与COVID-19疑似患者密切接触的双胎妊娠孕产妇临床分析

Clinical analysis of a twin pregnancy woman in close contact with a patient with suspected COVID-19

目的探讨1例与新型冠状病毒疾病(COVID-19)疑似患者密切接触的双胎妊娠孕产妇的临床分娩处理经过、诊断及结局。方法选择2020年2月19日,四川大学华西第二医院产科收治的1例孕龄为37+2孕周的与疑似COVID-19患者密切接触的双胎妊娠孕妇为研究对象。采用回顾性分析方法,对本例双胎妊娠孕妇的一般临床资料、流行病学资料,妊娠结局、COVID-19相关实验室与影像学检查结果进行分析。本研究遵循的程序符合2013年修订的《世界医学协会赫尔辛基宣言》要求。结果对本例受试者的临床分析如下。①一般临床资料:体外受精-胚胎移植双胎妊娠,无妊娠相关并发症,无发热、干咳等临床症状。②流行病学资料:丈夫为COVID-19疑似患者,与其共同居住、生活,未采取任何隔离、消毒等防护措施。③妊娠结局:对其按照COVID-19疑似患者防护标准进行管理,于37+3孕周接受剖宫产术分娩2例出生体重分别为2430 g和2510 g新生儿。④COVID-19相关实验室与影像学检查结果:分娩后,立即进行胸部CT检查未见明显异常;鼻咽拭子、直肠拭子、羊水、胎膜标本严重急性呼吸窘迫综合征冠状病毒2(SARS-CoV-2)核酸检测均呈阴性。结论在SARS-CoV-2感染疫情暴发期,产科应制定严格的防护、隔离措施与应对策略,有效切断传染源,防止医务人员与非SARS-CoV-2感染孕产妇被交叉感染,而对COVID-19疑似患者做好防护、隔离管理,防止其被反复感染,同时对其妊娠、分娩及产后进行严格管理。

Objective To explore clinical delivery process,diagnosis and outcome of a twin pregnancy woman who was closely contacted with a patient with suspected corona virus disease 2019(COVID-19).Methods A twin pregnancy women of 37+2 gestational weeks who was closely contacted with a patient with suspected COVID-19 and received treatment in Department of Obstetrics,West China Second University Hospital,Sichuan University on February 19,2020 was selected as research subject.Retrospective analysis method was used to analyze her general clinical data,epidemiological data,pregnancy outcome,laboratory examinations and imaging examination results of COVID-19.The procedures followed in this study were in accordance with the World Medical Association Declaration of Helsinki revised in 2013.Results Clinical analysis data of this subject were as follows.①The twin pregnancy with in vitro fertilization-embryo transfer,without pregnancy-related complications,and without fever,dry cough or other clinical symptoms.②Epidemiology data:the husband of this subject was a patient with suspected COVID-19.The subject lived in close contact with her husband and did not take any isolation,disinfection or other protective measures.③Pregnancy outcomes:after the admission to our hospital,the subject was admitted to a single isolation ward and managed in accordance with the protection standards for COVID-19 suspected patient.The subject delivered a pair of live twins at 37+3 gestational weeks by cesarean section,with birth weights of 2430 g and 2510 g,respectively.④Laboratory examinations and imaging examination results of COVID-19:the subject received chest CT examination immediately after delivery,and the results showed that there was no obvious abnormality,and the detections of severe acute respiratory distress syndrome coronavirus 2(SARS-CoV-2)nucleic acid in nasopharynx swab,rectum swab,amniotic fluid and fetal membrane samples all were negative.Conclusions During the outbreak of SARS-CoV-2 infection,obstetrics department should take strict protection,isolation measures and response strategies to effectively cut off the source of infection and prevent cross-infection among medical staff and non-SARS-CoV-2 infected pregnant women.And to pregnant women with suspected COVID-19,they should be well protected and quarantined to prevent repeatedly infected.At the same time,their pregnancy,childbirth and postpartum should be strictly managed.