Materno-Fetal and Obstetrics Research Unit, Department of Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland.
Center for Research and Innovation in Clinical Pharmaceutical Sciences, Institute of Pharmaceutical Sciences of Western Switzerland, Lausanne University Hospital and University of Lausanne, University of Geneva, Geneva, Switzerland.
Prenat Diagn. 2020 Dec;40(13):1641-1654. doi: 10.1002/pd.5759. Epub 2020 Jul 8.
Since December 2019, the novel SARS-CoV-2 outbreak has resulted in millions of cases and more than 200 000 deaths worldwide. The clinical course among nonpregnant women has been described, but data about potential risks for women and their fetus remain scarce. The SARS and MERS epidemics were responsible for miscarriages, adverse fetal and neonatal outcomes, and maternal deaths. For COVID-19 infection, only nine cases of maternal death have been reported as of 22 April 2020, and pregnant women seem to develop the same clinical presentation as the general population. However, severe maternal cases, as well as prematurity, fetal distress, and stillbirth among newborns have been reported. The SARS-CoV-2 pandemic greatly impacts prenatal management and surveillance and raise the need for clear unanimous guidelines. In this narrative review, we describe the current knowledge about coronaviruses (SARS, MERS, and SARS-CoV-2) risks and consequences on pregnancies, and we summarize available current candidate therapeutic options for pregnant women. Finally, we compare current guidance proposed by The Royal College of Obstetricians and Gynaecologists, The American College of Obstetricians and Gynecologists, and the World Health Organization to give an overview of prenatal management which should be utilized until future data appear.
自 2019 年 12 月以来，新型 SARS-CoV-2 爆发导致了数百万人患病，全球有 20 多万人死亡。非孕妇的临床病程已有描述，但有关妇女及其胎儿潜在风险的数据仍然很少。SARS 和 MERS 疫情导致了流产、胎儿和新生儿不良结局以及孕产妇死亡。截至 2020 年 4 月 22 日，COVID-19 感染报告的孕产妇死亡病例仅有 9 例，且孕妇的临床表现似乎与一般人群相同。然而，严重的孕产妇病例，以及早产儿、胎儿窘迫和新生儿死产的报道已有出现。SARS-CoV-2 大流行极大地影响了产前管理和监测，并提出了对明确一致的指导方针的需求。在这篇叙述性综述中，我们描述了目前关于冠状病毒（SARS、MERS 和 SARS-CoV-2）对妊娠的风险和影响的知识，并总结了目前可用于孕妇的候选治疗方案。最后，我们比较了英国皇家妇产科医师学院、美国妇产科医师学会和世界卫生组织提出的当前指南，以概述在出现新数据之前应采用的产前管理方法。
