中国首例COVID-19孕妇治疗后分娩三胞胎早产儿阴性

Chinese first COVID-19 pregnant woman gave birth to negative COVID-19 premature triplets

目的了解新型冠状病毒肺炎(COVID-19)三胞胎孕妇的疾病特点、治疗和分娩早产儿结局。方法分析中国首例COVID-19三胞胎孕妇的临床资料、诊疗过程,以及分娩早产儿陪娩、监测方法、结局。结果某院收治1例孕28周新型冠状病毒(SARS-CoV-2)核酸阳性13 h入院患者,病程中出现持续高热、呼吸困难等。给予COVID-19患者恢复期血浆(CP)、甲泼尼龙等治疗,及时处理相关症状后病情好转。孕32+5周因重度妊娠期肝内胆汁淤积症(ICP)、三绒毛膜和三羊膜腔(胎儿分别位于头位、臀位、横位),行剖宫产分娩。监测患者SARS-CoV-2核酸连续2次阴性后出院。剖宫产出生的每例早产儿分别由新生儿陪娩转运团队(穿二级防护服)单独转运至单间新生儿重症监护病房隔离治疗,住院期间监测SARS-CoV-2核酸为阴性;SARS-CoV-2 IgM为阴性;SARS-CoV-2 IgG为阳性,数值逐渐变小。孕妇和三例早产儿治疗成功,达到出院标准出院。结论COVID-19患者CP、甲泼尼龙治疗三胞胎孕妇的COVID-19有效,及时处理贫血、焦虑、失眠等相关症状对三胞胎孕妇的COVID-19治疗有帮助。COVID-19三胞胎孕妇ICP进展快,分娩是有效的治疗方法。COVID-19三胞胎孕妇经剖宫产娩出的三例早产儿未发生宫内垂直传播。

Objective To understand the disease characteristics and treatment of a pregnant COVID-19 woman who gave birth to triplets,as well as delivery outcome of triplets.Methods Clinical data,diagnosis and treatment process of the first pregnant COVID-19 woman who gave birth to triplets in China,as well as accompany delivery,monitoring methods and outcomes of premature infants were analyzed.Results One woman who was 28-week pregnancy and with 13-hour severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)nucleic acid positive was admitted in a hospital,persistent high fever and dyspnea occurred during disease course.Convalescent plasma(CP)of COVID-19 patient and methylprednisolone were given,condition improved after timely treatment of relevant symptoms.At 32+5 weeks of gestation,cesarean section was performed due to severe intrahepatic cholestasis in pregnancy(ICP),as well as three chorionic villus and three amniotic cavity(the fetuses were in head,hip and transverse position respectively).Patient was discharged after two consecutive negative test result of SARS-CoV-2 nucleic acid.Each premature infant delivered by caesarean section was individually transported to a single neonatal intensive care unit by the neonatal escort transport team(wearing secondary protective clothing)for isolated treatment.During hospitalization,SARS-CoV-2 nucleic acid and SARS-CoV-2 IgM test were both negative;SARS-CoV-2 IgG test was positive,value gradually decreased.Pregnant woman and three premature infants were treated suc-cessfully and reached the discharge standard.Conclusion Convalescent plasma and methylprednisolone are effective for the treatment of COVID-19 pregnant woman with triplets,timely treatment of anemia,anxiety,insomnia and other related symptoms is helpful for the treatment of pregnant woman with triplets.The progress of ICP in pregnant COVID-19 woman with triplets is fast,and delivery is an effective treatment.Three premature infants by cesarean section of COVOD-19 pregnant woman did not have intrauterine vertical transmission.