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妊娠晚期孕妇感染新型冠状病毒肺炎导致宫内胎儿死亡:一例报告

Intrauterine fetal demise as a result of maternal COVID-19 infection in the third trimester of pregnancy: A case report.

作者信息

Gant Tayler F, Villegas Timothy P, Summerall-Smith Janna, Watkins Bonnie

机构信息

OMS IV, Edward Via College of Osteopathic Medicine, United States of America.

Piedmont Columbus Regional Hospital, United States of America.

出版信息

Int J Surg Case Rep. 2022 Sep;98:107492. doi: 10.1016/j.ijscr.2022.107492. Epub 2022 Aug 12.

Abstract

INTRODUCTION

As the global pandemic continues, more information is being collected on the incidence and range of adverse maternal and fetal outcomes resulting from COVID-19 infection.

PRESENTATION OF CASE

We present a case of a 29-year-old unvaccinated patient at 36 weeks gestation with several days of mild symptoms after testing positive for COVID-19 who presented with a complaint of decreased fetal movement and was found to have an intrauterine fetal demise. This case was further notable for thrombocytopenia, acute postpartum hemorrhage and placental histologic findings showing morphologic changes consistent with previously reported pathology seen with maternal COVID-19 infection including marked perivillous fibrin deposition and marked acute and chronic intervillositis.

DISCUSSION

This case, combined with other similar reports in the literature, supports the conclusion that COVID-19 infection in pregnancy can result in severe perinatal adverse consequences regardless of initial maternal symptomatology.

CONCLUSION

Pregnancies affected by COVID-19 may benefit from a higher level of surveillance and proactive care and further research is warranted.

摘要

引言

随着全球疫情的持续,关于新冠病毒感染导致的孕产妇和胎儿不良结局的发生率及范围,正在收集更多信息。

病例介绍

我们报告一例29岁未接种疫苗的孕妇,妊娠36周,新冠病毒检测呈阳性后出现数天轻微症状,因胎动减少就诊,发现胎儿宫内死亡。该病例的其他显著特征包括血小板减少、急性产后出血以及胎盘组织学检查结果显示形态学变化,与先前报道的孕产妇新冠病毒感染病理学表现一致,包括明显的绒毛周围纤维蛋白沉积以及明显的急性和慢性绒毛间炎。

讨论

该病例与文献中的其他类似报告共同支持了这一结论,即孕期新冠病毒感染可导致严重的围产期不良后果,无论最初的孕产妇症状如何。

结论

受新冠病毒影响的妊娠可能受益于更高水平的监测和积极护理,有必要进行进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4dd9/9411687/746fbbfab6b3/gr1.jpg

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