COVID-19心脏病孕妇:分娩的挑战

M. Anant, Neeraj Kumar, S. Ahmad
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引用次数: 1

摘要

本病例系列包括4例合并COVID-19疾病的风湿性心脏病妊娠病例,报告了合并COVID-19的心脏病的分娩管理和并发症,重点介绍了症状、严重程度、分娩问题以及与母胎结局的临床管理。在四个足月分娩中,一个是正常分娩,一个是辅助分娩,两个是剖宫产。4例患者产后均需要氧支持,2/4(50%)转入重症监护病房(ICU), 1/4(25%)需要机械通气,1/4(25%)发生产后出血,1/4(25%)发生与COVID相关的脓毒症并接受恢复期血浆治疗,2/4(50%)接受抗病毒瑞德西韦治疗。心脏病合并冠状病毒血症合并先兆子痫患者病情最严重(COVID败血症和ICU住院时间)。所有新生儿检测结果均为SARS-CoV-2阴性,1例新生儿早期死亡。4名母亲出院时病情稳定,心脏状况稳定。与其他感染COVID的妊娠相比,心脏病妊娠中COVID-19的并发症发生率、供氧率和ICU需求均有所增加,需要多学科团队对产时和产后进行密切监测。
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COVID-19 Pregnancies with Heart Disease: Challenges of Delivery
This case series of four cases of pregnancy with rheumatic heart disease with COVD-19 disease reports on the management of delivery and complications of heart disease with COVID-19, high-lighting the presentation, severity, delivery concerns, and clinical management with the maternal and fetal outcomes. Of the four full-term deliveries, one delivered normally, one instrumental delivery and two by cesarean section. All four required oxygen support post-delivery, 2/4 (50%) were transferred for intensive care unit (ICU) care, 1/4 (25%) required mechanical ventilation, 1/4 (25%) had postpartum hemorrhage, 1/4 (25%) had COVID related sepsis and received convalescent plasma therapy, and 2/4 (50%) received antiviral remdesivir. The most severe disease (COVID sepsis and ICU stay) was seen in patient of heart disease with COVID with preclampsia. All neonates tested SARS-CoV-2 negative, with one early neonatal death. All four mothers were discharged in stable condition of COVID and heart status. COVID-19 in cardiac disease pregnancies has increased rates of complications, oxygen, and ICU requirements than other pregnancies with COVID, requiring multidisciplinary team for intensive monitoring of intrapartum and postpartum period.
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