Gasless laparoendoscopic single-site surgery for management of unruptured tubal pregnancy in a woman with moderate COVID-19 pneumonia after administration of remdesivir and casirivimab-imdevimab: A case report

Background: Diagnostic and therapeutic challenges may arise in the management of gynecologic emergencies, such as ectopic pregnancy, for women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Case: A 33-year-old woman (gravida 3, para 2) with a history of SARS-CoV-2 infec...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Shotaro Hayashi, Akihiro Takeda
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2022
Materias:	Anti-viral therapy COVID-19 SARS-CoV-2 Tubal pregnancy Laparoscopic surgery Methotrexate Surgery RD1-811 Gynecology and obstetrics RG1-991
Acceso en línea:	https://doaj.org/article/89b4d7f7c7c9462e816fafeca5acade7
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:89b4d7f7c7c9462e816fafeca5acade7
record_format	dspace
spelling	oai:doaj.org-article:89b4d7f7c7c9462e816fafeca5acade72021-11-16T04:10:42ZGasless laparoendoscopic single-site surgery for management of unruptured tubal pregnancy in a woman with moderate COVID-19 pneumonia after administration of remdesivir and casirivimab-imdevimab: A case report2214-911210.1016/j.crwh.2021.e00368https://doaj.org/article/89b4d7f7c7c9462e816fafeca5acade72022-01-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2214911221000862https://doaj.org/toc/2214-9112Background: Diagnostic and therapeutic challenges may arise in the management of gynecologic emergencies, such as ectopic pregnancy, for women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Case: A 33-year-old woman (gravida 3, para 2) with a history of SARS-CoV-2 infection 8 months prior experienced sudden onset of fever and cough. Four days later, she consulted her gynecologist because of a positive pregnancy test and was further referred because of suspected ectopic pregnancy at 11 weeks of gestation, as calculated from her last irregular menstrual period. At triage, the patient complained of dyspnea, chest pain, and cough. Real-time reverse transcription-polymerase chain reaction assay detected SARS-CoV-2, which was subsequently identified to be an L452R variant. Chest computerized tomography (CT) showed moderate COVID-19 pneumonia. Transvaginal ultrasonography and pelvic CT showed a right tubal mass without an intrauterine gestational sac, suggesting right tubal pregnancy. Systemic methotrexate (MTX) therapy was chosen for management of the tubal pregnancy because of the patient's unruptured hemodynamically stable status, along with immediate administration of remdesivir and casirivimab-imdevimab to prevent worsening of the pneumonia. After failed MTX therapy, gasless laparoendoscopic single-site right salpingectomy was performed due to concern for tubal rupture. Four days after surgery, the patient was discharged from the hospital without subsequent complications. Conclusions: Laparoscopic surgery, preceded by anti-viral therapy for COVID-19, is a feasible option for the management of hemodynamically stable tubal pregnancy in a woman with moderate COVID-19 pneumonia.Shotaro HayashiAkihiro TakedaElsevierarticleAnti-viral therapyCOVID-19SARS-CoV-2Tubal pregnancyLaparoscopic surgeryMethotrexateSurgeryRD1-811Gynecology and obstetricsRG1-991ENCase Reports in Women's Health, Vol 33, Iss , Pp e00368- (2022)
institution	DOAJ
collection	DOAJ
language	EN
topic	Anti-viral therapy COVID-19 SARS-CoV-2 Tubal pregnancy Laparoscopic surgery Methotrexate Surgery RD1-811 Gynecology and obstetrics RG1-991
spellingShingle	Anti-viral therapy COVID-19 SARS-CoV-2 Tubal pregnancy Laparoscopic surgery Methotrexate Surgery RD1-811 Gynecology and obstetrics RG1-991 Shotaro Hayashi Akihiro Takeda Gasless laparoendoscopic single-site surgery for management of unruptured tubal pregnancy in a woman with moderate COVID-19 pneumonia after administration of remdesivir and casirivimab-imdevimab: A case report
description	Background: Diagnostic and therapeutic challenges may arise in the management of gynecologic emergencies, such as ectopic pregnancy, for women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Case: A 33-year-old woman (gravida 3, para 2) with a history of SARS-CoV-2 infection 8 months prior experienced sudden onset of fever and cough. Four days later, she consulted her gynecologist because of a positive pregnancy test and was further referred because of suspected ectopic pregnancy at 11 weeks of gestation, as calculated from her last irregular menstrual period. At triage, the patient complained of dyspnea, chest pain, and cough. Real-time reverse transcription-polymerase chain reaction assay detected SARS-CoV-2, which was subsequently identified to be an L452R variant. Chest computerized tomography (CT) showed moderate COVID-19 pneumonia. Transvaginal ultrasonography and pelvic CT showed a right tubal mass without an intrauterine gestational sac, suggesting right tubal pregnancy. Systemic methotrexate (MTX) therapy was chosen for management of the tubal pregnancy because of the patient's unruptured hemodynamically stable status, along with immediate administration of remdesivir and casirivimab-imdevimab to prevent worsening of the pneumonia. After failed MTX therapy, gasless laparoendoscopic single-site right salpingectomy was performed due to concern for tubal rupture. Four days after surgery, the patient was discharged from the hospital without subsequent complications. Conclusions: Laparoscopic surgery, preceded by anti-viral therapy for COVID-19, is a feasible option for the management of hemodynamically stable tubal pregnancy in a woman with moderate COVID-19 pneumonia.
format	article
author	Shotaro Hayashi Akihiro Takeda
author_facet	Shotaro Hayashi Akihiro Takeda
author_sort	Shotaro Hayashi
title	Gasless laparoendoscopic single-site surgery for management of unruptured tubal pregnancy in a woman with moderate COVID-19 pneumonia after administration of remdesivir and casirivimab-imdevimab: A case report
title_short	Gasless laparoendoscopic single-site surgery for management of unruptured tubal pregnancy in a woman with moderate COVID-19 pneumonia after administration of remdesivir and casirivimab-imdevimab: A case report
title_full	Gasless laparoendoscopic single-site surgery for management of unruptured tubal pregnancy in a woman with moderate COVID-19 pneumonia after administration of remdesivir and casirivimab-imdevimab: A case report
title_fullStr	Gasless laparoendoscopic single-site surgery for management of unruptured tubal pregnancy in a woman with moderate COVID-19 pneumonia after administration of remdesivir and casirivimab-imdevimab: A case report
title_full_unstemmed	Gasless laparoendoscopic single-site surgery for management of unruptured tubal pregnancy in a woman with moderate COVID-19 pneumonia after administration of remdesivir and casirivimab-imdevimab: A case report
title_sort	gasless laparoendoscopic single-site surgery for management of unruptured tubal pregnancy in a woman with moderate covid-19 pneumonia after administration of remdesivir and casirivimab-imdevimab: a case report
publisher	Elsevier
publishDate	2022
url	https://doaj.org/article/89b4d7f7c7c9462e816fafeca5acade7
work_keys_str_mv	AT shotarohayashi gaslesslaparoendoscopicsinglesitesurgeryformanagementofunrupturedtubalpregnancyinawomanwithmoderatecovid19pneumoniaafteradministrationofremdesivirandcasirivimabimdevimabacasereport AT akihirotakeda gaslesslaparoendoscopicsinglesitesurgeryformanagementofunrupturedtubalpregnancyinawomanwithmoderatecovid19pneumoniaafteradministrationofremdesivirandcasirivimabimdevimabacasereport
_version_	1718426736090152960

Gasless laparoendoscopic single-site surgery for management of unruptured tubal pregnancy in a woman with moderate COVID-19 pneumonia after administration of remdesivir and casirivimab-imdevimab: A case report

Ejemplares similares