Covid-19: ¿cómo actuar en una embarazada?

Abstract

The case is presented of a woman in the second quarter of pregnancy, with coronavirus disease, who manifested abundant and varied symptoms with both gastrointestinal and respiratory involvement. During the 45 days of follow-up, she required multidisciplinary care by different care levels (family medicine and midwife), who conducted daily follow-up of the patient from the health care center and by remote consultation, and by the Hospital Emergency and gynecology Service at specific times. At all times, action was taken assuring the maternal-fetal well-being and analyzing the risk-benefit of the different diagnostic tests and therapeutic measures. Based on the case, the latest consensuses on the diagnostic and pharmacological treatment of the pregnant woman with SARS-CoV-2 infection are presented. Furthermore, the latest theories on the transmissibility of the disease from the mother to the newborn are set forth: vertical transmission is ruled out, in spite of the fact that recent studies state the presence of IgM antibodies in some of the newborns of ill mothers. The definition of the case, the diagnosis, prognosis and approach to the pregnant woman does not differ from that of the general population. However, it has certain nuances focused on the situation of hypercoagulability characteristic of the pregnant person; from the iatrogenic disease derived from the radiation of complementary tests such a chest x-ray or computerized axial tomography; or that due to certain drugs used for the treatment of the COVID-19, such as antiviral, which have been administered in compassionate use in some patients, or the hydroxychloroquine (it has not been demonstrated as beneficial and in studies with animals, accumulation in the fetal ocular tissue has been described).