Singh Parul, Bhuriya Vandana, Nanda Smiti, Chauhan Meenakshi Barsaul, Dahiya Pushpa, Singhal Savita
Department of Obstetrics and Gynaecology, Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India.
J Family Med Prim Care. 2022 Oct;11(10):6029-6035. doi: 10.4103/jfmpc.jfmpc_145_22. Epub 2022 Oct 31.
This article aims to discuss all the challenges faced in the diagnosis of coronavirus disease 2019 (COVID-19) in pregnancy, isolation of suspected and positive patients, their management, and the strategies to prevent the transmission of infection among the healthy population and medical fraternity. The diagnosis of COVID in pregnancy is influenced by many factors, including normal physiological changes in pregnancy, comorbid conditions associated with pregnancy, and the presence of asymptomatic infection in patients. Suspicion of COVID-19 in pregnant females is of utmost importance at a primary health center for risk mitigation of exposure to medical personnel.
A retrospective study was carried out in the labour room in a tertiary care center in India. Two groups were made, suspected COVID and confirmed COVID in pregnant patients. The case records were analysed.
Out of a total of 5164 admissions, 95 patients were admitted as suspected (1.8%), but only two patients were COVID-positive amongst them. 84% of COVID-positive patients were asymptomatic. Fever was the most common symptom in both groups (-value: 0.15). Preeclampsia and anaemia were the most common comorbidities in both groups, not statistically significant. There were 32% of intensive acre unit (ICU) admissions in suspected COVID patients, and 77% of them were having respiratory distress.
COVID-19 presents as an asymptomatic infection in most pregnant patients. Physiological changes to the cardiorespiratory and immune systems along with associated comorbidities in pregnancy, increase a woman's susceptibility and delay diagnosis. Consideration of patients as suspected COVID at triage stations on the basis of only contact or travel history poses a great burden on the health care system. Although triage is an essential tool to identify symptomatic COVID patients, universal testing strategies should continue simultaneously. Streamlining medical care professionals into self-sufficient teams ensures adequate clinical coverage amongst the suspected COVID, confirmed COVID, and routine labour room admissions.
本文旨在探讨妊娠期间新型冠状病毒肺炎（COVID-19）诊断过程中面临的所有挑战、疑似和确诊患者的隔离、管理以及预防感染在健康人群和医护人员中传播的策略。妊娠期间COVID的诊断受多种因素影响，包括妊娠期间的正常生理变化、与妊娠相关的合并症以及患者无症状感染的存在。在基层医疗中心，对妊娠女性怀疑感染COVID-19对于降低医护人员暴露风险至关重要。
在印度一家三级医疗中心的产房进行了一项回顾性研究。将妊娠患者分为两组，疑似COVID组和确诊COVID组。对病例记录进行了分析。
在总共5164例入院患者中，95例被怀疑入院（1.8%），但其中只有2例COVID呈阳性。84%的COVID阳性患者无症状。发热是两组中最常见的症状（-值：0.15）。子痫前期和贫血是两组中最常见的合并症，无统计学意义。疑似COVID患者中有32%入住重症监护病房（ICU），其中77%有呼吸窘迫。
COVID-19在大多数妊娠患者中表现为无症状感染。妊娠期间心肺和免疫系统的生理变化以及相关合并症增加了女性的易感性并延迟了诊断。仅根据接触史或旅行史在分诊站将患者视为疑似COVID会给医疗系统带来巨大负担。尽管分诊是识别有症状COVID患者的重要工具，但通用检测策略应同时继续。将医疗护理专业人员精简为自给自足的团队可确保在疑似COVID、确诊COVID和常规产房入院患者中提供足够的临床覆盖。
