Sinkey Rachel G, Rajapreyar Indranee, Robbins Lindsay S, Dionne-Odom Jodie, Pogwizd Steven M, Casey Brian M, Tita Alan T N
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama.
Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama.
AJP Rep. 2020 Apr;10(2):e165-e168. doi: 10.1055/s-0040-1712926. Epub 2020 Jun 4.
Our understanding of COVID-19 in pregnant and postpartum women is rapidly evolving. We present a case from March 2020 of a 25-year-old G2P2002 whose delivery was complicated by preeclampsia with severe features who presented to the emergency department 9 days after cesarean delivery with chest tightness and dyspnea on exertion. On presentation she had severe hypertension, pulmonary edema, elevated brain natriuretic peptide, and high-sensitivity troponin-I, suggesting a diagnosis of hypertensive emergency leading to heart failure with a preserved ejection fraction resulting in pulmonary edema and abnormal cardiac screening tests. However, bilateral opacities were seen on a computed tomography of the chest, and COVID-19 testing was positive. A high index of suspicion for both COVID-19 and cardiovascular complications are critical for optimal patient outcomes and protection of health care workers.
我们对孕妇和产后女性感染新冠病毒的认识正在迅速发展。我们呈现一个2020年3月的病例，一名25岁、孕2产2002的女性，其分娩因重度子痫前期而复杂化，剖宫产术后9天因活动时胸闷和呼吸困难就诊于急诊科。就诊时她有重度高血压、肺水肿、脑钠肽升高和高敏肌钙蛋白I升高，提示诊断为高血压急症导致射血分数保留的心力衰竭，进而引起肺水肿和心脏筛查检查异常。然而，胸部计算机断层扫描显示双侧混浊，新冠病毒检测呈阳性。对新冠病毒和心血管并发症保持高度怀疑指数对于实现最佳患者预后和保护医护人员至关重要。
