Key result
Dexamethasone and hydroxychloroquine support recovery in severe post-cesarean COVID-19 pneumonia.
Why the study?
Pregnant women with COVID-19 may present without clinical manifestations, complicating diagnosis and management during delivery.
Case Report (n=1)
No
COVID-19 pneumonia in pregnant women can present asymptomatically and rapidly progress to severe respiratory distress post-delivery, mimicking pulmonary thromboembolism.
Rapid postpartum progression of asymptomatic COVID-19 may mimic embolism; this case leaves open peripartum screening needs.
A 41 year old woman, 38 weeks and 3 days pregnant, without any past medical history and gravida (G) 4, parity (P) 2 and abortion (Ab) 2, gave birth by Cesarean section. The patient did not have any fever, cough, and dyspnea and did not report any close contact with COVID-19 patients. She was extubated post-surgery in the recovery room. She had oxygen saturation (SpO2) of 87-93% with face mask and was transferred to medical ward. Six hours later, she experienced dyspnea and her SpO2 fell down to 83%. Ten hours after surgery, due to worsening of her dyspnea and SpO2 of 78%, cardiology consultation was conducted and patient was admitted to the intensive care unit (ICU) with the diagnosis of pulmonary thromboembolism (PTE). Cardiac consultation and echocardiography excluded PTE. In the ICU, her chest computerized tomography scan (CT-scan) showed bilateral ground glass opacity in favor of COVID-19. Reverse Transcription-Polymerase Chain Reaction (RT-PCR) for COVID-19 was also positive. The baby was born with an Apgar score of 9, a normal physical examination and a positive PCR test for COVID-19.
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Lotfi et al. (2021) conducted a case report in COVID-19 (n=1). Dexamethasone and hydroxychloroquine was evaluated. A 41-year-old pregnant woman without prior symptoms developed severe respiratory distress post-cesarean section and was diagnosed with COVID-19 pneumonia, recovering after treatment with dexamethasone and hydroxychloroquine.
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