Department of Obstetrics and Gynecology, University of Health Sciences Diyarbakir Gazi Yasargil Research and Training Hospital, Diyarbakır, Turkey.
Department of Anesthesiology and Reanimation, University of Health Sciences Diyarbakir Gazi Yasargil Research and Training Hospital, Diyarbakır, Turkey.
J Obstet Gynaecol Res. 2021 Nov;47(11):4067-4076. doi: 10.1111/jog.14928. Epub 2021 Jul 12.
Coronavirus-19 disease is still a pandemic health problem and uncertainty in the management of severe or critically ill pregnant women confuses continually the obstetricians. The nationwide maternal mortality rate due to covid-19 still has not been presented in any study in Turkey. The study includes four maternal mortality cases in a referral single pandemic center in our country. Case 1, a 34-year-old, 34 weeks of gestation with moderate disease. The cesarean section was performed due to nonreassuring nonstress tests. She died on the postpartum seventh day. Case 2, a 37-year-old, at 36 weeks of gestation. The symptoms consisted of dry cough, shortness of breath and labor pain, and 3 cm cervical opening. Her second cesarean section was performed and she died at postpartum ninth day. Case 3, 33 years old, 33 weeks of gestation with moderate/severe stage of the disease. A few days after the treatment, CS was performed due to her severe condition and she died at postpartum 15th day. Case 4, 39 years old, 35 weeks of gestation, she was at a severe stage of the disease. On the second day after the treatment, CS was performed due to her severe condition and she died at postpartum seventh day. The postpartum period after cesarean section should be followed cautiously under the appropriate treatment of the COVID-19 disease. Unfortunately, the reason for this rapid deterioration which we observed in our cases is not well known and appropriate medications and algorithms should be established as soon as possible.
新型冠状病毒疾病仍然是一个全球性的健康问题,严重或危重新生儿的管理存在不确定性,这让产科医生感到困惑。由于 COVID-19 导致的全国孕产妇死亡率在土耳其的任何研究中都尚未呈现。本研究包括我国一家转诊单一流行中心的 4 例孕产妇死亡病例。病例 1,一名 34 岁,妊娠 34 周,中度疾病。由于非应激试验不可靠,进行了剖宫产。她在产后第 7 天死亡。病例 2,一名 37 岁,妊娠 36 周。症状包括干咳、呼吸急促和分娩疼痛,宫颈口开 3 厘米。她进行了第二次剖宫产,产后第 9 天死亡。病例 3,33 岁,妊娠 33 周,中度/重度疾病。治疗几天后,由于病情严重,行剖宫产术,产后第 15 天死亡。病例 4,39 岁,妊娠 35 周,处于疾病严重阶段。治疗后第二天,由于病情严重,行剖宫产术,产后第 7 天死亡。剖宫产后的产褥期应在 COVID-19 疾病的适当治疗下谨慎监测。不幸的是,我们在这些病例中观察到的这种迅速恶化的原因尚不清楚,应尽快制定适当的药物和算法。