Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Newark Beth Israel Medical Center, Newark, New Jersey.
Am J Obstet Gynecol MFM. 2020 May;2(2):100113. doi: 10.1016/j.ajogmf.2020.100113. Epub 2020 Apr 3.
At our institution, 2 of the initial 7 pregnant patients with confirmed coronavirus disease 2019 severe infection (28.6%; 95% CI, 8.2%-64.1%) developed cardiac dysfunction with moderately reduced left ventricular ejection fractions of 40%-45% and hypokinesis. Viral myocarditis and cardiomyopathy have also been reported in nonpregnant coronavirus disease 2019 patients. A case series of nonpregnant patients with coronavirus disease 2019 found that 33% of those in intensive care developed cardiomyopathy. More data are needed to ascertain the incidence of cardiomyopathy from coronavirus disease 2019 in pregnancy, in all pregnant women with coronavirus disease 2019, and those with severe disease (eg, pneumonia). We suggest an echocardiogram in pregnant women with coronavirus disease 2019 pneumonia, in particular those necessitating oxygen, or those who are critically ill, and we recommend the use of handheld, point-of-care devices where possible to minimize contamination of staff and traditional large echocardiogram machines.
在我们的机构中，最初的 7 名确诊为 2019 年冠状病毒病重症感染的孕妇中有 2 名（28.6%；95%置信区间，8.2%-64.1%）出现了心功能障碍，左心室射血分数中度降低至 40%-45%，且出现运动不能。在非妊娠的 2019 年冠状病毒病患者中也有病毒性心肌炎和心肌病的报道。一项非妊娠 2019 年冠状病毒病患者的病例系列研究发现，33%的重症监护患者发生了心肌病。需要更多的数据来确定在妊娠期间、所有患有 2019 年冠状病毒病的孕妇以及患有严重疾病（例如肺炎）的孕妇中，2019 年冠状病毒病导致心肌病的发生率。我们建议对患有 2019 年冠状病毒病肺炎的孕妇进行超声心动图检查，特别是那些需要吸氧或病情危急的孕妇，我们建议尽可能使用手持式即时检测设备，以最大程度减少医护人员和传统大型超声心动图机器的污染。
