Ryan Gillian A, Purandare Nikhil C, McAuliffe Fionnuala M, Hod Moshe, Purandare Chittaranjan N
Department of Obstetrics and Gynaecology, The National Maternity Hospital, Dublin, Ireland.
Department of Obstetrics and Gynaecology, University Hospital Galway, Galway, Ireland.
J Obstet Gynaecol Res. 2020 Aug;46(8):1235-1245. doi: 10.1111/jog.14321. Epub 2020 Jun 4.
The data pertaining to the COVID-19 pandemic has been rapidly evolving since the first confirmed case in December 2019. This review article presents a comprehensive analysis of the current data in relation to COVID-19 and its effect on pregnant women, including symptoms, disease severity and the risk of vertical transmission. We also review the recommended management of pregnant women with suspected or confirmed COVID-19 and the various pharmacological agents that are being investigated and may have a role in the treatment of this disease. At present, it does not appear that pregnant women are at increased risk of severe infection than the general population, although there are vulnerable groups within both the pregnant and nonpregnant populations, and clinicians should be cognizant of these high-risk groups and manage them accordingly. Approximately 85% of women will experience mild disease, 10% more severe disease and 5% critical disease. The most common reported symptoms are fever, cough, shortness of breath and diarrhea. Neither vaginal delivery nor cesarean section confers additional risks, and there is minimal risk of vertical transmission to the neonate from either mode of delivery. We acknowledge that the true effect of the virus on both maternal and fetal morbidity and mortality will only be evident over time. We also discuss the impact of social isolation can have on the mental health and well-being of both patients and colleagues, and as clinicians, we must be mindful of this and offer support as necessary.
自2019年12月首例确诊病例以来，与新冠疫情相关的数据一直在迅速演变。这篇综述文章对当前与新冠病毒及其对孕妇的影响相关的数据进行了全面分析，包括症状、疾病严重程度和垂直传播风险。我们还回顾了对疑似或确诊新冠病毒感染孕妇的推荐管理方法，以及正在研究的、可能在治疗该疾病中发挥作用的各种药物。目前，孕妇似乎并不比普通人群有更高的严重感染风险，尽管孕妇和非孕妇群体中都有弱势群体，临床医生应该认识到这些高危群体并相应地进行管理。大约85%的女性会经历轻症，10%会经历重症，5%会经历危重症。报告的最常见症状是发热、咳嗽、呼吸急促和腹泻。阴道分娩和剖宫产都不会带来额外风险，两种分娩方式对新生儿的垂直传播风险都极小。我们承认，病毒对孕产妇和胎儿发病率及死亡率的真正影响只有随着时间推移才会显现出来。我们还讨论了社会隔离对患者和同事心理健康及幸福感的影响，作为临床医生，我们必须意识到这一点并在必要时提供支持。
