Possible formation of pulmonary microthrombi in the early puerperium of pregnant women critically ill with COVID-19: Two case reports

Case Reports in Women's Health

Filomena B. de Mello¹  Maria Regina Torloni²  Celso T. Tutiya³  Monica M. Siaulys³  Mario M. Kondo³  Elaine C. A. Galvão³  Cilene C. Pinheiro³  Lisia Miglioli-Galvão³ 

[1] Hospital e Maternidade Santa Joana, Rua Dr. Eduardo Amaro 225, São Paulo, SP CEP 04104 080, Brazil;Corresponding author at: Hospital e Maternidade Santa Joana, Rua Dr. Eduardo Amaro 225, São Paulo, SP, CEP, 04104 080, Brazil;Hospital e Maternidade Santa Joana, Rua Dr. Eduardo Amaro 225, São Paulo, SP CEP 04104 080, Brazil;

关键词: COVID-19;    Critical illness;    Pregnancy;    Postpartum period;    Anticoagulants;   

DOI  :  

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown