Infección por coronavirus (COVID-19) durante el embarazo y su manejo terapéutico. Una revisión bibliográfica
DOI:
https://doi.org/10.29166/rfcmq.v47i1.3345Palabras clave:
Infecciones por coronavirus, Embarazo, Protección personal, Terapia, corticosteroidesResumen
Introducción: La COVID-19, produjo una emergencia sanitaria global. Además de los pocos conocimientos sobre el efecto de esta infección en la gestación, hay dudas sobre su impacto en el producto de la gestación. A pesar de que se sabe que las embarazadas son particularmente vulnerables, no se cuenta con un esquema de manejo particular para estas; aunque hay reportes del uso de varios fármacos, de forma similar al tratamiento en otros adultos sin gestación.
Objetivo: Conocer sobre la infección por la COVID-19 en la gestación y su tratamiento.
Materiales y Métodos: se llevó a cabo una revisión teórica, como fuentes de información se tuvieron en cuenta las bibliotecas: MEDLlNE, EMBASE, PubMed y Cochrane. Se realizó una búsqueda basada en términos MeSH. Se incluyeron publicaciones sobre este tema, con diseño de revisión bibliográfica, observacional o analítico.
Resultados: Se encontraron 43 publicaciones, de las que se suprimieron diez y se incluyeron 33. Las acciones terapéuticas para el abordaje de la COVID-19 en la gestación abarca tres pilares: las acciones de prevención, el ingreso hospitalario y el manejo terapéutico individualizado.
Conclusión: En las embarazadas con la COVID-19, el manejo no es diferente del utilizado en el resto de los adultos; incluye cuidados individualizados, según el estado de la paciente, encaminados a garantizar la sobrevida del binomio madre – feto. Se necesita más estudios para argumentar de forma objetiva estos resultados a favor de los puntos críticos de discusión que están descritos en la presente revisión, ya que se trata de una enfermedad de aparición reciente.
Descargas
Métricas
Citas
Organización Mundial de la Salud. Intervención del Director General de la OMS en la conferencia de prensa sobre el 2019-nCoV del 11 de febrero de 2020 [Internet]. 2020. Available from: https://www.who.int/es/director-general/speeches/detail/who-director-general-s-remarks-at-the-media-briefing-on-2019-ncov-on-11-february-2020
Wu D, Fang D, Wang R, Deng D, Liao S. Management of pregnancy during the COVID‐19 Pandemic. Glob Challenges [Internet]. 2021 Feb 22 [cited 2021 May 16];5(2):20–5. Available from: www.global-challenges.com
Wenling Y, Junchao Q, Zhirong X, Shi O. Pregnancy and COVID-19: Management and challenges. Rev Inst Med Trop Sao Paulo [Internet]. 2020 [cited 2021 May 16];62:1–9. Available from: https://pubmed.ncbi.nlm.nih.gov/32876296/
Benski C, Di Filippo D, Taraschi G, Reich MR. Guidelines for pregnancy management during the COVID-19 pandemic: A public health conundrum. Int J Environ Res Public Health [Internet]. 2020 Nov 1 [cited 2021 May 16];17(21):1–22. Available from: /pmc/articles/PMC7664946/
Ciapponi A. Manifestaciones clínicas, factores de riesgo y resultados maternos y perinatales de COVID-19 en el embarazo. Evidencia [Internet]. 2020;23(4):1–2. Available from: http://webcache.googleusercontent.com/search?q=cache:HHTzN-eOmrAJ:evidencia.org/index.php/Evidencia/article/download/6885/4463+&cd=1&hl=es-419&ct=clnk&gl=ec
Liu R, Han H, Liu F, Lv Z, Wu K, Liu Y, et al. Positive rate of RT-PCR detection of SARS-CoV-2 infection in 4880 cases from one hospital in Wuhan, China, from Jan to Feb 2020. Clin Chim Acta [Internet]. 2020 Jun 1 [cited 2021 May 16];505:172–5. Available from: /pmc/articles/PMC7094385/
Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet [Internet]. 2020 Mar 7 [cited 2021 May 16];395(10226):809–15. Available from: https://pubmed.ncbi.nlm.nih.gov/32151335/
Kasraeian M, Zare M, Vafaei H, Asadi N, Faraji A, Bazrafshan K, et al. COVID-19 pneumonia and pregnancy; a systematic review and meta-analysis. J Matern Neonatal Med [Internet]. 2020 [cited 2021 May 16]; Available from: https://pubmed.ncbi.nlm.nih.gov/32429786/
Vigil-De Gracia P, Caballero LC, Ng Chinkee J, Luo C, Sánchez J, Quintero A, et al. COVID-19 y embarazo. Revisión y actualización. Rev peru ginecol Obs (En línea) [Internet]. 2020 [cited 2021 May 16];66(2):1. Available from: https://doi.org/10.31403/rpgo.v66i2248
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. Declaración PRISMA 2020: una guía actualizada para la publicación de revisiones sistemáticas. Rev Española Cardiol [Internet]. 2021 Sep;74(9):790–9. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0300893221002748
Oxford Centre for Evidence-Based Medicine. OCEBM Levels of Evidence Working Group. The Oxford Levels of Evidence 2. 2011.
Ebell M, Siwek J, Weiss B, Woolf S, Susman J. Strength of Recommendation Taxonomy (SORT): A Patient-Centered Approach to Grading Evidence in the Medical Literature. Am Fam Physician [Internet]. 2004;69(3):548–56. Available from: https://www.aafp.org/pubs/afp/issues/2004/0201/p548.html#:~:text=Our scale is called the,studies or bodies of evidence.
Guan W jie, Ni Z yi, Hu Y, Liang W hua, Ou C quan, He J xing, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med [Internet]. 2020 Apr 30 [cited 2021 May 16];382(18):1708–20. Available from: https://www.nejm.org/doi/full/10.1056/nejmoa2002032
Yu N, Li W, Kang Q, Xiong Z, Wang S, Lin X, et al. Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-centre, descriptive study. Lancet Infect Dis [Internet]. 2020 May 1 [cited 2021 May 17];20(5):559–64. Available from: /pmc/articles/PMC7158904/
Borre-Naranjo D, Santacruz J, Gonzalez-Hernandez J, Anichiarico W, Rubio-Romero J. Infección por SARS-CoV-2 en la paciente obstétrica: una perspectiva desde el cuidado crítico. Acta Colomb Cuid Intensivo [Internet]. 2020 Apr [cited 2021 May 16];20(2):98–107. Available from: /pmc/articles/PMC7158844/
Wastnedge EAN, Reynolds RM, van Boeckel SR, Stock SJ, Denison FC, Maybin JA, et al. Pregnancy and COVID-19. Physiol Rev [Internet]. 2021 Jan 1 [cited 2021 May 16];101(1):303–18. Available from: https://doi.org/10.1152/physrev.00024.2020
Chen L, Jiang H, Zhao Y. Pregnancy with COVID-19: Management considerations for care of severe and critically ill cases. Am J Reprod Immunol [Internet]. 2020 Nov 1 [cited 2021 May 16];84(5). Available from: https://pubmed.ncbi.nlm.nih.gov/32623810/
Breslin N, Baptiste C, Gyamfi-Bannerman C, Miller R, Martinez R, Bernstein K, et al. Coronavirus disease 2019 infection among asymptomatic and symptomatic pregnant women: two weeks of confirmed presentations to an affiliated pair of New York City hospitals. Am J Obstet Gynecol MFM [Internet]. 2020 May 1 [cited 2021 May 16];2(2):100118. Available from: https://pubmed.ncbi.nlm.nih.gov/32292903/
Dubey P, Thakur B, Reddy S, Martinez CA, Nurunnabi M, Manuel SL, et al. Current trends and geographical differences in therapeutic profile and outcomes of COVID-19 among pregnant women - a systematic review and meta-analysis. BMC Pregnancy Childbirth [Internet]. 2021 Dec 1 [cited 2021 May 16];21(1):1–16. Available from: https://doi.org/10.1186/s12884-021-03685-w
Homer CS, Roach V, Cusack L, Giles ML, Whitehead C, Burton W, et al. The National COVID ‐19 Clinical Evidence Taskforce: pregnancy and perinatal guidelines. Med J Aust [Internet]. 2022 Nov 6;217(9):2–15. Available from: https://onlinelibrary.wiley.com/doi/10.5694/mja2.51729
Ryan GA, Purandare NC, McAuliffe FM, Hod M, Purandare CN. Clinical update on COVID-19 in pregnancy: A review article [Internet]. Vol. 46, Journal of Obstetrics and Gynaecology Research. Blackwell Publishing; 2020 [cited 2021 May 16]. p. 1235–45. Available from: https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/jog.14321
Vlachodimitropoulou Koumoutsea E, Vivanti AJ, Shehata N, Benachi A, Le Gouez A, Desconclois C, et al. COVID-19 and acute coagulopathy in pregnancy. J Thromb Haemost [Internet]. 2020 Jul 1 [cited 2021 May 16];18(7):1648–52. Available from: https://pubmed.ncbi.nlm.nih.gov/32302459/
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 [Internet]. 2020 Sep 1 [cited 2021 May 16];99(9):1110–20. Available from: https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/aogs.13962
D’Souza R, Ashraf R, Rowe H, Zipursky J, Clarfield L, Maxwell C, et al. Pregnancy and COVID ‐19: pharmacologic considerations. Ultrasound Obstet Gynecol [Internet]. 2021 Feb 1 [cited 2021 May 16];57(2):195–203. Available from: www.clinicaltrials.gov,
Hayakawa S, Komine-Aizawa S, Mor GG. Covid-19 pandemic and pregnancy. J Obstet Gynaecol Res [Internet]. 2020 Oct 1 [cited 2021 May 16];46(10):1958–66. Available from: https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/jog.14384
Pierce-Williams RAM, Burd J, Felder L, Khoury R, Bernstein PS, Avila K, et al. Clinical course of severe and critical coronavirus disease 2019 in hospitalized pregnancies: a United States cohort study. Am J Obstet Gynecol MFM [Internet]. 2020 Aug 1 [cited 2021 May 17];2(3):100134. Available from: https://pubmed.ncbi.nlm.nih.gov/32391519/
Ferrazzi E, Frigerio L, Savasi V, Vergani P, Prefumo F, Barresi S, et al. Vaginal delivery in SARS-CoV-2-infected pregnant women in Northern Italy: a retrospective analysis. BJOG An Int J Obstet Gynaecol [Internet]. 2020 Aug 1 [cited 2021 May 16];127(9):1116–21. Available from: https://pubmed.ncbi.nlm.nih.gov/32339382/
Ortiz E, Herrera E, De la Torre A. Coronavirus (COVID 19) Infection in Pregnancy. Colomb Med [Internet]. 2020;51(2):42–51. Available from: https://www.redalyc.org/jatsRepo/283/28364445003/28364445003.pdf
Rasmussen SA, Smulian JC, Lednicky JA, Wen TS, Jamieson DJ. Coronavirus Disease 2019 (COVID-19) and pregnancy: what obstetricians need to know [Internet]. Vol. 222, American Journal of Obstetrics and Gynecology. Mosby Inc.; 2020 [cited 2021 May 16]. p. 415–26. Available from: https://pubmed.ncbi.nlm.nih.gov/32105680/
Lampejo T. Remdesivir for the treatment of COVID‐19 in pregnancy. J Med Virol [Internet]. 2021 Apr 14 [cited 2021 May 17]; Available from: https://onlinelibrary.wiley.com/doi/full/10.1002/jmv.26986
Taylor MM, Kobeissi L, Kim C, Amin A, Thorson AE, Bellare NB, et al. Inclusion of pregnant women in COVID-19 treatment trials: a review and global call to action [Internet]. Vol. 9, The Lancet Global Health. Elsevier Ltd; 2021 [cited 2021 May 17]. p. e366–71. Available from: www.thelancet.com/lancetgh
Ortiz EI, Herrera E, De La Torre A. Coronavirus (Covid-19) infection in pregnancy [Internet]. Vol. 51, Colombia Medica. Facultad de Salud de la Universidad del Valle; 2020 [cited 2021 May 16]. p. 1–7. Available from: http://doi.org/10.25100/cm.v51i2.4271http://doi.org/10.25100/cm.v51i2.4271http://doi.org/10.25100/cm.v51i2.4271
Ferrazzi EM, Frigerio L, Cetin I, Vergani P, Spinillo A, Prefumo F, et al. COVID-19 Obstetrics Task Force, Lombardy, Italy: Executive management summary and short report of outcome. Int J Gynecol Obstet [Internet]. 2020 Jun 1 [cited 2021 May 17];149(3):377–8. Available from: https://pubmed.ncbi.nlm.nih.gov/32267531/
Udugama B, Kadhiresan P, Kozlowski HN, Malekjahani A, Osborne M, Li VYC, et al. Diagnosing COVID-19: The Disease and Tools for Detection [Internet]. Vol. 14, ACS nano. NLM (Medline); 2020 [cited 2021 May 17]. p. 3822–35. Available from: https://pubmed.ncbi.nlm.nih.gov/32223179/
De Melo G, De Araújo K. COVID-19 infection in pregnant women, preterm delivery, birth weight, and vertical transmission: A systematic review and meta-analysis. Cad Saude Publica [Internet]. 2020 Jan 1 [cited 2021 May 17];36(7):54–60. Available from: https://pubmed.ncbi.nlm.nih.gov/32696830/
Benhamou D, Keita H, Ducloy-Bouthors AS. Coagulation changes and thromboembolic risk in COVID-19 obstetric patients. Anaesth Crit Care Pain Med [Internet]. 2020 Jun 1 [cited 2021 May 17];39(3):351–3. Available from: https://pubmed.ncbi.nlm.nih.gov/32437961/
Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost [Internet]. 2020 Apr 1 [cited 2021 May 17];18(4):844–7. Available from: https://pubmed.ncbi.nlm.nih.gov/32073213/
Yaqoub S, Ahmad S, Mansouri Z, Pallivalapila A, El Kassem W, Maslamani M, et al. Management of life-threatening acute respiratory syndrome and severe pneumonia secondary to COVID-19 in pregnancy: A case report and literature review. Clin Case Reports [Internet]. 2020 Jan 1 [cited 2021 May 17];9(1):137–43. Available from: https://onlinelibrary.wiley.com/doi/full/10.1002/ccr3.3485
Descargas
Publicado
Cómo citar
Número
Sección
Licencia
Derechos de autor 2022 CRISTINA CUMBE
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-SinDerivadas 4.0.
