Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Ave No. 1277, Wuhan 430022, China.
Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China.
AJR Am J Roentgenol. 2020 Jul;215(1):127-132. doi: 10.2214/AJR.20.23072. Epub 2020 Mar 18.
The purpose of this study was to describe the clinical manifestations and CT features of coronavirus disease (COVID-19) pneumonia in 15 pregnant women and to provide some initial evidence that can be used for guiding treatment of pregnant women with COVID-19 pneumonia. We reviewed the clinical data and CT examinations of 15 consecutive pregnant women with COVID-19 pneumonia in our hospital from January 20, 2020, to February 10, 2020. A semiquantitative CT scoring system was used to estimate pulmonary involvement and the time course of changes on chest CT. Symptoms and laboratory results were analyzed, treatment experiences were summarized, and clinical outcomes were tracked. Eleven patients had successful delivery (10 cesarean deliveries and one vaginal delivery) during the study period, and four patients were still pregnant (three in the second trimester and one in the third trimester) at the end of the study period. No cases of neonatal asphyxia, neonatal death, stillbirth, or abortion were reported. The most common early finding on chest CT was ground-glass opacity (GGO). With disease progression, crazy paving pattern and consolidations were seen on CT. The abnormalities showed absorptive changes at the end of the study period for all patients. The most common onset symptoms of COVID-19 pneumonia in pregnant women were fever (13/15 patients) and cough (9/15 patients). The most common abnormal laboratory finding was lymphocytopenia (12/15 patients). CT images obtained before and after delivery showed no signs of pneumonia aggravation after delivery. The four patients who were still pregnant at the end of the study period were not treated with antiviral drugs but had achieved good recovery. Pregnancy and childbirth did not aggravate the course of symptoms or CT features of COVID-19 pneumonia. All the cases of COVID-19 pneumonia in the pregnant women in our study were the mild type. All the women in this study-some of whom did not receive antiviral drugs-achieved good recovery from COVID-19 pneumonia.
本研究旨在描述 15 例妊娠合并新型冠状病毒肺炎（COVID-19）患者的临床表现和 CT 特征，为妊娠合并 COVID-19 肺炎的治疗提供初步证据。回顾性分析 2020 年 1 月 20 日至 2 月 10 日我院收治的 15 例妊娠合并 COVID-19 肺炎患者的临床资料和 CT 检查结果，采用半定量 CT 评分系统评估肺部受累情况和胸部 CT 变化时间过程。分析症状和实验室检查结果，总结治疗经验，跟踪临床转归。研究期间 11 例患者分娩（10 例剖宫产，1 例阴道分娩），研究结束时仍有 4 例患者（3 例孕 2 月，1 例孕 3 月）继续妊娠。无新生儿窒息、新生儿死亡、死胎或流产发生。胸部 CT 早期最常见的表现是磨玻璃影（GGO），随着病情进展，出现铺路石征和实变。所有患者在研究结束时病变均有吸收性改变。妊娠合并 COVID-19 肺炎患者最常见的首发症状是发热（13/15 例）和咳嗽（9/15 例），最常见的实验室异常是淋巴细胞减少（12/15 例）。分娩前后 CT 图像显示分娩后肺炎无加重迹象。研究结束时仍有 4 例继续妊娠的患者未接受抗病毒治疗，但已恢复良好。妊娠和分娩并未加重 COVID-19 肺炎的症状或 CT 特征。本研究中所有妊娠合并 COVID-19 肺炎患者均为轻症，所有患者（部分未接受抗病毒治疗）均从 COVID-19 肺炎中恢复良好。
