无症状伴肺部影像学改变的新型冠状病毒肺炎孕妇一例

本文为孕晚期无症状新型冠状病毒肺炎(COVID-19)一例报告,孕妇分娩前有胸部CT典型肺炎表现,母儿结局良好。患者孕37周+3因"新型冠状病毒核酸检测阳性7 h余"于2020年2月12日由外院转入宜春市人民医院。患者孕期定期产前检查无异常,入院前无任何不适。患者的丈夫和婆婆分别于患者入院前8 d和当日确诊为COVID-19。入院第2天胸部CT示右肺下叶见斑片状模糊影,胎心监测发现基线微小变异,考虑胎儿窘迫可能,在做好防护的情况下行,急诊剖宫产娩出一活女婴。术后产妇及新生儿分别送至隔离病区进行单间隔离观察治疗。参与剖宫产手术相关医护人员术后均采取单间隔离。术后给予患者抗病毒和抗感染治疗,患者恢复良好,仍无发热、乏力、咳嗽等症状,术后3和5 d咽拭子新型冠状病毒核酸检测均为阴性,术后4 d胸部CT提示右肺下叶炎症、术后7 d复查示右肺下叶炎症稍吸收。新生儿分别于出生当天、4日龄和7日龄取外周血和咽拭子标本行新型冠状病毒核酸检测,结果均为阴性。母女术后9 d顺利出院。参与手术的相关医护人员术后7和14 d咽拭子新型冠状病毒核酸检测结果均阴性。

Asymptomatic COVID-19 in pregnant woman with typical chest CT manifestation: a case report

We report a case of maternal asymptomatic COVID-19 in a patient with typical CT image of pneumonia in the third trimester,and both the mother and baby were well.The patient,a 30-year-old female,was transferred to Yichun People's Hospital at 37+3 gestational weeks because of a positive 2019 novel coronavirus nucleic acid result over seven hours.Her husband and mother-in-law were diagnosed with COVID-19 eight days before her admission and on the same day,respectively.The patient reported no discomfort before admission,and there were no abnormalities in the prenatal course during her pregnancy.On February 13(the second day of admission),a patchy blurred shadow was observed in the lower lobe of the right lung in chest CT scan,and a live baby girl was delivered by a precaution-based emergent cesarean section because of suspected fetal distress shown in electrical fetal heart monitoring.Both the mother and the newborn were isolated separately after the operation.All the medical staff involved in the cesarean section were isolated as well.The mother was healthy and remained asymptomatic after delivery,while antiviral and anti-inflammatory treatment was offered.COVID-19 nucleic acid tests of pharyngeal swab were negative on the 4th and 6th day after operation.Chest CT on the 5th day after delivery showed inflammation in the lower lobe of the right lung,and reexamination on the 8th day showed a slight absorption of the inflammation.Samples of peripheral blood and pharynx swab were obtained from the newborn on the day of birth and four and seven days after birth,and novel coronavirus nucleic acid test were all negative.The mother and baby dyad were discharged nine days after operation.And novel coronavirus nucleic acid tests were all negative in all medical staff involved.