A case of COVID-19 in pregnancy complicated by fetal pleural effusion

• Authors: Natalia Filochowska , Łukasz Witek , Helena Sławska , Anita Olejek

Title variants

PL

Ciąża powikłana wysiękiem opłucnowym płodu u matki z COVID-19 – opis przypadku

• Languages of publication: EN PL

Abstracts

EN

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which can lead to severe respiratory failure, has become a real threat to pregnancy. Although vertical transmission of the virus through the placenta appears to be rare, there is increasing evidence that a SARS-CoV-2 infection may cause complications during pregnancy. We report a case of COVID-19 in a pregnancy complicated by fetal pleural effusion in the third trimester of pregnancy. To our knowledge, only 4 similar cases have been reported to date. A 29-year-old woman in the 37th week of pregnancy admitted to the department of pregnancy pathology due to right fetal pleural effusion. In the 34th week of pregnancy, the patient suffered from COVID-19 with symptoms of fever and general weakness. The infection was confirmed by reverse-transcription polymerase chain reaction (RT-PCR). At 38 weeks, vaginal delivery occurred. The male newborn with a 6/7/8 point Apgar score required continuous positive airway pressure (CPAP) breathing assistance and was transferred to the intensive care unit. The rapid antigen test was negative. The ultrasound showed collapse of the right lung compressed by fluid in the pleural cavity. Inflammation, congenital TORCH and group B Coxsackie virus infection, chromosomal disorders and anatomical defects were excluded. During hospitalization 850 ml of lymphatic fluid was drained. We suspect a possible causal relationship between non-immune fetal hydrops and coronavirus disease.

PL

Choroba COVID-19 (coronavirus disease 2019), powodowana wirusem SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), który może prowadzić do ciężkiej niewydolności oddechowej, stała się realnym zagrożeniem dla kobiet w ciąży. Mimo iż wertykalna transmisja wirusa przez łożysko wydaje się rzadka, istnieje coraz więcej dowodów na to, że zakażenie SARS-CoV-2 może być przyczyną powikłań w czasie ciąży. Opisany przypadek dotyczy ciąży powikłanej wysiękiem w prawej jamie opłucnej płodu po potwierdzeniu zakażenia SARS-CoV-2 u matki w III trymestrze ciąży. Według naszej wiedzy do tej pory opisano cztery podobne przy-padki. Kobieta, 29-letnia, w 37 tygodniu ciąży, zgłosiła się do kliniki z powodu wysięku w prawej jamie opłuc-nowej u płodu. W 34 tygodniu ciąży pacjentka chorowała na COVID-19 z objawami ogólnego osłabienia i gorączką. Zakażenie SARS-CoV-2 potwierdzono testem PCR. W 38 tygodniu ciąży odbył się poród siłami natury. Noworodek płci męskiej, żywy, donoszony, z oceną w skali Apgar 6/7/8 pkt; zastosowano wspomaganie oddychania CPAP (continuous positive airway pressure). Ze względu na zaburzenia oddychania dziecko przekazano na oddział intensywnej terapii bezpośrednio po urodzeniu. Wynik testu antygenowego był ujemny. W badaniu ultrasonograficznym stwierdzono zapadnięcie się płuca prawego oraz obecność płynu w prawej jamie opłucnej. W dalszych etapach wykluczono stan zapalny, wrodzoną infekcję TORCH, zakażenie wirusem Coxsackie z grupy B, zaburzenia chromosomalne oraz wady anatomiczne. W trakcie hospitalizacji zastosowano drenaż jamy opłucnej, uzyskując łącznie 850 ml płynu limfatycznego. Podejrzewamy możliwy związek przyczynowy między nieimmunologicznym obrzękiem płodu a chorobą COVID-19.

Keywords

EN

COVID-19; SARS-CoV-2; ciąża; fetal pleural effusion; hydrops fetalis; obrzęk płodu; pregnancy; wysięk opłucnowy płodu

Discipline

• MEDICINE: MEDICINE

• Publisher: Śląski Uniwersytet Medyczny w Katowicach
• Journal: Annales Academiae Medicae Silesiensis
• Year: 2024
• Issue: 78
• Pages: 89–93

Contributors

author

Natalia Filochowska

• Department of Gynaecology, Obstetrics and Oncological Gynaecology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland

author

Łukasz Witek

• Department of Gynaecology, Obstetrics and Oncological Gynaecology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland

author

Helena Sławska

• Department of Gynaecology, Obstetrics and Oncological Gynaecology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland

author

Anita Olejek

• Department of Gynaecology, Obstetrics and Oncological Gynaecology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland

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• Document Type: article