Controversial issues in obstetric management of women with novel coronavirus disease covid-19 during pregnancy and childbirth

Bezhenar, V. F.; Zazerskaya, Irina E.; Bettikher, Ofelia A.; Nesterov, I. M.; Баутин, А. Е.

doi:10.18565/aig.2020.5.13-21

Cited by 14 publications

(6 citation statements)

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“…С увеличением срока беременности нарастают физиологические изменения в организме, способствующие быстрому увеличению объема поражения легочной ткани, стремительному развитию ДН и высокому риску тромбозов [7,26]. На нашем материале среди пациенток с КПЛ за два года пандемии не было ни одной женщины в I триместре беременности, все находились в конце II -начале III триместра гестации, что согласуется с данными литературы [5,27].…”

Section: Original Articleunclassified

“…Т. Е. Белокриницкая и др., изучая материнскую смертность (МС) и случаи near miss при COVID-19, выявили площадь поражения легких более 50 % в 71,4 % случаев МС и только в 21,6 % случаев near miss. Авторы продемонстрировали, что поражение легких более 50 % (КТ-3, КТ-4) по данным КТ повышает риск неблагоприятного исхода для женщины в 9 раз, а позднее начало лечения антибиотиками -в 4,6 раза [5]. В то же время А. И. Гареева и др.…”

Section: Original Articleunclassified

“…Каждой четвертой беременной с пневмонией в период 1-4 волн пандемии требовалась интенсивная терапия с респираторной поддержкой [4]. Описаны единичные случаи материнской смерти, связанные с фатальными осложнениями COVID-19 [5][6][7]. В то же время Э. М. Локкен и др.…”

Section: Introductionunclassified

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Clinical and Laboratory Features and Maternal Outcomes in Pregnant Women with Critical Lung Damage in the COVID-19

Voropaeva,

Khaidukova,

Kazachkova

et al. 2024

Урал. мед. журнал

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Introduction. The spread of the delta strain of the SARS-CoV-2 virus during the third and fourth waves of the pandemic led to the fact that a large cohort of pregnant women and maternity women needed respiratory support, standard treatment methods had no effect, and negative outcomes for the mother and fetus has increased.Purpose of the study. The aim is to determine clinical and laboratory features and maternal outcomes in pregnant women with the coronavirus disease 2019 (COVID-19) and critical lung damage.Materials and methods. A comparative study was conducted, followed by a retrospective analysis of clinical and laboratory features, maternal outcomes in 56 pregnant women with COVID-19 treated in this maternity hospital in the first-fourth wave of the pandemic. The research method is continuous, sequential. The first group (main) consisted of 28 women with severe or extremely severe form of the course of COVID-19 and critical lung damage (more 75 %); The second group (comparison) — 28 pregnant women with a moderate form of the disease and lung damage of 25–50 %. Screening assessment of the degree of endogenous intoxication was carried out. The severity of the disease was determined by the evaluation scale National Early Warning Score (NEWS).Results. Laboratory parameters of patients at admission and at the height of the disease have statistically significant differences in the general blood test, such as higher levels of leukocytes, eosinophils, rod-shaped neutrophils, hemoglobin, as well as lymphopenia and monocytopenia in women of the main group at the height of the disease. At the same time, the hematological indices of intoxication in the main group exceed the value of these indicators in the comparison group by two times. Patients of both groups had high levels of acute-phase markers of inflammation — C-reactive protein and ferritin, — an indicator of tissue destruction of lactate dehydrogenase, however, both at admission and at the height of the disease, these indicators were statistically significantly higher in the group of women with critical lung damage. In general, 20/28 patients (71.4 %) of group 1 had an extremely severe course of the disease, 8/28 (28.6 %) had a severe course. In second group, 28/28 patients (100 %) had moderate-severe NCI (p = 0.000), while recovery was noted in all of them. Outcomes of COVID-19 in women with critical lung damage: recovered — 25/28 (89 %); 3/28 (10.7 %) the patients died from complications of COVID-19 of an extremely severe degree.Discussion. The most frequent laboratory anomaly was leukocytosis and a rod-shaped shift in the midst of the disease in women with critical lung damage, as well as a statistically significant increase in the level of C-reactive protein, lactate dehydrogenase, D-dimer. Pulmonary complications (parapneumonic pleurisy, pneumothorax, pneumomediastinum, hydrothorax, lung abscess) and extrapulmonary complications (encephalopathy, panic attacks, acute liver injury, sepsis, thromboembolic complications) were observed only with critical lung damage.Conclusion. In the laboratory, at the height of the disease, in the group of pregnant women with critical lung damage, leukocytosis and stab shift are statistically significantly more common. Hematological indices of intoxication, leukocyte and hematological, confirm endogenous intoxication at the height of the disease. A statistically significantly higher level of aspartate aminotransferase, lactate dehydrogenase, C-reactive protein, D-dimer is determined upon admission to the hospital and at the height of the disease as markers of systemic inflammatory response and cytolysis, which demonstrates the defeat of several organ systems simultaneously.

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Section: Original Articleunclassified

Section: Introductionunclassified

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Clinical and Laboratory Features and Maternal Outcomes in Pregnant Women with Critical Lung Damage in the COVID-19

Voropaeva,

Khaidukova,

Kazachkova

et al. 2024

Урал. мед. журнал

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“…Одним из наиболее противоречивых и нерешённых аспектов проблемы новой коронавирусной инфекции COVID-19 остаётся вопрос патогенеза и течения данно го заболевания у беременных [1,2]. Также сохраняет ся множество спорных вопросов и в отношении такти ки ведения беременности, связанных с неоднозначно стью течения новой COVID-19 и высокими рисками ма теринской смертности от COVID-19-ассоциированной пневмонии [3]. Среди множества звеньев патогенеза COVID-19 при беременности, обуславливающих повы шенную угрозу матери и плоду, важное место отводится гестационным гормональным изменениям и низкой им мунной реактивности [3,4].…”

Section: о б о с н о в а н и еunclassified

“…Также сохраняет ся множество спорных вопросов и в отношении такти ки ведения беременности, связанных с неоднозначно стью течения новой COVID-19 и высокими рисками ма теринской смертности от COVID-19-ассоциированной пневмонии [3]. Среди множества звеньев патогенеза COVID-19 при беременности, обуславливающих повы шенную угрозу матери и плоду, важное место отводится гестационным гормональным изменениям и низкой им мунной реактивности [3,4]. Однако существует и пред ставление о модулирующем эффекте гормональных из менений при беременности в отношении иммунной си стемы и о более лёгком течении заболевания у беремен ных женщин с COVID-19 [5,6].…”

Section: о б о с н о в а н и еunclassified

Smell and taste disorders in pregnant women with COVID-19

Kosovtseva

Bairova

Rychkova

et al. 2022

Acta biomedica scientifica

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Background. Smell disorder is a recognized clinical symptom of COVID-19 infection. The problem of the loss of sense of smell in the structure of COVID-19 pathogenesis during pregnancy remains unresolved. The aim of the study. To determine the sense of smell and taste in pregnant women with COVID-19, as well as to evaluate the relationship between the sense of smell and the number of SARS-CoV-2 genome equivalents in the nasopharyngeal secretion. Material and methods. In the case-control study, 121 pregnant women participated: 40 of them were infected with COVID-19; 81 were not infected with COVID-19 earlier and at the time of the study. The survey was conducted in July 2021. Sense of smell was assessed using the Connecticut Chemosensory Clinical Research Center (CCCRC) olfactory test, which includes olfactory threshold determination and odor identification assessment. Taste was measured according to the O. Massarelli method. Viral load was calculated using a standardized method for determining the numberof SARS-CoV-2 RNA copies in 1 ml of nasopharyngeal secretion. Results. The incidence of olfactory disorders (moderate / severe and anosmia) in pregnant women with COVID-19 is 62.5 % compared to 22.23 % among pregnant women who have never had COVID-19 (p = 0.002). No significant taste disorders were identified. The threshold value for the manifestation of olfactory disorders was 17794 RNA copies of the SARS-CoV-2 virus, which corresponds to the 37th threshold cycle (Ct). Conclusion. During pregnancy in the acute phase of COVID-19, sense of smell is significantly impaired, but not sense of taste. Decreased sense of smell is associated with SARS-CoV-2 viral load.

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Risk factors for severe novel coronavirus infection SARS-CoV-2 in women during pregnancy

Medyannikova,

Kuklis,

Savelyeva

et al. 2024

Rus. J. Hum. Repro.

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Controversial issues in obstetric management of women with novel coronavirus disease covid-19 during pregnancy and childbirth

Cited by 14 publications

References 0 publications

Clinical and Laboratory Features and Maternal Outcomes in Pregnant Women with Critical Lung Damage in the COVID-19

Clinical and Laboratory Features and Maternal Outcomes in Pregnant Women with Critical Lung Damage in the COVID-19

Smell and taste disorders in pregnant women with COVID-19

Risk factors for severe novel coronavirus infection SARS-CoV-2 in women during pregnancy

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