Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, and the Division of Surgical Critical Care, Department of Anesthesiology, the University of Texas Medical Branch at Galveston, Galveston, Texas; and the Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, United Kingdom.
Obstet Gynecol. 2020 Oct;136(4):823-826. doi: 10.1097/AOG.0000000000004103.
Recent evidence supports the use of an early, short course of glucocorticoids in patients with COVID-19 who require mechanical ventilation or oxygen support. As the number of coronavirus disease 2019 (COVID-19) cases continues to increase, the number of pregnant women with the disease is very likely to increase as well. Because pregnant women are at increased risk for hospitalization, intensive care unit admission, and mechanical ventilation support, obstetricians will be facing the dilemma of initiating maternal corticosteroid therapy while weighing its potential adverse effects on the fetus (or neonate if the patient is postpartum and breastfeeding). Our objective is to summarize the current evidence supporting steroid therapy in the management of patients with acute respiratory distress syndrome and COVID-19 and to elaborate on key modifications for the pregnant patient.
最近的证据支持对需要机械通气或氧疗的 COVID-19 患者使用早期、短程糖皮质激素。随着 2019 年冠状病毒病（COVID-19）病例数量的持续增加，患有该病的孕妇数量很可能也会增加。由于孕妇住院、入住重症监护病房和接受机械通气支持的风险增加，因此产科医生将面临两难境地，即启动母亲皮质激素治疗，同时权衡其对胎儿（或如果患者产后正在哺乳，则为新生儿）的潜在不良影响。我们的目的是总结目前支持类固醇治疗急性呼吸窘迫综合征和 COVID-19 患者的证据，并详细阐述针对孕妇的关键修改。
