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2020 ; 27
(ä): e00237
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gab.com Text
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English Wikipedia
Possible formation of pulmonary microthrombi in the early puerperium of pregnant
women critically ill with COVID-19: Two case reports
#MMPMID32637327
Tutiya CT
; Siaulys MM
; Kondo MM
; Miglioli-Galvão L
; C A Galvão E
; Pinheiro CC
; Torloni MR
; de Mello FB
Case Rep Womens Health
2020[Jul]; 27
(ä): e00237
PMID32637327
show ga
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.