Sivevski Atanas, Karadzova Dafina, Davceva Natasha, Aleksioska-Papestiev Irena, Kadriu Romir, Velickovic Ivan, Markovic Ivana, Pejcic Nada, Baysinger Curtis L
Department of Anesthesiology, University Hospital of Gynecology and Obstetrics, Saints Cyril and Methodius University of Skopje, Skopje, North Macedonia.
Institute of Forensic Medicine, Criminology, and Medical Deonthology, Saints Cyril and Methodius University of Skopje, Skopje, North Macedonia.
Front Glob Womens Health. 2020 Sep 24;1:567810. doi: 10.3389/fgwh.2020.567810. eCollection 2020.
There are few case reports describing maternal mortality and intensive care of the pregnant patient with COVID-19 infection. A 27-year-old patient at 34 weeks of gestation was admitted for the evaluation of cough, fever, tachypnea, and oligohydramnios. The day of admission she underwent cesarean delivery for a non-reassuring fetal heart rate tracing. Over the next 6 days her clinical condition deteriorated, she developed multi organ system failure, and died despite aggressive supportive care. Although mortality related to COVID-19 in pregnancy has been rarely reported to date, we describe a case of progressive clinical deterioration postpartum despite aggressive supportive care. Management strategies specific for pregnant women have not been developed. In timing delivery, the obstetrician must consider the possibility that the inflammatory response associated with CD may increase the risk for multiorgan system failure in parturients with COVID-19 while recognizing that risks to the fetus may be higher in patients with COVID-19 than in other critically ill parturients. Vertical transmission of infection to the neonate did not occur in our case and has not been demonstrated in other pregnancies with COVID-19 disease.
关于感染新型冠状病毒肺炎（COVID-19）的孕妇的孕产妇死亡率及重症监护的病例报告很少。一名孕34周的27岁患者因咳嗽、发热、呼吸急促和羊水过少入院评估。入院当天，因胎儿心率监护情况不佳，她接受了剖宫产。在接下来的6天里，她的临床状况恶化，出现多器官系统功能衰竭，尽管给予了积极的支持治疗仍死亡。虽然迄今为止很少有关于妊娠合并COVID-19死亡率的报道，但我们描述了一例产后尽管给予积极支持治疗仍出现临床进行性恶化的病例。尚未制定针对孕妇的管理策略。在决定分娩时机时，产科医生必须考虑到与COVID-19相关的炎症反应可能会增加感染COVID-19的产妇发生多器官系统功能衰竭的风险，同时要认识到感染COVID-19的患者中胎儿面临的风险可能高于其他重症产妇。在我们的病例中未发生感染垂直传播给新生儿的情况，在其他感染COVID-19的妊娠中也未得到证实。
