妊娠晚期合并新冠肺炎的围生期结局

目的:探讨妊娠晚期合并新型冠状病毒肺炎患者的临床特点、治疗及母儿结局。方法回顾分析2020年1月1日至2020年2月12日华中科技大学同济医学院附属同济医院收治的23例妊娠晚期合并新冠肺炎患者的临床资料,分析其流行病学特点、临床特点、治疗和母儿结局。结局随访至2月18日。结果23例患者均无华南海鲜市场接触史,均为武汉疫区居住史。患者平均年龄(32.34±6.21)岁(23~42岁),均为足月妊娠,平均孕周为39周(37~41+2周)。临床表现中有发热13例(56.52%)、咳嗽6例(26.09%)、呼吸急促1例(4.35%)和腹泻2例(8.70%)。18例患者行剖宫产和5例患者经阴分娩终止妊娠,平均39+2周,孕妇和新生儿的预后良好。对其中9例新生儿进行新型冠状病毒(SARS-CoV-2)咽试纸核酸检测,36h后发现1例新生儿感染SARS-CoV-2。结论产妇为新型冠状病毒肺炎的易感人群,对于足月或肺部病变进展迅速患者,建议及时终止妊娠。本例研究发现,妊娠晚期合并新冠肺炎及时终止妊娠者母婴结局良好,远期结局及是否存在母婴垂直传播有待进一步研究。

Novel coronavirus pneumonia in pregnancy:perinatal outcomes

Objective:To investigate the clinical feature,diagnosis,treatment and pregnancy outcome of pregnancy women with novel coronavirus pneumonia(COVID-19).Methods:Retrospective analysis of epidemiological,radiological features,laboratory data,treatment and maternal and fetal outcomes of 23 cases of pregnancy women with novel coronavirus pneumonia occurred in Tongji Hospital of Huazhong University of Science and Technology during Jan.1 to Feb.12,2020.The results were followed up to Feb.18,2020.Results:All the patients had no contact history with huanan seafood market,and all of them had lived in Wuhan epidemic area.The mean age and gestational age were(32.34±6.21)years and 39 weeks(37~41+2weeks).In clinical manifestations,13 had fever(56.52%),6 coughing(26.09%),1 shortness of breath(4.35%)and 2 diarrhea(8.70%).18 patients underwent cesarean section and 5 cases vaginal delivery of termination of pregnancy,with an average of 39+2 weeks.The prognosis of pregnant women and newborns was good.A novel coronavirus(SARS-CoV-2)test was performed on 9 newborns,and 1 neonates were infected 36 hours after birth.Conclusion:Pregnant women is susceptible population of novel coronavirus pneumonia,it is recommended that the pregnancy be terminated in time for patients in term or lung lesions with rapid progress.Our study found that pregnancy with novel coronavirus pneumonia in late pregnancy which timely termination of pregnancy had good maternal and infant outcomes,and the long-term outcome and whether there is mother to child vertical transmission need further study.