| Abstract [eng] |
Pregnancy is a period of physiological changes in a woman's body, including changes in the immune system, which make the body less resistant to infections, including SARS-CoV-2. In severe COVID-19 infection, an excessive immune response - a cytokine storm - can lead to respiratory and other organ failure and hypercoagulability, increasing the risk of pre-eclampsia, placental abruption and fetal growth restriction. Pneumonia caused by COVID-19 infection can lead to hypoxia, which can impair fetal development and even result in fetal or maternal death. Studies in pregnant women have shown that infection with SARS-CoV-2 increases the likelihood of a severe clinical course of COVID-19 disease, the death, the development of pneumonia, the need for intensive care unit treatment, the risk of preterm birth, and the risk of intrauterine growth restriction for gestational age. The risk of these complications is higher in pregnant women with comorbidities, for example, diabetes, hypertension or obesity. This paper describes a clinical case illustrating the potential adverse consequences and risks of COVID-19 infection in pregnancy. A 29-year-old pregnant woman was infected with SARS-CoV-2 in the second trimester of pregnancy and developed a critically severe, rapidly progressive form of COVID-19 disease. Due to bilateral pneumonia, severe hypoxia and hypovolemic shock, the patient was admitted to the intensive care unit. Artificial pulmonary ventilation and veno-venous extracorporeal membrane oxygenation were applied. The pregnancy was terminated due to fetal death. The patient was treated in hospital for 44 days with a two-phase rehabilitation programme, followed by outpatient rehabilitation. COVID-19 vaccines are safe and effective in pregnant women and are recommended to reduce the risk of infection and complications. The vaccination also provides some protection for the newborn by allowing maternal antibodies to enter the fetus through the placenta. Pregnant women are advised to follow preventive measures to reduce the risk of COVID-19 infection. |
