The Rare Case of a COVID-19 Pregnant Patient with Quadruplets and Postpartum Severe Pneumonia. Case Report and Review of the Literature
<i>Background and Objectives</i>: The multiple pregnancies associated with COVID-19 is a new and difficult condition to manage. The prognosis for rapid deterioration after the cesarean delivery is difficult to assess and needs close interdisciplinary follow-up due to pregnancy and postpa...
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2021
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oai:doaj.org-article:49bbc38cfc974e78a05e0bc786465d3c2021-11-25T18:18:24ZThe Rare Case of a COVID-19 Pregnant Patient with Quadruplets and Postpartum Severe Pneumonia. Case Report and Review of the Literature10.3390/medicina571111861648-91441010-660Xhttps://doaj.org/article/49bbc38cfc974e78a05e0bc786465d3c2021-11-01T00:00:00Zhttps://www.mdpi.com/1648-9144/57/11/1186https://doaj.org/toc/1010-660Xhttps://doaj.org/toc/1648-9144<i>Background and Objectives</i>: The multiple pregnancies associated with COVID-19 is a new and difficult condition to manage. The prognosis for rapid deterioration after the cesarean delivery is difficult to assess and needs close interdisciplinary follow-up due to pregnancy and postpartum-related changes. <i>Materials and Methods</i>: We report the case of a 37-year-old primigesta primipara patient who was admitted to “Elena Doamna” Clinical Hospital of Obstetrics and Gynecology at 33 weeks and 3 days of gestation with high-grade multiple pregnancies (triplets) for threatened premature birth associated with COVID-19. The patient had a history of surgically corrected atrial septal defect during childhood and currently is known to have paroxysmal supraventricular tachycardia. Tocolysis was ineffective and the decision to perform a cesarean operation was made. The diagnosis was established: primigesta, primipara, at 34 weeks of gestation, high-grade multiple pregnancy with triplets, intact membranes, threatened premature birth, surgically corrected atrial septal defect, paroxysmal supraventricular tachycardia, infection with COVID-19. The patient underwent a cesarean intervention and treatment for COVID-19 pneumonia. The intervention took place at 33 weeks and 4 days of gestation resulting in four newborns with weights between 1400 g and 1820 g and Apgar scores between 6–8. All newborns were transferred to a third-degree Neonatology ICU service due to their prematurity. The fourth newborn was not identified in any of the ultrasounds performed during pregnancy. During the postpartum period, the patient had a fulminant evolution of COVID-19 pneumonia, with rapid deterioration, needing respiratory support and antiviral treatment. <i>Discussions</i>: Managing high-risk obstetrical pregnancies associated with COVID-19 requires a multidisciplinary team consisting of obstetricians, anesthesiologists, neonatologists, and infectious disease doctors. <i>Conclusion</i>: Our case is the first to our knowledge in Romania to present an association of high-grade multiple pregancy with COVID19 moderate form, rapidly evolving postpartum, needing rapid intensive care admission, and specific treatment with Remdesivir, with good post-treatment evolution.Răzvan SocolovMona AkadMaricica PăvăleanuDiana PopoviciMădălina CiuhodaruRoxana CovaliFawzy AkadIoana PăvăleanuMDPI AGarticlemultiple pregnancyCOVID-19postpartum pneumoniaMedicine (General)R5-920ENMedicina, Vol 57, Iss 1186, p 1186 (2021) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
multiple pregnancy COVID-19 postpartum pneumonia Medicine (General) R5-920 |
| spellingShingle |
multiple pregnancy COVID-19 postpartum pneumonia Medicine (General) R5-920 Răzvan Socolov Mona Akad Maricica Păvăleanu Diana Popovici Mădălina Ciuhodaru Roxana Covali Fawzy Akad Ioana Păvăleanu The Rare Case of a COVID-19 Pregnant Patient with Quadruplets and Postpartum Severe Pneumonia. Case Report and Review of the Literature |
| description |
<i>Background and Objectives</i>: The multiple pregnancies associated with COVID-19 is a new and difficult condition to manage. The prognosis for rapid deterioration after the cesarean delivery is difficult to assess and needs close interdisciplinary follow-up due to pregnancy and postpartum-related changes. <i>Materials and Methods</i>: We report the case of a 37-year-old primigesta primipara patient who was admitted to “Elena Doamna” Clinical Hospital of Obstetrics and Gynecology at 33 weeks and 3 days of gestation with high-grade multiple pregnancies (triplets) for threatened premature birth associated with COVID-19. The patient had a history of surgically corrected atrial septal defect during childhood and currently is known to have paroxysmal supraventricular tachycardia. Tocolysis was ineffective and the decision to perform a cesarean operation was made. The diagnosis was established: primigesta, primipara, at 34 weeks of gestation, high-grade multiple pregnancy with triplets, intact membranes, threatened premature birth, surgically corrected atrial septal defect, paroxysmal supraventricular tachycardia, infection with COVID-19. The patient underwent a cesarean intervention and treatment for COVID-19 pneumonia. The intervention took place at 33 weeks and 4 days of gestation resulting in four newborns with weights between 1400 g and 1820 g and Apgar scores between 6–8. All newborns were transferred to a third-degree Neonatology ICU service due to their prematurity. The fourth newborn was not identified in any of the ultrasounds performed during pregnancy. During the postpartum period, the patient had a fulminant evolution of COVID-19 pneumonia, with rapid deterioration, needing respiratory support and antiviral treatment. <i>Discussions</i>: Managing high-risk obstetrical pregnancies associated with COVID-19 requires a multidisciplinary team consisting of obstetricians, anesthesiologists, neonatologists, and infectious disease doctors. <i>Conclusion</i>: Our case is the first to our knowledge in Romania to present an association of high-grade multiple pregancy with COVID19 moderate form, rapidly evolving postpartum, needing rapid intensive care admission, and specific treatment with Remdesivir, with good post-treatment evolution. |
| format |
article |
| author |
Răzvan Socolov Mona Akad Maricica Păvăleanu Diana Popovici Mădălina Ciuhodaru Roxana Covali Fawzy Akad Ioana Păvăleanu |
| author_facet |
Răzvan Socolov Mona Akad Maricica Păvăleanu Diana Popovici Mădălina Ciuhodaru Roxana Covali Fawzy Akad Ioana Păvăleanu |
| author_sort |
Răzvan Socolov |
| title |
The Rare Case of a COVID-19 Pregnant Patient with Quadruplets and Postpartum Severe Pneumonia. Case Report and Review of the Literature |
| title_short |
The Rare Case of a COVID-19 Pregnant Patient with Quadruplets and Postpartum Severe Pneumonia. Case Report and Review of the Literature |
| title_full |
The Rare Case of a COVID-19 Pregnant Patient with Quadruplets and Postpartum Severe Pneumonia. Case Report and Review of the Literature |
| title_fullStr |
The Rare Case of a COVID-19 Pregnant Patient with Quadruplets and Postpartum Severe Pneumonia. Case Report and Review of the Literature |
| title_full_unstemmed |
The Rare Case of a COVID-19 Pregnant Patient with Quadruplets and Postpartum Severe Pneumonia. Case Report and Review of the Literature |
| title_sort |
rare case of a covid-19 pregnant patient with quadruplets and postpartum severe pneumonia. case report and review of the literature |
| publisher |
MDPI AG |
| publishDate |
2021 |
| url |
https://doaj.org/article/49bbc38cfc974e78a05e0bc786465d3c |
| work_keys_str_mv |
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