Experience in managing severe and extremely severe COVID-19 in pregnant women

Gareyeva, Aygul I.; Mozgovaya, Elena V.; Belopolskaya, Maria; Kovalchuk, A. S.; Kucheryavenko, A. N.

doi:10.17816/jowd72169

Cited by 4 publications

(6 citation statements)

References 23 publications

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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

“…В то же время А. И. Гареева и др. не выявили статистически значимых различий в клинических проявлениях COVID-19 у 22 выздоровевших и 17 умерших беременных с тяжелым течением заболевания [7].…”

Section: Original Articleunclassified

“…Анализ данных лабораторных исследований показал значимые отличия между группами как при поступлении в стационар, так и в разгар заболевания. Самой частой лабораторной аномалией явился лейкоцитоз и палочкоядерный сдвиг в разгар болезни у женщин с КПЛ, а также статистически значимое повышение уровня СРБ, ЛДГ, D-димера, что согласуется с литературными данными [7,31,32].…”

Section: Original Articleunclassified

“…По литературным данным, железодефицитная анемия является устойчивым фактором риска тяжелого течения COVID-19 у беременных [7,27]. Однако наше исследование показало, напротив, статистически значимо более высокий уровень гемоглобина пациенток с КПЛ в разгар заболевания, что может быть связано со сгущением крови.…”

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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Effects of COVID-19 on the body of a pregnant woman with preeclampsia: Birth outcomes (literature review)

Shchegolikhina,

Zainetdinova,

Amirova

2023

V.F.Snegirev Archives of Obstetrics and Gynecology

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In contemporary obstetrics, increasing attention is being paid to identifying problems diagnosed during pregnancy that are believed to increase the risk of complications during pregnancy and labor. The effect of COVID-19 on the body of the pregnant woman as well as its association with preeclampsia and their combined effect on the organisms of the mother and fetus, as well as the specifics of the effect on the course and outcome of labor, have emerged as significant and well-studied problems in obstetric. The aim of this study was to analyze the effects of COVID-19 on pregnant women with preeclampsia, including possible maternal and/or fetal complications, birth outcomes, delivery methods, and the influence of existing extragenital pathology. The authors conducted a detailed analytical review of the scientific literature published from 2020 to 2022 on the study topic, gathering information from various sources, such as conference proceedings, technical reports, journal articles, abstracts, and papers available through databases, such as Medline, Google Scholar, and PubMed. Based on current scientific evidence, pregnant women with COVID-19 have a high incidence of preeclampsia, preterm labor, and operative delivery. The existence of intrauterine vertical transmission has not been reliably proven. The frequency of complications in newborns corresponds with general population indicators.

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Labor in women with the new coronavirus infection (COVID-19) and HIV infection

Gareyeva¹,

Kovalchuk²,

Lioznov

et al. 2023

Journal of obstetrics and women's diseases

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BACKGROUND:HIV and COVID-19 remain some of global health problems today. Complications of these diseases, pregnancy and labor, as well as the perinatal condition of newborns can make a significant contribution to the deterioration of the demographic situation in this country. Summarizing the foreign and domestic literature, one may assess the impact of each individual pathogen on the condition of the pregnant woman and the fetus. However, we have not found data on the associative or antagonistic form of symbiosis of these pathogens, as well as on the joint effect on the pregnancy, labor and the condition of newborns in the available literature. AIM:The aim of this work was to analyze the outcomes of labor in women with the new coronavirus infection (COVID-19) and HIV infection. MATERIALS AND METHODS:We performed a retrospective analysis of birth histories of 63 women who were delivered in S.P. Botkin Clinical Infectious Diseases Hospital (Saint Petersburg, Russia) in the period from April 2020 to March 2022. Of these, 26 birth histories are of women with a combination of HIV infection and COVID-19, and 37 birth histories of women with HIV infection alone. We assessed the severity of COVID-19 in pregnant women with HIV infection, the course of labor, complications during childbirth and the condition of newborns. RESULTS:The groups did not differ in the duration of labor, the frequency of labor abnormalities, the volume of blood loss during delivery, the frequency of postpartum complications and the condition of newborns after one and five minutes on the Apgar scale. The duration of the anhydrous interval was significantly longer in women with HIV infection who did not suffer from COVID-19. The frequency of cesarean section was significantly higher in pregnant women with HIV infection and COVID-19. According to pathological examination, inflammatory changes in the placenta and signs characteristic of viral infection occurred more often in the group of women with HIV infection and COVID-19. CONCLUSIONS:The presence of COVID-19 affects the course of labor in patients with HIV infection. However, the frequency of caesarean section in the group of patients with HIV infection and COVID-19 was significantly higher due to obstetric reasons, and was not related to the severity of the mothers condition and the prenatal state of the fetus due to the infectious process. Inflammatory changes in the placenta and signs of a viral infection are more common in patients with COVID-19 and HIV infection. These data suggest that the combined course of these diseases may have a greater negative impact on the fetus than in women with HIV infection who do not suffer from COVID-19.

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Experience in managing severe and extremely severe COVID-19 in pregnant women

Cited by 4 publications

References 23 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

Effects of COVID-19 on the body of a pregnant woman with preeclampsia: Birth outcomes (literature review)

Labor in women with the new coronavirus infection (COVID-19) and HIV infection

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