Alsayyed Farah, Hastings Victoria, Lederman Sanford
Division of Obstetrics and Gynecology, New York Presbyterian-Brooklyn Methodist Hospital, Brooklyn, NY, USA.
Case Rep Obstet Gynecol. 2020 Nov 25;2020:8891787. doi: 10.1155/2020/8891787. eCollection 2020.
Coronavirus Disease 2019 (COVID-19) is responsible for a global pandemic that has significantly affected New York City. There is limited data about COVID-19 infection in pregnancy, especially in critically ill patients.
A 30-year-old female who presented at 26 weeks gestation with acute severe respiratory distress that required intubation and intensive care unit (ICU) admission. We had a high suspicion of COVID-19 disease despite repeated negative SARS-CoV-2 PCR testing, with eventual positive COVID IgG antibody testing. Through an integration of obstetrical knowledge, critical care, and comparing outcomes from similar cases in the literature, we decided to expectantly manage her pregnancy and did not recommend administration of antenatal steroids. She was extubated after 23 days of mechanical ventilation and recovered from her respiratory illness. She had a full-term spontaneous vaginal delivery of a baby boy at 39 weeks gestation with excellent maternal and fetal outcomes at delivery.
In the face of COVID-19, a new disease with unclear maternal and fetal outcomes to date, a collaboration of care teams is essential to navigate through the challenging decisions made, including timing of delivery, treatment options, and administration of steroids. Our paper is unique as there is no other published case report of a critically ill pregnant patient with COVID-19 in which delivery was deferred, and a full recovery was observed, with a vaginal delivery at term.
2019冠状病毒病（COVID-19）引发了一场全球大流行，对纽约市产生了重大影响。关于妊娠期COVID-19感染的数据有限，尤其是在重症患者中。
一名30岁女性，孕26周时出现急性严重呼吸窘迫，需要插管并入住重症监护病房（ICU）。尽管多次进行严重急性呼吸综合征冠状病毒2（SARS-CoV-2）聚合酶链反应（PCR）检测结果均为阴性，但我们高度怀疑其患有COVID-19疾病，最终COVID免疫球蛋白G（IgG）抗体检测呈阳性。通过整合产科知识、重症护理，并比较文献中类似病例的结果，我们决定对其妊娠进行期待管理，不建议使用产前类固醇。机械通气23天后她拔除了气管插管，呼吸道疾病康复。她在孕39周时自然分娩一名男婴且足月，母婴分娩结局良好。
面对COVID-19这种迄今母婴结局尚不明确的新疾病，护理团队的协作对于应对包括分娩时机、治疗选择和类固醇给药等具有挑战性的决策至关重要。我们的论文具有独特性，因为没有其他已发表的关于患有COVID-19的重症孕妇的病例报告，其中分娩被推迟且观察到完全康复，并足月阴道分娩。
