KLINIČKE KARAKTERISTIKE I LABORATORIJSKI REZULTATI TRUDNICE SA SARS-CoV-2 INFEKCIJOM

Marijana Banašević

doi:10.5937/zdravzast51-37066

Marijana Banašević Dom zdravlja Voždovac, Beograd, Republika Srbija

DOI: https://doi.org/10.5937/zdravzast51-37066

Ključne reči: COVID-19, trudnoća, prikaz slučaja

Sažetak

Uvod/cilj: Najčešći klinički simptomi i laboratorijski znaci SARS-CoV-2 infekcije u trudnoći su povišena temperatura, kašalj, dispneja, dijareja, limfocitopenija, leukocitoza i porast vrednosti C reaktivnog proteina. Međutim, trudnice sa komorbiditetima imaju veći rizik od teže forme kovida-19. Mnoge studije upućuju na to da trudnice sa potvrđenom SARS-CoV-2 infekcijom imaju više od dva puta povišen rizik od prevremnog porođaja, da su pod većim rizikom za razvoj preeklampsije i potrebom za hitnim carskim rezom. Cilj ovog rada je da se analizira tok i ishod SARS-CoV-2 infekcije potvrđene kod mlade žene u 39 nedelji trudnoće.

Prikaz bolesnika: Trudnica sa dokazanom SARS-CoV-2 infekcijom u 39 nedelji trudnoće porađaja se šesti dan od pojave simptoma i znakova bolesti. Na početku infekcije pacijentkinja navodi temperaturu i opšte loše stanje, a potom kašalj i na kraju bol u grudnom košu. Infekciju prate povišene vrednosti C reaktivnog proteina, D-dimera i limfocitopenija. Trudnica je mlađa osoba, osoba bez komorbiditeta, ali se kod nje šestog dana od pojave simptoma i znakova bolesti dijagnostikuje pneumonija sa tendencijom progresije, zbog čega je njena hospitalizacija nakon porođaja produžena. Nalaz kompjuterizovane tomografije odgovara bilateralnoj intersticijalnoj COVID-19 pneumoniji. Pacijentkinja je bila, sve vreme tokom hospitalizacije, hemodinamski stabilna bez potrebe za kiseoničnom potpornom terapijom. Dete je rođeno vaginalnim putem i na rođenju je bilo dobrog zdravstvenog stanja (Apgar skor 9/10, telesna težina). SARS-CoV-2 infekcija nije dokazana brzim antigenskim testom kod novorođenog deteta.

Zaključak: Neophodna su dalja istraživanja u ovoj oblasti, pogotovo toka i ishoda infekcije kod trudnica tokom prvog i drugog trimestra trudnoće, kao i kako smanjiti neželjene neonatalne ishode kod trudnica sa SARS-CoV-2 infekcijom.

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