ОСОБЕННОСТИ ТЕЧЕНИЯ БЕРЕМЕННОСТИ С МАНИФЕСТАЦИЕЙ ИНФЕКЦИИ COVID-19 В ТРЕТЬЕМ ТРИМЕСТРЕ

Abstract

Women during gestation are considered to be at high risk of viral respiratory infections with conversion to pneumonia due to physiological changes in the immune and cardiopulmonary systems. This research publication examined the peculiarities of the course of pregnancy, obstetric and perinatal outcomes during pregnancy against the background of a new coronavirus infection COVID-19 and assessed the changes in laboratory indices. Objective. to evaluate the features of the course of pregnancy with COVID-19 manifestation in the third trimester. Materials and Methods. 139 pregnant women at 28 weeks' gestation or more, including 112 pregnant women admitted to the obstetric department of an infectious diseases hospital with a confirmed diagnosis of COVID-19 and with mild to moderate degrees of infection, and 27 pregnant women in the antenatal clinic, who were conventionally healthy. The first group of pregnant women was divided into two subgroups, depending on the prescription of low molecular weight heparins for the prevention of venous thromboembolic complications (55 and 57 subjects, respectively). We evaluated the data of gynecological anamnesis, extragenital diseases, peculiarities of pregnancy course, clinical characteristics of COVID-19, comparison of laboratory tests. The features of the course of infection and pregnancy with altered blood parameters: lymphopenia, elevated levels of C-reactive protein, D-dimer were considered in the acute period of infection. The correlation between the gestational age at infection and the term of delivery as a result of the treatment was analyzed. The presence of iron deficiency anemia was considered as an additional risk factor for new coronavirus infection in pregnant women. Changes in the levels of fibrinogen, C-reactive protein, D-dimer may be the main markers in predicting the course of COVID-19 infection. Prescription of low-molecular-weight heparins at the initial stage of therapy may serve as a factor that allows prolongation of pregnancy to a pre-term term.