Possible formation of pulmonary microthrombi in the early puerperium of pregnant women critically ill with COVID-19: Two case reports.
Case Rep Womens Health
; 27: e00237, 2020 Jul.
Article
in English
| MEDLINE | ID: covidwho-626939
ABSTRACT
BACKGROUND:
Limited data are available on the management of pregnant women with severe or critical forms of COVID-19, such as the optimal timing of provider-initiated delivery, and post-partum care, including antithrombotic prophylaxis. We present the clinical course, pre- and post-partum management, and outcomes of two pregnant women critically ill with COVID-19. CASES Both women had confirmed SARS-CoV-2 pneumonia with rapid clinical decompensation that required admission to the intensive care unit, intubation, and delivery by emergency cesarean section at 32 and 29 weeks. Both patients clinically improved in the first two postoperative days, but this was followed by clinical, laboratory and radiological deterioration on the third postoperative day; however, they both improved again after full anticoagulation. This pattern suggests the possible formation of pulmonary microthrombi in the early puerperium. We discuss the challenges faced by the multiprofessional team in the management of these patients.CONCLUSIONS:
There are few resources to guide health professionals caring for pregnant women with critical COVID-19. These two cases contribute to the rapidly evolving knowledge on the management and outcomes of pregnant women with COVID-19.
Anticoagulants; BMI, Body mass index; BP, Blood pressure; COVID-19; CS, Cesarean section; CT, Computed tomography; Critical illness; HR, Heart rate; ICU, Intensive care unit; NICU, Neonatal intensive care unit; PaO2/FiO2, Partial pressure of arterial oxygen /fraction of inspired oxygen; Postpartum period; Pregnancy; RR, respiratory rate; SpO2, Oxygen saturation
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Type of study:
Case report
/
Experimental Studies
/
Prognostic study
Language:
English
Journal:
Case Rep Womens Health
Year:
2020
Document Type:
Article
Affiliation country:
J.crwh.2020.e00237
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