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24COVID-19 AND PREGNANCY Kuvandikov G.B.1, Usmanova Z.M.2, Kudratova Z.E.3
1Kuvandikov Golib Berdirasulovich - Assistant, DEPARTMENT OF CLINICAL LABORATORY DIAGNOSTICS;
Usmanova Zarina Mukhtarovna - Resident, MA IN OBSTETRICS AND GYNECOLOGY;
Kudratova Zebo Erkinovna - Assistant, DEPARTMENT OF CLINICAL LABORATORY DIAGNOSTICS, SAMARKAND STATE MEDICAL INSTITUTE, SAMARKAND, REPUBLIC OF UZBEKISTAN
Abstract: pregnant women occupy a special place among the risk groups for COVID-19 infection. It is known that pregnancy itself, though a physiological state, is accompanied by changes in a number of organs and systems, including the immune system. Because of this, the susceptibility to a number of infections during pregnancy increases significantly. Pregnancy is a physiological condition that creates a predisposition to respiratory viral infections. Due to physiological changes in the immune and cardiopulmonary systems, pregnant women are more likely to have a severe course of respiratory viral infections. The mortality rate from SARS-CoV infection among pregnant women is up to 25% [1, 3].
Keywords: pregnancy, infection, hypertension, diabetes mellitus.
Given the increased risk of infection and severe consequences, including increased mortality, in people with comorbidities (especially diabetes mellitus, hypertension, etc.), it is important to consider the potential impact of prior hyperglycemia and hypertension on the outcome of COVID-19 in pregnant women [1]. The group of the highest risk of severe COVID-19 are pregnant women with somatic diseases: chronic lung diseases, including bronchial asthma of moderate and severe severity; cardiovascular diseases, arterial hypertension; diabetes mellitus; immunosuppression, including cancer treatment; obesity (BMI>40); chronic kidney disease, liver disease, AFS [9].
It is currently unknown whether a pregnant woman with COVID-19 can transmit the virus to her baby during pregnancy or delivery. To date, the virus has not been detected in amniotic fluid, placenta or breast milk samples [10].
COVID-19 is most dangerous in the second and third trimesters, given the stresses on different systems of the body. In no case it is necessary to forget about the risk factors of pregnancy itself. In order not to increase the percentage of maternal or infant mortality, we must not forget about the period when the patient must undergo screenings. All pregnant women, regardless of coronavirus, should be screened at clearly defined times in the pregnancy management protocol. Timely tests, ultrasounds, consult a doctor. Do not miss the deadline for obstetric screening - this is a guarantee of reducing obstetric and neonatal complications [2, 4].
Of course, there can be limitations due to coronavirus infection. But with proper rest, exercise and lifestyle management (social distancing and hygiene and protection methods) these limitations can be overcome. The fetus is not a direct target for coronavirus infection. The virus has no proven teratogenic effects on the fetus [6].
The placental barrier is a really good barrier for the fetus. As a rule, babies are born healthy. Much, of course, depends on the condition of the mother and the severity of the coronavirus infection. Childbirth is usually easy. That is, children, as a rule, do not suffer, are born without signs of the disease. The most important thing is to isolate them in time. Understanding the general anxiety and stress of everything that is happening in the world, it should be said that stress is the main danger to a happy pregnancy. There is no need to read unverified news, we must follow all hygienic measures and be positive. The placenta and the health of the mother reliably protect the fetus from the virus [7,8].
Documented neonatal cases of COVID-19 infection have been attributed to close contact with a sick mother or other caregivers [8, 10]. The U.S. Centers for Disease Control and Prevention (CDC, 2020) also notes that mother-to-child transmission of coronavirus during pregnancy is unlikely, but after birth the
newborn may be susceptible to infection due to contact with a COVID-positive person. Complications in pregnant women with COVID-19 include: miscarriage (2%), fetal growth retardation (10%), and preterm delivery (39%) [1,5]. In a group of 15 pregnant women with COVID-19 and pneumonia, an increased rate of cesarean section due to the development of fetal distress syndrome has been shown [8].
COVID-19 case ranking in pregnant, parturient and postpartum women is performed according to standard approaches [9]. Suspicion of COVID-19 case: - Clinical manifestations of acute respiratory infection (body temperature above 37.5 °C and one or more of the following signs: cough, shortness of breath, feeling of tightness in the chest, blood oxygen saturation by pulse oximetry (SpO2) < 95%, sore throat, runny nose, decreased sense of smell and taste, signs of conjunctivitis) in the absence of other known causes that explain the clinical presentation regardless of epidemiologic history.
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