Severe COVID-19 during Pregnancy and Possible Vertical Transmission.
Am J Perinatol
; 37(8): 861-865, 2020 Jun.
Article
in English
| MEDLINE | ID: covidwho-72492
ABSTRACT
There are few cases of pregnant women with novel corona virus 2019 (COVID-19) in the literature, most of them with a mild illness course. There is limited evidence about in utero infection and early positive neonatal testing. A 41-year-old G3P2 with a history of previous cesarean deliveries and diabetes mellitus presented with a 4-day history of malaise, low-grade fever, and progressive shortness of breath. A nasopharyngeal swab was positive for COVID-19, COVID-19 serology was negative. The patient developed respiratory failure requiring mechanical ventilation on day 5 of disease onset. The patient underwent a cesarean delivery, and neonatal isolation was implemented immediately after birth, without delayed cord clamping or skin-to-skin contact. The neonatal nasopharyngeal swab, 16 hours after delivery, was positive for severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) real-time polymerase chain reaction (RT-PCR), and immunoglobulin (Ig)-M and IgG for SARS-CoV-2 were negative. Maternal IgM and IgG were positive on postpartum day 4 (day 9 after symptom onset). We report a severe presentation of COVID-19 during pregnancy. To our knowledge, this is the earliest reported positive PCR in the neonate, raising the concern for vertical transmission. We suggest pregnant women should be considered as a high-risk group and minimize exposures for these reasons. KEY POINTS · We report a severe presentation of COVID-19 in pregnancy requiring invasive ventilatory support.. · This is a case of positive RT-PCR in first day of life, suggesting possible vertical transmission.. · There were no detectable maternal antibodies for COVID-19 until after delivery..
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Pregnancy Complications, Infectious
/
Respiration, Artificial
/
Respiratory Insufficiency
/
Cesarean Section
/
Coronavirus Infections
/
Pandemics
/
Betacoronavirus
/
Infant, Newborn, Diseases
Type of study:
Case report
/
Diagnostic study
/
Prognostic study
Topics:
Vaccines
Language:
English
Journal:
Am J Perinatol
Year:
2020
Document Type:
Article
Affiliation country:
S-0040-1710050
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