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Revista Cubana de Anestesiología y Reanimación

2022, Number 1

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Revista Cubana de Anestesiología y Reanimación 2022; 21 (1)

Fatal outcome wiht pregnant and COVID-19

Vasallo CVJ

Language: Spanish
References: 14
Page: 1-7
PDF size: 313.47 Kb.


ABSTRACT

Introduction: Multiple deaths and infections due to the new coronavirus have occurred. In the midst of this context, the spread of the disease in pregnant patients has been well documented.
Objective: Present the events that occurred in pregnant women, in order to share the experience with those who treat these patients.
Presentation of the case: The case of a 24-year-old pregnant woman, obese, with a pregnancy of 25 weeks is presented. She was admitted with COVID-19 pneumonia and evolution towards severe respiratory failure led to her death during cesarean section. She was received in the operating room with hypoxemia and hypercapnia, tachycardia, cyanosis, oliguria and ventilated at positive pressure with 100% oxygen. She was treated with ketamine, fentanyl and rocuronium. At 35 min, and after hysterotomy, she presented progressive bradycardia, so external chest compressions and pharmacological treatment were initiated. The sinus rhythm was recovered at 12 min, but the asystole stop relapsed at 20 min, with cyanosis. Compressions and administration of epinephrine were implemented until death 30 minutes later due to non-recovery of rhythm and certain signs of death.
Conclusions: Multidisciplinary care improves treatment conditions at all stages. Individualized anesthetic management offers an invaluable strategy in cases like these, regardless of the outcome. Pulmonary thromboembolism in pregnant women is a latent risk associated with COVID-19, exponentially increasing its lethality.


REFERENCES

  1. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239-42. DOI: https://doi.org/10.1001/jama.2020.2648

  2. Hunt BJ, Jurd KM. Endothelial cell activation. A central pathophysiological process. BMJ. 1998;316(7141):1328-9. DOI: https://doi.org/10.1136/bmj.316.7141.1328

  3. Casini A, Fontana P, Glauser F, Robert-Ebadi H, Righini M, Blondon M. Venous thrombotic risk related to SARS-CoV-2 : prevalence, recommendations and perspectives. Rev Med Suisse. 2020[acceso: 03/012/2020];16(692):951-4. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32374544/

  4. Godoy LC, Goligher EC, Lawler PR, Slutsky AS, Zarychanski R. Anticipating and managing coagulopathy and thrombotic manifestations of severe COVID-19. CMAJ. 2020;192(40):E1156-61. DOI: https://doi.org/10.1503/cmaj.201240

  5. D'Souza R, Malhamé I, Teshler L, Acharya G, Hunt BJ, McLintock C. A critical review of the pathophysiology of thrombotic complications and clinical practice recommendations for thromboprophylaxis in pregnant patients with COVID-19. Acta Obstet Gynecol Scand. 2020;99(9):1110-20. DOI: https://doi.org/10.1111/aogs.13962

  6. Di Micco P, Russo V, Lodigiani C. Venous thromboembolism and its association with COVID-19: Still an Open Debate. Medicina (Kaunas). 2020;56(10):E506. DOI: https://doi.org/10.3390/medicina56100506

  7. Ranucci M, Ballotta A, Di Dedda U, Bayshnikova E, Dei Poli M, Resta M, et al. The procoagulant pattern of patients with COVID-19 acute respiratory distress syndrome. J Thromb Haemost. 2020;18(7):1747-51. DOI: https://doi.org/10.1111/jth.14854

  8. Klok FA, Kruip MJHA, Van der Meer NJM, Arbous MS, Gommers Da. MPJ, Kant KM, et al. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thromb Res. 2020;191:145-7. DOI: https://doi.org/10.1016/j.thromres.2020.04.013

  9. Cui S, Chen S, Li X, Liu S, Wang F. Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia. J Thromb Haemost. 2020;18(6):1421-4. DOI: https://doi.org/10.1111/jth.14830

  10. Llitjos JF, Leclerc M, Chochois C, Monsallier JM, Ramakers M, Auvray M, et al. High incidence of venous thromboembolic events in anticoagulated severe COVID-19 patients. J Thromb Haemost. 2020;18(7):1743-6. DOI: https://doi.org/10.1111/jth.14869

  11. Xiong TY, Redwood S, Prendergast B, Chen M. Coronaviruses and the cardiovascular system: acute and long-term implications. Eur Heart J. 2020;41(19):1798-800. DOI: https://doi.org/10.1093/eurheartj/ehaa231

  12. Sardu C, Gambardella J, Morelli MB, Wang X, Marfella R, Santulli G. Hypertension, thrombosis, kidney failure, and diabetes: is COVID-19 an endothelial disease? A comprehensive evaluation of clinical and basic evidence. J Clin Med. 2020;9(5):E1417. DOI: https://doi.org/10.3390/jcm9051417

  13. Kvåle R, Azrakhsh NA, Mohn KG-I, Aanerud M, Guttormsen AB, Reikvam H. COVID-19 and venous thromboembolism-prophylaxis and treatment. Tidsskr Nor Laegeforen. 2020;140(11). DOI: https://doi.org/10.4045/tidsskr.20.0440

  14. Barrett CD, Moore HB, Yaffe MB, Moore EE. ISTH interim guidance on recognition and management of coagulopathy in COVID-19: A comment. J Thromb Haemost. 2020;18(8):2060-3. DOI: https://doi.org/10.1111/jth.14860




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