孕晚期合并无症状新型冠状病毒感染一例

本文为孕晚期无症状新型冠状病毒感染一例报告,母儿结局良好。患者孕38周因"新型冠状病毒核酸检测阳性1 d"于2020年2月11日入住合肥市第二人民医院。患者孕期定期产前检查且均未见异常。因其丈夫及姐姐分别于患者入院前14和7 d先后确诊为新型冠状病毒肺炎(COVID-19),患者入院前咽拭子新型冠状病毒核酸检测阳性。患者入院前无任何不适。入院第3天,胸部CT示两肺未见异常,仅两侧少量胸腔积液;患者出现不规律宫缩,急诊剖宫产娩出一活女婴。未行羊水、脐带血、胎盘等病原学检查。术后未行母乳喂养,患者与新生儿分室隔离,参与剖宫产手术相关医护人员术后均采取单间隔离。新生儿于出生当天、1日龄分别取外周血、鼻咽拭子,9日龄分别取鼻咽拭子、肛拭子进行新型冠状病毒核酸检测,结果均为阴性。患者术后恢复情况良好,生命体征平稳,术后8 d胸部CT提示两侧少量胸腔积液,术后11和12 d复测咽拭子新型冠状病毒核酸结果均为阴性。母女于术后14 d顺利出院。参与手术的相关医护人员术后14 d咽拭子新型冠状病毒核酸检测结果均阴性。     

妊娠晚期危重型新型冠状病毒肺炎一例

本文报告一例妊娠晚期合并新型冠状病毒肺炎(COVID-19)危重型孕妇。患者32岁,孕35周+2因"咽痛4 d,发热3 h"入院。入院前曾至湖北孝感应城,回家隔离期间发病。入院后病情进展迅速,7 h后出现左侧胸背部疼痛、气促、头晕,迅即出现呼吸衰竭、感染性休克。考虑病情严重,且有2次剖宫产史,行紧急子宫下段剖宫产术。术前血气分析示呼吸衰竭、呼吸性酸中毒合并代谢性酸中毒。术中娩出一男婴,2700 g,1 min Apgar评分1分(心率20次/min),经复苏抢救,5和10 min评分均为1分,家属放弃抢救后死亡。产妇术后气管插管呼吸机维持,同时给予其他支持治疗。入院时的新型冠状病毒核酸检测结果于分娩后报告为阳性,遂转入定点医院治疗。患者术后26 d体外膜肺氧合脱机成功,术后36 d脱离呼吸机,进入康复阶段。     

新型冠状病毒感染孕妇是否存在宫内垂直传播

新型冠状病毒肺炎疫情期间,母婴垂直传播问题引起了社会及围产医学界的广泛关注及热议,但目前尚无足够证据证明新型冠状病毒存在宫内垂直传播。本文重申了宫内垂直传播的相关概念,明确了相关研究的意义,并对未来在这一方面可能的研究方向及注意事项进行了阐述。同时呼吁科研工作者,坚持更加严谨求实的作风,进行科学的临床及基础研究,为提高对新型冠状病毒的认识提供科学的证据和信息。     

妊娠合并新型冠状病毒肺炎九例临床分析

目的评估妊娠合并新型冠状病毒肺炎(COVID-19)患者的临床特征及母婴妊娠结局。方法回顾性分析武汉大学人民医院2020年1月22日至2月1日收治入院的9例COVID-19孕妇的病例资料,包括流行病学史、临床症状、实验室检查、胸部CT影像学表现、治疗方案、分娩方式和新生儿结局的相关资料。并对其中6例孕妇的阴道分泌物标本和4例分娩孕妇的羊水、脐带血、新生儿鼻咽拭子、母乳标本进行新型冠状病毒核酸检测。对数据资料进行描述性统计分析。结果(1)9例孕妇中,5例为妊娠晚期,4例为妊娠中期。潜伏期中位数为8(1~14)d。9例孕妇均出现发热症状,7例出现咳嗽,5例出现腹泻症状。其他症状包括气短或气促、肌肉疼痛、乏力(各4例),鼻塞、咽痛、胸痛、头痛或头晕(各3例),皮疹(2例),以及寒战和咳痰(各1例)。7例孕妇合并淋巴细胞减少,6例C-反应蛋白升高。7例孕妇行胸部CT检查,均见肺部多发斑片状毛玻璃影。1例孕37周+5孕妇在确诊7 d后,超声提示羊水过少。(2)所有患者均给予经验性抗生素治疗、抗病毒治疗和中成药物辅助治疗。8例患者接受吸氧及激素治疗,6例接受免疫治疗。(3)9例孕妇中,4例分娩,1例于孕26周引产。分娩的4例中3例行剖宫产术终止妊娠;1例胎膜早破自发性早产并经阴道分娩,产后2 d出现急性呼吸窘迫综合征,转入重症监护病房治疗。4例新生儿中2例为足月儿;2例为早产儿,其中1例为低出生体重儿。所有新生儿出生时均无窒息。其余4例继续妊娠孕妇病情均稳定。羊水、脐带血、新生儿鼻咽拭子、母乳及母亲阴道分泌物行新型冠状病毒核酸检测均为阴性。结论妊娠合并COVID-19患者的临床特征与非妊娠期成人患者相比无特异性,尚无证据表明妊娠合并COVID-19可导致更严重不良母儿结局或垂直传播。     

围产期新型冠状病毒感染一例

本文报告1例围产期新型冠状病毒感染患者的诊治经过及围产结局。孕妇孕37周+2因"严重肝功能异常"行急诊剖宫产娩出一活男婴。术后第2天产妇出现发热,经咽拭子核酸检测确诊新型冠状病毒感染。经隔离及对症支持治疗12 d,连续2次核酸检测阴性痊愈出院。患者血、尿、乳汁及新生儿咽拭子均未检测到新型冠状病毒核酸。新生儿心肌酶升高,隔离14 d后痊愈出院。     

新型冠状病毒肺炎与妊娠

新型冠状病毒肺炎(COVID-19)于2019年12月在中国湖北武汉流行,2020年3月11日世界卫生组织(WHO)宣布疫情全球大流行.COVID-19是由新型冠状病毒(SARS-CoV-2)引起的,SARS-CoV-2在基因上与SARS病毒(SARS-CoV)相似,但不同于SARS-CoV.人类感染SARS-CoV-...     

妊娠合并新型冠状病毒肺炎治愈17例临床分析

目的:探讨妊娠合并新型冠状病毒肺炎(COVID-19)的临床特点及治疗方法。方法:对武汉大学人民医院东院2020年1月31日至3月26日收治的妊娠合并COVID-19并痊愈出院的患者17例临床资料进行回顾性分析。结果:17例患者中轻型6例,普通型11例,无一例转为重症或危重症。发热10例,咳嗽6例,同时出现咳嗽、腹泻、气促及乏力等症状1例,无呼吸道症状4例。4例孕妇合并白细胞计数升高,10例出现淋巴细胞计数降低,11例出现淋巴细胞百分比降低,13例孕妇D-二聚体值升高。17例痊愈患者行抗病毒、抗感染及中成药物等对症支持治疗,10例使用小剂量糖皮质激素治疗,3例使用免疫调节剂,11例行低流量吸氧治疗。17例中6例患者(包含瘢痕子宫)因临产或先兆临产等原因经剖宫产术分娩,1例顺产,1例早孕自然流产,7例新生儿出生后查新型冠状病毒核酸均阴性。9例患者出院后继续妊娠。17例患者经治疗后各项指标均好转,符合出院标准。结论:早发现、早治疗、适时终止妊娠对改善妊娠合并COVID-19的预后有一定效果,轻型或普通型COVID-19孕妇无终止妊娠的其他医学指征,可在严密监测下继续妊娠,COVID-19病...     

新生儿科新型冠状病毒感染防控专家建议

为防控新型冠状病毒感染流行,国家卫生健康委员会连续发布了一系列规范化文件。如何将这些规范化文件落实应用在新生儿科,仍需针对性的指导方案。现制订新生儿科新型冠状病毒感染防控专家建议。     

妊娠期与产褥期新型冠状病毒感染专家建议

于2019年12月始发于湖北省武汉市的新型冠状病毒感染迅速流行。以往资料证实,孕产妇是病毒感染的高危人群。为保证孕产妇得到最优化的管理和救治,根据最新新型冠状病毒感染国家管理方案并结合实际情况,特制订妊娠期与产褥期新型冠状病毒感染的专家建议。     

新型冠状病毒肺炎疫情对孕妇孕期焦虑情绪的影响及研究

目的:探讨新型冠状病毒肺炎(COVID-19)疫情下孕妇孕期焦虑情绪的影响因素.方法:于2020年1月23日—2020年4月8日在湖北、湖南、江西、河南、广东、贵州、陕西7个省的43家医院开展孕妇心理健康状况横断面调查,采取问卷调查方式,获得有效问卷1793份,主要调查内容包括孕妇孕期的基本信息(年龄、身高、体质量、产...     

Emergent cesarean section in a preterm pregnant woman with severe COVID-19 pneumonia in Taiwan: A case report

ObjectiveThe pandemic Coronavirus Disease 2019 (COVID-19) is a global public health crisis. Many maternity units worldwide are currently establishing the management protocols for these patients.Case reportWe report the first critically ill pregnant woman with COVID-19-induced respiratory failure undergoing emergent caesarean delivery at 32 weeks of gestation, in the setting of a positive pressure operating room (OR) with negative pressure anteroom in Taiwan.ConclusionMultidisciplinary planning and collaboration are necessary to achieve satisfactory clinical outcomes in pregnancies with critical COVID-19 pneumonia. The combinations of comprehensive evaluation, timely treatment as well as establishment of rigorous protocol and safe environment for the emergent delivery are important.     

Maternal and fetal outcomes of the pregnant woman with COVID-19: The first case report in Taiwan

ObjectiveA real-Taiwan experience to deal with near-term pregnant woman infected by severe acute respiratory syndrome coronavirus 2, SARS-CoV-2 (coronavirus disease 2019, COVID-19) is extremely limited. We described the first case in Taiwan.Case reportA 30-year-old woman, primigravida had a laboratory-confirmed COVID-19 infection at 36 gestational weeks (GW). She was asymptomatic. Ten days later, she was hospitalized and receive a selective cesarean section with a term baby weighted 3142 gm (Apgar score 8 and 9 at 1st and 5th minute, respectively) at 38 GW. No evidence of in utero and direct transmission was found and newborn was free of COVID-19.ConclusionIt is still uncertain whether timing or mode of delivery is appropriate in SARS-CoV-2 infected pregnant woman in near term, but we suggested that a selective delivery time at 38 GW or later, regardless of which mode of delivery is finally decided, can be considered.     

Review of care and management of pregnant women during COVID-19 pandemic

Coronavirus disease-19 (COVID-19) is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Covid-19 pandemic began in the end of 2019 and spread all over the world in a short duration of time. Measures have been taken such as social distancing, compulsory lockdown and restriction of activities so as to prevent spread of virus. It has posed problem to both the antenatal women and maternity care workers. The care and management of pregnant women is an essential service to identify high-risk mothers and also to have good pregnancy outcome for both mother and baby. Any delay in this may lead to catastrophe, hence this issue needs to be addressed properly. This review briefs about the literature available on antenatal care during covid-19 pandemic. Pregnancy is not very adversely affected by the virus itself but extra caution should be taken to prevent and complications should they arise. The norms of social distancing by patients and wearing personal protective equipment by hospital staff, testing of pregnant women should be followed as per regional and national guidelines. This will help ensure safety of all people along with care to the expecting mother. The presence of covid-19 infection should not deter women from receiving antenatal care nor should the obstetric treatment be delayed during labor. Decision for timing and mode of delivery should be individualised based on obstetric indications and maternal–fetal status.     

Clinical and obstetric characteristics of pregnant women with Covid-19: A case series study on 26 patients

ObjectiveTo evaluate the clinical characteristics and outcomes of pregnant women with Covid-19.Materials and methodsThis case series study was performed to investigate demographic, clinical and obstetric characteristics of 26 pregnant women with COVID-19 referring to a university hospital of Kashan during the epidemic of COVID-19 (March to May 2020).ResultsThe mean gestational age of the patients at admission and delivery was 31.8 ± 5.2 and 36.3 ± 3.4 weeks, respectively. The most common symptoms were fever (96.2%) followed by dyspnea and cough (30.8%). The findings of lung CT scan showed abnormalities confirming the pneumonia in 22 patients (84.6%). Cesarean section was performed in 69.2% of the mothers. The most common maternal–fetal outcome was preterm delivery (38%). Two mothers were transferred to the ICU due to deterioration in clinical condition and they underwent mechanical ventilation without any maternal death. The most common neonatal outcomes were prematurity (38%) and low birth weight (34.6%). No cases of confirmed COVID-19 were observed in the neonates.ConclusionClinical manifestations and laboratory and radiographic findings in pregnant women with COVID-19 are similar to the general population. Common outcomes of pregnancy and delivery in mothers included increased rate of preterm delivery and cesarean section. The most prevalent neonatal outcomes included prematurity and LBW. Careful monitoring of pregnant women with COVID-19 is recommended.