Severe course of COVID-19 in pregnant woman and newborn's alloimmune thrombocytopenia - case study and review of the literature.

So far, little is known about the impact of the coronavirus disease 2019 (COVID-19) on pregnancy and data is often inconsistent. Even less information has been published on the management of severe courses of COVID-19 in pregnant women. By writing this article, we aim to share our experience in the treatment of pregnant woman critically ill with COVID-19 and newborn's condition, FNAIT (Fetal and neonatal alloimmune thrombocytopenia), as well as literature review of this disease. After admission,the woman's respiratory status rapidly worsened, requiring administration of oxygen and in the end ECMO therapy. At the 9th day of ECMO support, and 28 weeks 3 days of gestation, due to mother's prognosis and increased feto-placental vascular resistance a decision of Caesarean section was taken. The neonate required intensive care not only due to extreme prematurity but coagulation disorder, alloimmune thrombocytopenia, which we diagnosed a few weeks after delivery.

Is the Course of COVID-19 Different during Pregnancy? A Retrospective Comparative Study.

The COVID-19 pandemic has challenged health systems around the world. Maternal-foetal medicine, which has been particularly affected, must consider scientific data on the physiological processes occurring in the pregnant woman's body to develop relevant standards of care. Our study retrospectively compared the clinical and laboratory characteristics of 52 COVID-19 pregnant patients with 53 controls. Most of the pregnant patients required medical attention during the third trimester and therefore we propose that vaccination is needed prior to the 30th week of pregnancy. We found no differences between the 2 groups in the course of illness classification system, days of hospital stay, need for oxygen supplementation, need for mechanical ventilation, and ICU admission. Moreover, clinical manifestations and imaging findings were comparable. Pregnant patients needed a greater oxygen flow rate and required high flow oxygen therapy more frequently. Considering pregnancy-related physiological adaptations, we found that COVID-19 infection in pregnant patients is associated with higher levels of inflammatory markers, apart from serum ferritin, than in non-pregnant women, and concluded that biomarkers of cardiac and muscle injury, as well as kidney function, may not be good predictors of COVID-19 clinical course in pregnant patients at the time of admission, but more research needs to be conducted on this topic.