Features of the postcovid period in women in labor

Clinical case

Authors

DOI:

https://doi.org/10.18370/2309-4117.2021.59.46-50

Keywords:

COVID-19, post-COVID period, vesicular rash, women in labor

Abstract

Clinical manifestations in the abdominal cavity of a woman in labor, discovered during an urgent cesarean section at 41 weeks of gestation 2 months after an acute form of COVID-19, are described. The materials of medical documentation were analyzed and the features of the course of pregnancy by trimester, urgent cesarean section, postoperative period, laboratory parameters, ultrasound data, cardiotocography, fetal condition at birth and three days later were determined.
Presentation of case. 33-year-old pregnant woman (pregnant for the first time) had COVID-19 at 26 weeks of gestation. At a cesarean section for urgent indications at 41 weeks of gestation during the revision of the abdominal cavity was found that the visceral peritoneum of the uterus along the anterior and posterior surfaces, fallopian tubes, wide and round uterus ligaments, ovaries and parietal peritoneum of the pelvis, areas of the serous intestinal layer were with expressive signs of edema covered with vesicular rash, in places in the conglomerate, which were bleeding. There was no abdominal effusion.
The child was born with 7–8 points Apgar score and had a negative PCR result for COVID-19. Placenta measuring 25 x 21 x 5.0 x 0.5 cm with multiple petrification, single red heart attacks. The shells are distinctly yellow-gray-green in color. The umbilical cord is 70 cm long and usual color. Amniotic fluid is clear. The early and late postoperative periods and the postpartum period proceeded without complications. At once the disorders in the blood coagulation system, immune system, positive COVID-19 IgG and IgM were identified in mother. Videin, Magniсum-antistress, preparations of acetylsalicylic acid and for the comprehensive support of the physiological state of the intestine were used in the complex treatment of the postpartum period.
Conclusion. COVID-19 disease is pathology with many unknowns. Therefore, each clinical observation is important for studying of its course. Post-COVID syndrome and long-COVID syndrome have individual characteristics. Collective experience will contribute to the definition of an algorithm for the therapy of patients and personalized dispensary observation after an acute period.

Author Biographies

V.P. Mishchenko, Odesa National Medical University, Odesa

MD, professor, Department of Obstetrics and Gynecology

I.V. Shpak, Odesa National Medical University; Maternity Hospital No. 5, Odesa

MD, associate professor, Department of Obstetrics and Gynecology;

Director

I.V. Rudenko, College of Medicine Gulf Medical University, Ajman

Clinical professor, Department of Clinical Sciences (Obstetrics and Gynecology)

V.V. Mishchenko, Odesa National Medical University, Odesa

MD, professor, Department of Surgery No. 1

T.Y. Moskalenko, Odesa National Medical University; Maternity Hospital No. 7, Odesa

MD, professor, Department of Obstetrics and Gynecology;

Director

I.L. Golovatyuk-Józefpolska, Odesa National Medical University; Maternity Hospital No. 1, Odesa

PhD, assistant, Department of Obstetrics and Gynecology;

Director

M.Y. Golubenko, Odesa National Medical University; Maternity Hospital No. 2, Odesa

MD, professor, Department of Obstetrics and Gynecology;

Director

A.S. Makoshyba, Maternity Hospital No. 1, Odesa

Obstetrician-gynecologist

References

  1. Temporary guidelines Ministry of Health of Russian Federation. Prevention, diagnosis and treatment of new coronavirus infection (COVID-19). Version 6 (04/24/2020). Available from: [http://rushiv.ru/profilaktika-diagnostika-i-lechenie-novoj-koronavirusnoj-infektsii-covid-19-vremennye-metodicheskie-rekomendatsii-versiya-6-ot-24-04-2020], last accessed June 11, 2021.
  2. Makarenko, M.V., Govseev, D.A., Sokol I.V., et al. “Gestational coagulopathy: a breakthrough in views on the prevention of bleeding.” Perinatology and Pediatrics 3.71 (2017): 39–43. DOI: 10.15574/pp.2017.71.39
  3. Makatsaria, A.D., Grigorieva, K.N., Mingalimov, M.A., et al. “Coronavirus infection (COVID-19) and disseminated intravascular coagulation syndrome.” Obstetrics, Gynecology and Reproduction 14.2 (2020): 123–31. DOI: 10.17749/2313-7347.132
  4. Melekhina, E.V., Gorelov, A.V., Muzika, A.D.“Clinical features of the course of COVID-19 in children of different age groups. Literature review by the beginning of 2020.” Questions of practical pediatrics 15.2 (2020): 7–20.
  5. Priputnevich, T.V., Gordeev, A.B., Lyubasovskaya, L.A., Shabanova, N.Y. “The new coronavirus SARS-COV-2 and pregnancy: a literature review.” Obstetrics and gynecology 5 (2020): 6–12. DOI: 10.18565/aig.2020.5.6-12
  6. Yusupova, L.A. “Modern state of the problem of skin angiitis.” Physician 5 (2013): 38–43.
  7. Brodin, P. “Why is COVID-19 so mild in children?” Acta Paediatr 109 (2020): 1082–3. DOI: 10.1111/apa.15271
  8. Centers for Disease Control and Prevention. Considerations for inpatient obstetric healthcare settings. Available from: [https://www.cdc.gov/coronavirus/2019-ncov/hcp/inpatient-obstetric-healthcare-guidance.html].
  9. Centers for Disease Control and Prevention. Interim clinical guidance for management of patients with confirmed coronavirus disease (COVID-19). Available from: [https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html].
  10. Centers for Disease Control and Prevention. Pregnancy and breastfeeding. Available from: [https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnancy-breastfeeding.html]
  11. Chen, H., Guo, J., Wang, C., et al. “Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records.” Lancet 395.10226 (2020): 809–15. DOI: 10.1016/S0140-6736(20)30360-3
  12. Chen, D., Yang, H., Cao, Y., et al. “Expert consensus for managing pregnant women and neonates born to mothers with suspected or confirmed novel coronavirus (COVID-19) infection.” Int J Gynaecol Obstet 149.2 (2020): 130–6. DOI: 10.1002/ijgo.13146
  13. Gidlöf, S., Savchenko, J., Brune, T., Josefsson, H. “COVID-19 in pregnancy with comorbidities: more liberal testing strategy is needed.” Acta Obstet Gynecol Scand (2020). DOI: 10.1111/aogs.13862
  14. Hantoushzadeh, S., Shamshirsaz, A.A., Aleyasin, A., et al. “Maternal death due to COVID-19 disease.” Am J Obstet Gynecol 223.1 (2020): 109.e1–109.e16. DOI: 10.1016/j.ajog.2020.04.030
  15. Holick, M.F. “Resurrection of vitamin D deficiency and rickets.” J Clin Invest 116 (2006): 2062–72.
  16. Karimi-Zarchi, M., Neamatzadeh, H., Dastgheibetal, S.A. “Vertical transmission of coronavirus disease 19 (COVID-19) from infected pregnant mothers to neonates: a review.” Fetal Pediatr Pathol 39.3 (2020): 246–50. DOI: 10.1080/15513815.2020.1747120
  17. Lippi, G., Plebani, M., Henry, B.M. “Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: A meta-analysis.” Clin Chim Acta 506 (2020): 145–8. DOI: 10.1016/j.cca.2020.03.022
  18. Ludvigsson, J.F. “Systematic review of COVID-19 in children chows milder cases and a better prognosis than adults.” Acta Paediatr 109.6 (2020): 1088–95. DOI: 10.1111/apa.15270
  19. Rasmussen, S.A., Smulian, J.C., Lednicky, J.A., et al. “Coronavirus disease 2019 (COVID-19) and pregnancy: what obstetricians need to know.” Am J Obstet Gynecol 222.5 (2020): 415–26. DOI: 10.1016/j.ajog.2020.02.017
  20. Royal College of Obstetricians and Gynaecologists. Coronavirus infection and pregnancy. Available from: [https://www.rcog.org.uk/en/guidelines-research-services/guidelines/coronavirus-pregnancy/COVID-19-virus-infection-and-pregnancy/].
  21. Salf, L.J. “Animal coronaviruses: what can they teach us abohut the severe acute respiratory syndrome?” Rev Sci Tech 23.2 (2004): 643–60.
  22. Sudre, C.Y., Murray, B., Varsavsky, T., et al. “Attributes and predictors of Long-COVID.” Nature Medicine 27 (2021): 626–31.
  23. Tang, N., Li, D., Wang, X., Sun, Z. “Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia.” J Thromb Haemost 18.4 (2020): 844–7. DOI: 10.1111/jth.14768.
  24. Tang, N., Bai, H., Chen, X., et al. “Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy.” J Thromb Haemost 18.5 (2020): 1094–9. DOI: 10.1111/jth.14817
  25. The American College of Obstetricians and Gynecologists (ACOG). Novel Coronavirus 2019 (COVID-19). Practice Advisory. Available from: [https://www.acog. org/clinical/clinical-guidance/practice-advisory/articles/2020/03/novel-coronavirus-2019].
  26. Zaigham, M., Andersson, O. “Maternal and perinatal outcomes with COVID-19: A systematic review of 108 pregnancies.” Acta Obstet Gynecol Scand 99.7 (2020): 823–82. DOI: 10.1111/aogs.13867
  27. Zimmermann, P., Curtis, N. “Coronavirus Infections in Children Including COVID-19.” Pediatr Infect Dis J 39.5 (2020): 355–68. DOI: 10.1097/INF.0000000000002660

Published

2021-07-22

How to Cite

Mishchenko, V., Shpak, I., Rudenko, I., Mishchenko, V., Moskalenko, T., Golovatyuk-Józefpolska, I., Golubenko, M., & Makoshyba, A. (2021). Features of the postcovid period in women in labor: Clinical case. REPRODUCTIVE ENDOCRINOLOGY, (59), 46–50. https://doi.org/10.18370/2309-4117.2021.59.46-50

Issue

Section

Pregnancy and childbirth