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COVID-19 na gravidez : abordagem da grávida durante a pandemia
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A doença do coronavírus 2019 (COVID-19), causada pelo coronavírus da síndrome respiratória aguda grave 2 (SARS-CoV-2), foi declarada pandemia pela World Health Organization (WHO) a 11 de março de 2020. A rápida evolução da pandemia obrigou o Serviço Nacional de Saúde a adaptar-se a esta nova realidade, nomeadamente na área de Obstetrícia, de modo a não comprometer os cuidados de excelência prestados às grávidas.
A presente revisão da literatura apresenta uma análise dos dados atuais relativos à COVID-19 e ao seu efeito nas mulheres grávidas, incluindo sintomatologia, gravidade da doença e risco de transmissão vertical. Esta revisão expõe ainda recomendações de abordagem e gestão da grávida com COVID-19 suspeito ou confirmado, resultantes de uma adaptação das maternidades. Atualmente, a literatura sugere que a grávida não se encontra em maior risco de infeção em comparação com a população em geral. Contudo, existem grupos vulneráveis tanto no seio da população obstétrica como na população em geral, e os profissionais de saúde devem estar cientes destes grupos de risco e geri-los em conformidade. A infeção por SARS-CoV-2 na gravidez pode estar associada a manifestações clínicas mais graves e a maior tendência para complicações perinatais. Os sintomas mais comuns são febre, tosse e dispneia. O parto por via vaginal não confere riscos adicionais para a grávida ou para o recém-nascido, e existe um risco mínimo de transmissão vertical.
É importante reconhecer que o verdadeiro impacto do vírus na morbilidade e mortalidade materna e fetal apenas será evidente com o tempo. A literatura atualmente disponível tem procurado estabelecer algoritmos de atuação no que diz respeito aos cuidados prestados à grávida com COVID-19. No entanto, à medida que o conhecimento sobre esta doença avança, novas evidências baseadas na prática clínica vão surgindo.
Coronavirus disease 2019 (COVID-19) caused by the coronavirus of severe acute respiratory syndrome 2 (SARS-CoV-2) was declared a pandemic by the World Health Organization (WHO) on March 11, 2020. The rapid progression of the pandemic has forced the National Health Service to adapt to this new reality, particularly in the Obstetrics field, to avoid putting at risk the excellent care provided to pregnant women. This review presents a comprehensive analysis of the current data in relation to COVID-19 and its effect on pregnant women, including symptoms, disease severity and the risk of vertical transmission. Additionally this review presents recommendations regarding the management of pregnant women with suspected or confirmed COVID-19, as a result of an adjustment of maternity wards. At presente, the literature suggests that pregnant women are not at higher risk of infection compared to the general population. However, there are vulnerable groups within both the pregnant and nonpregnant populations, and the healthcare workers should be aware of these risk groups and manage them accordingly. SARS-CoV-2 infection in pregnancy may be associated with severe symptoms and worse outcomes. The most common reported symptoms are fever, cough and dyspnea. Vaginal delivery does not confer additional risks for the pregnant woman or neonate, and there is a minimal risk of vertical transmission. It is important to acknowledge that the true effect of the virus on both maternal and fetal morbidity and mortality will only be evident over time. The current data has sought to establish algorithms of action regarding the care provided to pregnant women with COVID-19. However, as the knowledge about this disease progresses, new evidence based on clinical practice is emerging.
Coronavirus disease 2019 (COVID-19) caused by the coronavirus of severe acute respiratory syndrome 2 (SARS-CoV-2) was declared a pandemic by the World Health Organization (WHO) on March 11, 2020. The rapid progression of the pandemic has forced the National Health Service to adapt to this new reality, particularly in the Obstetrics field, to avoid putting at risk the excellent care provided to pregnant women. This review presents a comprehensive analysis of the current data in relation to COVID-19 and its effect on pregnant women, including symptoms, disease severity and the risk of vertical transmission. Additionally this review presents recommendations regarding the management of pregnant women with suspected or confirmed COVID-19, as a result of an adjustment of maternity wards. At presente, the literature suggests that pregnant women are not at higher risk of infection compared to the general population. However, there are vulnerable groups within both the pregnant and nonpregnant populations, and the healthcare workers should be aware of these risk groups and manage them accordingly. SARS-CoV-2 infection in pregnancy may be associated with severe symptoms and worse outcomes. The most common reported symptoms are fever, cough and dyspnea. Vaginal delivery does not confer additional risks for the pregnant woman or neonate, and there is a minimal risk of vertical transmission. It is important to acknowledge that the true effect of the virus on both maternal and fetal morbidity and mortality will only be evident over time. The current data has sought to establish algorithms of action regarding the care provided to pregnant women with COVID-19. However, as the knowledge about this disease progresses, new evidence based on clinical practice is emerging.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2021
Palavras-chave
Gravidez Infeção COVID-19 SARS-CoV-2 Transmissão vertical