References

sechenov

Sechenov Medical Journal

Сеченовский вестник

2218-73322658-3348

Сеченовский Университет

10.47093/2218-7332.2021.12.2.44-54

sechenov-391

Research Article

ОBSTETRICS AND GYNECOLOGY

АКУШЕРСТВО И ГИНЕКОЛОГИЯ

Treatment of COVID-19 disease in pregnancy and breastfeeding

Лечение COVID-19 при беременности и кормлении грудью

https://orcid.org/0000-0003-1162-6263

Риос

С. С.

Rios

S. S.

Риос Салети да Силва - PhD, профессор кафедры акушерства и гинекологии, Медицинский факультет, Университет Бразилиа (UnB).

Аса Норте-Бразилиа, 70.910-900.

Salete da Silva Rios - PhD, Professor, Department of Obstetrics and Gynecology, School of Medicine, University of Brashia (UnB).

Asa Norte-Brasttia-DF, 70.910-900.

https://orcid.org/0000-0003-2798-3564

Резенде

Ц. Н.

Resende

C. N.

Резенде Церес Нуньес - MD, PhD, кафедра акушерства и гинекологии, Медицинский факультет, Университет Бразилиа (UnB).

Аса Норте-Бразилиа, 70.910-900.

Ceres Nunes de Resende - MD, PhD, Department of Obstetrics and Gynecology, School of Medicine, University of Brashia (UnB).

Asa Norte-Brasttia-DF, 70.910-900.

https://orcid.org/0000-0002-1655-3609

Пейшото

А. Б.

Peixoto

A. B.

Пейшото Альберто Борхес - MD, PhD, Университетская больница Марио Палмерио, Университет Уберабы (UNIUBE); кафедра акушерства и гинекологии, Федеральный университет Триангуло Минейро (UFTM).

пр. Нене Сабино, Убераба - MG, 38050-501; ул. Фрей Паулино, Убераба - MG, 38025-180.

Alberto Borges Peixoto - MD, PhD, Mario Palmerio Universitary Hospital, University of Uberaba (UNIUBE); Department of Obstetrics and Gynecology, Federal University of Triangulo Mineiro (UFTM).

Avenida Nene Sabino, Uberaba - MG, 38050-501; R. Frei Paulino, Uberaba - MG, 38025-180.

https://orcid.org/0000-0002-6145-2532

Араухо-мл.

Э.

Araujo Junior

Араухо-младший Эдвард - PhD, профессор кафедры акушерства, Медицинский факультет, Федеральный университет де Сан-Паулу (EPM-UNIFESP); Медицинский курс, кампус Бела Виста, Муниципальный университет Сан-Каэтану-ду-Сул (USCS).

ул. Бельхиор де Азеведо, 156, 111 Торре Виторио, 05089-030, Сан-Паулу – SP.

Тел.: +55-11-37965944

Edward Araujo Junior - PhD, Prof., Department of Obstetrics, Paulista School of Medicine, Federal University of Sao Paulo (EPM-UNIFESP); Medical Course, Bela Vista Campus, Municipal University of Sao Caetano do Sul (USCS).

Rua Belchior de Azevedo, 156 apto. 111 Torre Vitoria, CEP 05089-030, Sao Paulo – SP.

Tel.: +55-11-37965944

araujojred@terra.com.br

Кафедра акушерства и гинекологии, Медицинский факультет Университета Бразилиа (UnB)БразилияDepartment of Obstetrics and Gynecology, School of Medicine, University of Brasttia (UnB)Brazil

Университетская больница Марио Палмерио, Университет Уберабы (UNIUBE); Кафедра акушерства и гинекологии, Федеральный университет Триангуло Минейро (UFTM)БразилияMario Palmerio Universitary Hospital, University of Uberaba (UNIUBE); Department of Obstetrics and Gynecology of Federal University of Triangulo Mineiro (UFTM)Brazil

Кафедра акушерства, Медицинский факультет, Федеральный университет де Сан-Паулу (EPM-UNIFESP); Медицинский курс, кампус Бела Виста, Муниципальный университет Сан-Каэтану-ду-Сул (USCS)БразилияDepartment of Obstetrics, Paulista School of Medicine, Federal University of Sao Paulo (EPM-UNIFESP); Medical Course, Bela Vista Campus, Municipal University of Sao Caetano do Sul (USCS)Brazil

2021

14122021

122

Special Issue "COVID-19 and pregnancy"

4454

2021

Риос С.С., Резенде Ц.Н., Пейшото А.Б., Араухо-мл. Э.

Rios S.S., Resende C.N., Peixoto A.B., Araujo Junior E.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.sechenovmedj.com/jour/article/view/391

The physiological and anatomical clinical characteristics of pregnant women make them susceptible to complications caused by coronavirus disease (COVID-19). Increased coagulation and risk of thromboembolic phenomena are common during pregnancy; they are further enhanced when associated with a thrombogenic pathology such as in COVID-19. The treatment of COVID-19 is controversial and limited, even for non-pregnant patients. During pregnancy, the options are even more restricted due to the teratogenicity of some drugs and anatomical and physiological difficulties, especially in advanced pregnancy in patients with respiratory failure. Therefore, the focus of treatment for pregnant patients should be centered on isolation, monitoring fetal and maternal vital signs, uterine activity, and general maternal-fetal well-being. The prescription of drugs and management orientation should be based on gestational age and maternal clinical conditions. The optimal type of delivery is guided by obstetric indications and COVID-19 disease severity. Breastfeeding should be encouraged with the use of masks and hand hygiene. The treatment of pregnant women with COVID-19 brings important peculiarities that should be considered in order to make better decisions for preserving the health of the mother and fetus.

Анатомо-физиологические особенности беременных женщин делают их особенно восприимчивыми к осложнениям коронавирусного заболевания (COVID-19). Повышенная свертываемость крови с риском тромбоэмболических осложнений характерна в период беременности, она еще более усиливается, когда ассоциирована с протромбо-тическими состояниями, такими как COVID-19. Лечение COVID-19 является предметом дискуссии даже для небеременных. Во время беременности медикаментозная терапия ограничена из-за тератогенности некоторых препаратов и анатомо-физиологических особенностей, особенно в поздние сроки беременности у пациенток с дыхательной недостаточностью. Поэтому основное внимание в лечении беременных женщин должно уделяться изоляции, мониторингу жизненно важных показателей плода и матери, сократительной активности матки. Назначение препаратов и общие принципы ведения должны основываться на гестационном возрасте и клиническом состоянии матери. Выбор способа родоразрешения определяется акушерскими показаниями и тяжестью течения COVID-19. Следует сохранять грудное вскармливание при условии использования масок и средств для гигиены рук. Лечение беременных женщин с COVID-19 имеет важные особенности, которые необходимо учитывать для принятия лучшего решения с целью сохранения здоровья матери и плода.

противовирусные средствакортикостероидыантикоагуляцияэноксапаринкислородная поддержкаведение родов

antiviralscorticosteroidsanticoagulationenoxaparinoxygen supplementationlabor management

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The authors declare that there are no conflicts of interest present.