Intensive Care Medicine, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
Intensive Care Medicine, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.
BMJ Case Rep. 2021 Sep 8;14(9):e243516. doi: 10.1136/bcr-2021-243516.
We describe the successful treatment of a 24-week pregnant, 44-year-old woman with COVID-19. Management of this complex case required multidisciplinary collaboration and included prolonged invasive mechanical ventilation and prone positioning. Caesarean section delivery was delayed for 32 days, with no monitored fetal compromise, while stabilising the mother. To our knowledge, this is the longest reported duration of invasive ventilation while pregnant in a patient with COVID-19. COVID-19 has been shown to cause increased disease severity in pregnant women, and certain pregnancy-related physiological adaptations that occur could help explain this association. While COVID-19 has been shown to cause no increased adverse neonatal outcomes, clinicians should be aware that data show increased preterm birth in symptomatic pregnant women, thereby increasing the chance of prematurity-related complications. Further research on COVID-19 in pregnancy is crucial to facilitate better management, and full inclusion of pregnant women in therapeutic clinical trials will help achieve this.
我们成功治疗了一名 24 周妊娠、44 岁的 COVID-19 患者。该复杂病例的管理需要多学科协作，包括长时间的有创机械通气和俯卧位通气。剖宫产分娩延迟了 32 天，在此期间胎儿情况未受监测且母亲病情稳定。据我们所知，这是 COVID-19 孕妇有创通气时间最长的报道。COVID-19 已被证明会导致孕妇病情加重，而妊娠期间发生的某些与妊娠相关的生理适应性变化可能有助于解释这种关联。虽然 COVID-19 不会导致新生儿不良结局增加，但临床医生应注意到，数据显示有症状的孕妇早产增加，从而增加了与早产相关的并发症的发生几率。进一步研究妊娠期间的 COVID-19 至关重要，这有助于更好地管理，而将孕妇全面纳入治疗性临床试验将有助于实现这一目标。
