VP31.24: Preterm Caesarean section in a pregnant woman infected with COVID‐19

Abstract

Since the outbreak of COVID-19 disease in 2019, many reports have been describing the pregnancy situation among COVID-19 positive patients. We report a pregnant woman in whom early medical management for pneumonia due to COVID-19 and Caesarean section leads to saving the life of both mother and infant. The patient was a 37-year-old Iranian woman, gravida 1, with a singleton pregnancy, at 32 weeks and 6 days of gestation. She was previously healthy without any prior comorbid diagnosis. Her body mass index (BMI) was 30. Because of dyspnea, fever, and a positive COVID-19 RT PCR test, the patient was transferred to our tertiary centre on April 13, 2021. At admission time, O2 saturation was 98% with oxygen mask. She was admitted to intensive care unit due to the extensive involvement of lungs that was seen in chest CT. Remdesivir 100 mg, Dexamethasone 6 mg, Enoxaparin 60 mg were prescribed for her. During the second day of hospitalisation O2 saturation decreased progressively (60-70%) so the mother being intubated and put under mechanical ventilation. Because of repetitive late deceleration in CTG, emergency Caesarean section was done. The Apgar score of the neonate was 2/10 and 6/10, so resuscitation protocol was done immediately. She was admitted to the neonatal intensive treatment unit. The result of the newborn's COVID-19 test was negative. The mother was successfully extubated after 3 days and discharged 7 days after Caesarean section. Presently, the condition evaluation of the mother and her newborn is normal. This case shows that immunological and physiologic changes during pregnancy making them more susceptible to viral infections and timely treatment can be successful. In addition, combination therapy of Remdesivir and Dexamethasone can be a suitable treatment choice for pregnant women infected with COVID-19. In this respect, it is worth mentioning that more studies are required to evaluate the side effects of Remdesivir during pregnancy.