respectively. The patient reported no discomfort before admission, and there were no abnormalities in the prenatal course during her pregnancy. On February 13 (the second day of admission), a patchy blurred shadow was observed in the lower lobe of the right lung in chest CT scan, and a live baby girl was delivered by a precaution-based emergent cesarean section because of suspected fetal distress shown in electrical fetal heart monitoring. Both the mother and the newborn were isolated separately after the operation without etiological examination of amniotic fluid, umbilical cord blood, placenta, etc. All the medical staff involved in the cesarean section were isolated as well. The mother was healthy and remained asymptomatic after delivery, while antiviral and anti-inflammatory treatment was offered. COVID-19 nucleic acid tests of pharyngeal swab were negative on the 4th and 6th day after operation. Chest CT on the 5th day after delivery showed inflammation in the lower lobe of the right lung, and reexamination on the 8th day showed a slight absorption of the inflammation. Samples of peripheral blood and pharynx swab were obtained from the newborn on the day of birth and four and seven days after birth and novel coronavirus nucleic acid test were all negative. The mother and baby dyad were discharged nine days after operation. And novel coronavirus nucleic acid tests were all negative in all medical staff involved. \u0000 \u0000 \u0000Key words: \u0000Coronavirus; Coronavirus infections; COVID-19; Pregnancy complications, infectious","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47862378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-02DOI: 10.3760/CMA.J.CN113903-20200216-00117
Di Lei, Chen Wang, Chunyan Li, Congcong Fang, Wenbing Yang, Biheng Chen, M. Wei, Xiaoyu Xu, Huixia Yang, Suqing Wang, Cuifang Fan
Objective To evaluate the clinical characteristics and pregnant outcomes of gravidae with COVID-19. Methods This study involved nine gravidae with COVID-19 admitted to the Renmin Hospital of Wuhan University from January 22 to February 1, 2020. Their clinical data, including epidemiological history, clinical symptoms, laboratory examinations, chest CT, treatment, delivery mode, and pregnancy outcomes, were analyzed retrospectively. Specimens of maternal vaginal swab were collected in six pregnant women, and the specimens of amniotic fluid, cord blood, neonatal throat swab and breast milk samples were collected in four pregnant women who had a delivery during our study. All samples were tested for the existence of COVID-19. Descriptive analysis was applied in this study. Results (1) Among the nine cases, five were admitted in the third trimester and four in the second trimester. The median incubation period of COVID-19 was 8 (1-14) d. Fever was presented in all cases on admission, and the other commonly seen symptoms were cough (seven cases) and diarrhea (five cases). Other signs and symptoms were also reported, including shortness of breath, myalgia and fatigue (four cases in each), nasal obstruction, pharyngalgia, chest pain, and headache/dizziness (three cases in each), rash (two cases), and chills and expectoration (one case in each). The most common laboratory abnormalities were a decreased number of lymphocytes (seven cases) and elevated C-reactive protein (six cases). Chest CT scans were performed in seven women, and all showed patchy areas or ground-glass opacity in both lungs. Oligohydramnios was detected in only one case at 37+5 weeks, which was 7 d after the diagnosis of COVID-19. (2) All nine cases received empiric antibiotic and antiviral therapy with Chinese medicine as adjuvant treatment. Eight patients required oxygen inhalation, and eight were treated with glucocorticoid. Six cases received immunotherapy. (3) Four of the nine cases had delivered, including three cesarean sections and one spontaneous vaginal preterm birth after premature rupture of membranes, and the mother was transferred to the intensive care unit 2 d after delivery due to acute respiratory distress syndrome. One case was terminated at 26 gestational weeks. Of the four neonates, there were two term and two premature babies, and one preterm baby was small-for-gestational-age. No neonatal asphyxia was observed. Serial real-time quantitative reverse transcription-polymerase chain reaction showed negative results in the detection of 2019-novel coronavirus in all samples obtained from amniotic fluid, umbilical cord blood, neonatal nasopharynx, breast milk, and vagina. Maternal conditions were all stable in all cases, including the four continuing pregnancy, and the terminated ones, except the case mentioned above. Conclusions There is no distinguishable clinical feature between pregnant and non-pregnant COVID-19 patients. So far, there is no evidenc
{"title":"Clinical characteristics of COVID-19 in pregnancy: analysis of nine cases","authors":"Di Lei, Chen Wang, Chunyan Li, Congcong Fang, Wenbing Yang, Biheng Chen, M. Wei, Xiaoyu Xu, Huixia Yang, Suqing Wang, Cuifang Fan","doi":"10.3760/CMA.J.CN113903-20200216-00117","DOIUrl":"https://doi.org/10.3760/CMA.J.CN113903-20200216-00117","url":null,"abstract":"Objective \u0000To evaluate the clinical characteristics and pregnant outcomes of gravidae with COVID-19. \u0000 \u0000 \u0000Methods \u0000This study involved nine gravidae with COVID-19 admitted to the Renmin Hospital of Wuhan University from January 22 to February 1, 2020. Their clinical data, including epidemiological history, clinical symptoms, laboratory examinations, chest CT, treatment, delivery mode, and pregnancy outcomes, were analyzed retrospectively. Specimens of maternal vaginal swab were collected in six pregnant women, and the specimens of amniotic fluid, cord blood, neonatal throat swab and breast milk samples were collected in four pregnant women who had a delivery during our study. All samples were tested for the existence of COVID-19. Descriptive analysis was applied in this study. \u0000 \u0000 \u0000Results \u0000(1) Among the nine cases, five were admitted in the third trimester and four in the second trimester. The median incubation period of COVID-19 was 8 (1-14) d. Fever was presented in all cases on admission, and the other commonly seen symptoms were cough (seven cases) and diarrhea (five cases). Other signs and symptoms were also reported, including shortness of breath, myalgia and fatigue (four cases in each), nasal obstruction, pharyngalgia, chest pain, and headache/dizziness (three cases in each), rash (two cases), and chills and expectoration (one case in each). The most common laboratory abnormalities were a decreased number of lymphocytes (seven cases) and elevated C-reactive protein (six cases). Chest CT scans were performed in seven women, and all showed patchy areas or ground-glass opacity in both lungs. Oligohydramnios was detected in only one case at 37+5 weeks, which was 7 d after the diagnosis of COVID-19. (2) All nine cases received empiric antibiotic and antiviral therapy with Chinese medicine as adjuvant treatment. Eight patients required oxygen inhalation, and eight were treated with glucocorticoid. Six cases received immunotherapy. (3) Four of the nine cases had delivered, including three cesarean sections and one spontaneous vaginal preterm birth after premature rupture of membranes, and the mother was transferred to the intensive care unit 2 d after delivery due to acute respiratory distress syndrome. One case was terminated at 26 gestational weeks. Of the four neonates, there were two term and two premature babies, and one preterm baby was small-for-gestational-age. No neonatal asphyxia was observed. Serial real-time quantitative reverse transcription-polymerase chain reaction showed negative results in the detection of 2019-novel coronavirus in all samples obtained from amniotic fluid, umbilical cord blood, neonatal nasopharynx, breast milk, and vagina. Maternal conditions were all stable in all cases, including the four continuing pregnancy, and the terminated ones, except the case mentioned above. \u0000 \u0000 \u0000Conclusions \u0000There is no distinguishable clinical feature between pregnant and non-pregnant COVID-19 patients. So far, there is no evidenc","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"23 1","pages":"225-231"},"PeriodicalIF":0.0,"publicationDate":"2020-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41664907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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