妊娠合并新型冠状病毒肺炎治愈17例临床分析

目的:探讨妊娠合并新型冠状病毒肺炎(COVID-19)的临床特点及治疗方法。方法:对武汉大学人民医院东院2020年1月31日至3月26日收治的妊娠合并COVID-19并痊愈出院的患者17例临床资料进行回顾性分析。结果:17例患者中轻型6例,普通型11例,无一例转为重症或危重症。发热10例,咳嗽6例,同时出现咳嗽、腹泻、气促及乏力等症状1例,无呼吸道症状4例。4例孕妇合并白细胞计数升高,10例出现淋巴细胞计数降低,11例出现淋巴细胞百分比降低,13例孕妇D-二聚体值升高。17例痊愈患者行抗病毒、抗感染及中成药物等对症支持治疗,10例使用小剂量糖皮质激素治疗,3例使用免疫调节剂,11例行低流量吸氧治疗。17例中6例患者(包含瘢痕子宫)因临产或先兆临产等原因经剖宫产术分娩,1例顺产,1例早孕自然流产,7例新生儿出生后查新型冠状病毒核酸均阴性。9例患者出院后继续妊娠。17例患者经治疗后各项指标均好转,符合出院标准。结论:早发现、早治疗、适时终止妊娠对改善妊娠合并COVID-19的预后有一定效果,轻型或普通型COVID-19孕妇无终止妊娠的其他医学指征,可在严密监测下继续妊娠,COVID-19病毒及治疗药物对胎儿的影响尚待进一步研究。

Clinical Analysis of 17 cases of Corona Virus Disease 2019 Complicating Pregnancy

Objective:To investigate the clinical characteristics and management of the novel coronavirus disease 2019(COVID-19)in pregnancy.Methods:The clinical data of 17 cases of cured COVID-19 complicating pregnancy who were admitted to the East Hospital of the people′s Hospital of Wuhan University from Jan 31th to Mar19 th were analyzed retrospectively.Results:In the total of 17 cases,there were 6 mild and 11 moderate cases.None of them turned into severe or extremely severe cases.Ten cases were with fever.Six cases showed the symptom of cough.There was only one case with all the symptom of cough,diarrhea,anhelation and fatigue.Four cases showed no respiratory symptom.The increase of white blood cells was observed in four women.The decrease of lymphocytes was detected in ten women.The percentage of lymphocytes decreased in 11 cases.The values of D-Dimer in 13 women increased.All the cases of COVID-19 complicating pregnancywere treated with antiviral and anti-infective therapy,including 10 cases treated with glucocorticoid,3 case treated with immunomodulatory and 11 cases treated with low flow oxygen.Six cases delivered by cesarean section due to in labor,threatened labor or scarred uterus.,One vaginal delivery and one spontaneous abortion in first trimester was observed in the 17 cases.All the newborns were negative for COVID-19 nuclear acid detection.9 patients continued pregnancy after discharged.After treatment,all of 17 patients showed satisfactory markers and matched the standard of discharge.Conclusions:Early detection,early treatment and appropriate termination of pregnancy is the key to the treatment of pregnancy with COVID-19,The pregnant women with mild or moderate COVID-19 showed no indications of pregnancy termination.Pregnancy could be continued under close monitor.However,the influence of COVID-19 virus and therapeutic drugs on fetus still needs further study.