| Autor: |
Álvarez Bartolomé A; Department of Anesthesia & Critical Care, Puerta de Hierro University Hospital of Majadahonda, 28222 Madrid, Spain., Abdallah Kassab NA; Department of Anesthesia & Critical Care, Puerta de Hierro University Hospital of Majadahonda, 28222 Madrid, Spain., Cruz Melguizo S; Department of Gynecology and Obstetrics, Puerta de Hierro University Hospital of Majadahonda, 28222 Madrid, Spain., de la Cruz Conty ML; Fundación de Investigación Biomédica, Puerta de Hierro University Hospital of Majadahonda, 28222 Madrid, Spain., Forcen Acebal L; Department of Gynecology and Obstetrics, University Hospital 12 de Octubre, 28041 Madrid, Spain., Abascal Saiz A; Department of Gynecology and Obstetrics, La Paz University Hospital, 28046 Madrid, Spain., Pintado Recarte P; Department of Gynecology and Obstetrics, Gregorio Marañón University Hospital, 28007 Madrid, Spain., Martinez Varea A; Department of Gynecology and Obstetrics, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain., Cerrillos Gonzalez L; Department of Gynecology and Obstetrics, Virgen del Rocío University Hospital, 41013 Sevilla, Spain., García Fernández J; Chairman of Anesthesia & Critical Care Department, Puerta de Hierro University Hospital of Majadahonda, 28222 Madrid, Spain., Martínez Pérez O; Maternal-Fetal Medicine Unit, Department of Gynecology and Obstetrics, Puerta de Hierro University Hospital of Majadahonda, 28222 Madrid, Spain. |
| Abstrakt: |
Evidence suggests that pregnant women are at a higher risk of complications compared to the general population when infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the reasons that lead them to need intensive care are not clear. This is a prospective multicenter study of SARS-CoV-2 positive pregnant women, registered by the Spanish Obstetric Emergency Group, with the objective to define the characteristics of the mothers who were admitted to the Intensive Care Unit (ICU) and to investigate the causes and risk factors for ICU admission. A total of 1347 infected pregnant women were registered and analyzed, of whom, 35 (2.6%) were admitted to the ICU. No differences in maternal characteristics or comorbidities were observed between ICU and non-ICU patients, except for in vitro fertilization and multiple pregnancies. The main causes of admission to the ICU were non-obstetric causes (worsening of the maternal condition and respiratory failure due to SARS-CoV-2 pneumonia, 40%) and a combination of coronavirus disease 2019 (COVID-19) symptoms and obstetrical complications (31.4%). The multivariable logistic analysis confirmed a higher risk of ICU admission when pre-eclampsia or hemorrhagic events coexist with pneumonia. The incidence of thromboembolic events and disseminated intravascular coagulation were also significantly higher among patients admitted to the ICU. Therefore, surveillance and rapid intervention should be intensified in SARS-CoV-2 infected pregnant women with the mentioned risk factors and complications. Emphasis should always be placed on anticoagulant therapy in these patients due to the increased thromboembolic risk, C-section surgery and immobilization in the ICU. |
