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西班牙大流行中期有症状的孕妇的 COVID-19 感染:一项回顾性分析。

COVID-19 infection in symptomatic pregnant women at the midpoint of the pandemic in Spain: a retrospective analysis.

机构信息

Hospital Mancha Centro, Av Constitucion sn, Alcazar de San Juan, Spain, Spain.

University Castilla La Mancha, Ciudad Real, Spain, Spain.

出版信息

Ginekol Pol. 2020;91(12):755-763. doi: 10.5603/GP.a2020.0130.

Abstract

OBJECTIVES

Determine the strengths and weakness of a symptomatic screening for COVID-19 in pregnant women. Analyze the clinical presentation, management, and outcomes.

DESIGN

Descriptive retrospective observational study.

SETTING

Mancha-Centro Hospital (Spain).

MATERIAL AND METHODS

Population: Symptomatic pregnant women with confirmed diagnosis of COVID-19. Between the 12th of March and 17th of April 2020, all the symptomatic pregnancies were screened with diagnostic test for SARS-CoV-2. Data collection was done by reviewing the medical records and telephone interviews.

MAIN OUTCOME MEASURES

Clinical characteristics, management, treatment, and obstetric and neonatal outcomes.

RESULTS

Twenty patients with positive COVID-19 diagnostic test out of thirty-four suspected. The most common symptoms were fever (70%), cough (65%) and myalgia (35%). A unique symptom of presentation in 20% of cases. COVID-19 pneumonia was diagnosed in 30% by chest X-ray and one case had pulmonary embolism associated diagnosed by CT-Scan. Thromboprophylaxis was indicated in 16 out of 20 patients. Eight women finished their pregnancy during the observation period. Type of birth: 25% natural birth, 12.5% assisted vaginal delivery and 62.5% caesarean section. We had three severe cases, two of them with intensive care support. All neonates had negative test for COVID 19 infection.

CONCLUSIONS

We recommend universal screening of all pregnant woman for COVID-19 during the pandemic because of the limits of the symptomatic screening seen in this studio and the ratio of asymptomatic pregnancies with positive test for COVID-19 recently published.

摘要

目的

确定对 COVID-19 感染孕妇进行症状性筛查的优势和劣势。分析临床表现、处理方法和结局。

设计

描述性回顾性观察性研究。

地点

西班牙 Mancha-Centro 医院。

材料和方法

人群:COVID-19 确诊的有症状孕妇。2020 年 3 月 12 日至 4 月 17 日期间,对所有有症状的妊娠进行了 SARS-CoV-2 诊断性检测筛查。通过查阅病历和电话访谈进行数据收集。

主要结局指标

临床特征、处理方法、治疗以及产科和新生儿结局。

结果

在 34 例疑似病例中,有 20 例 COVID-19 检测阳性。最常见的症状是发热(70%)、咳嗽(65%)和肌痛(35%)。20%的病例出现独特的首发症状。胸部 X 线检查诊断出 30%的 COVID-19 肺炎,1 例病例通过 CT 扫描诊断为合并肺栓塞。20 例患者中有 16 例接受了血栓预防治疗。8 名孕妇在观察期间分娩。分娩方式:25%自然分娩,12.5%辅助阴道分娩,62.5%剖宫产。我们有 3 例重症病例,其中 2 例需要重症监护支持。所有新生儿的 COVID-19 感染检测均为阴性。

结论

鉴于本研究中症状性筛查的局限性以及最近报道的无症状妊娠 COVID-19 检测阳性率,我们建议在大流行期间对所有孕妇进行 COVID-19 普遍筛查。

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