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严重急性呼吸综合征冠状病毒2与妊娠:事实综述

SARS-CoV-2 and Pregnancy: A Review of the Facts.

作者信息

Czeresnia Ricardo Mamber, Trad Ayssa Teles Abrao, Britto Ingrid Schwach Werneck, Negrini Romulo, Nomura Marcelo Luís, Pires Pedro, Costa Fabricio da Silva, Nomura Roseli Mieko Yamamoto, Ruano Rodrigo

机构信息

Faculty of Medical Sciences, Santa Casa de São Paulo, São Paulo, SP, Brazil.

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Mayo Clinic College of Medicine, Rochester, MN, United States.

出版信息

Rev Bras Ginecol Obstet. 2020 Sep;42(9):562-568. doi: 10.1055/s-0040-1715137. Epub 2020 Sep 29.

Abstract

OBJECTIVE

The present comprehensive review aims to show the full extent of what is known to date and provide a more thorough view on the effects of SARS-CoV2 in pregnancy.

METHODS

Between March 29 and May, 2020, the words , , , , and were searched in the PubMed and Google Scholar databases; the guidelines from well-known societies and institutions (Royal College of Obstetricians and Gynaecologists [RCOG], American College of Obstetricians and Gynecologists [ACOG], International Society of Ultrasound in Obstetrics & Gynecology [ISUOG], Centers for Disease Control and Prevention [CDC], International Federation of Gynecology and Obstetrics [FIGO]) were also included.

CONCLUSION

The COVID-19 outbreak resulted in a pandemic with > 3.3 million cases and 230 thousand deaths until May 2. It is caused by the SARS-CoV2 virus and may lead to severe pulmonary infection and multi-organ failure. Past experiences show that unique characteristics in pregnancy make pregnant women more susceptible to complications from viral infections. Yet, this has not been reported with this new virus. There are risk factors that seem to increase morbidity in pregnancy, such as obesity (body mass index [BMI] > 35), asthma and cardiovascular disease. Current reports describe an increased rate of preterm birth and C-section. Vertical transmission is still a possibility, due to a few reported cases of neonatal positive real-time polymerase chain reaction (RT-PCR) in nasal swab, amniotic fluid, and positive immunoglobulin M (IgM) in neonatal blood. Treatments must be weighed in with caution due to the lack of quality trials that prove their effectiveness and safety during pregnancy. Medical staff must use personal protective equipment in handling SARS-CoV2 suspected or positive patients and be alert for respiratory decompensations.

摘要

目的

本综述旨在全面展示目前已知的情况,并更深入地探讨严重急性呼吸综合征冠状病毒2(SARS-CoV2)对妊娠的影响。

方法

2020年3月29日至5月期间,在PubMed和谷歌学术数据库中搜索了“ ”、“ ”、“ ”、“ ”和“ ”等关键词;还纳入了知名协会和机构(皇家妇产科学院[RCOG]、美国妇产科学院[ACOG]、国际妇产科超声学会[ISUOG]、疾病控制与预防中心[CDC]、国际妇产科联合会[FIGO])的指南。

结论

截至5月2日,新型冠状病毒肺炎疫情已导致全球超过330万例感染和23万例死亡。它由SARS-CoV2病毒引起,可能导致严重肺部感染和多器官功能衰竭。以往经验表明,妊娠的独特生理特征使孕妇更容易因病毒感染而出现并发症。然而,这种新型病毒尚未出现此类报道。一些危险因素似乎会增加妊娠期发病几率,如肥胖(体重指数[BMI]>35)、哮喘和心血管疾病。目前的报告显示早产率和剖宫产率有所上升。由于有少数新生儿鼻拭子、羊水实时聚合酶链反应(RT-PCR)呈阳性以及新生儿血液中免疫球蛋白M(IgM)呈阳性的病例报道,垂直传播仍有可能。由于缺乏高质量试验来证明治疗在孕期的有效性和安全性,因此必须谨慎权衡治疗措施。医护人员在处理疑似或确诊SARS-CoV2感染的患者时必须使用个人防护装备,并警惕呼吸功能不全。

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