Maternal-embryonic approach at Covid-19:

Roberta Simões Guerra, Vanessa Cristina Castro Carvalho, Erlene Roberta Ribeiro dos Santos, L. A. Mello
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Abstract

The pathophysiology of Covid-19 has a cytokine storm, causing exacerbation of inflammatory lesions, mainly of the lungs and vascular endothelium. The mechanism of entry into the human cell uses the Angiotensin-Converting Enzyme 2 as a cell surface receptor. Among the most at-risk groups are pregnant women, due to the physiological, anatomical and immunological changes of the gestational cycle, causing susceptibility to infections. In addition, there are uncertainties about safe breastfeeding and possible vertical transmission. This group, which has a continuous obstetric follow-up, within pandemic circumstances, needed to minimize the risk of exposure in medical settings, using care through telehealth, as a helper. It was possible to replace some face-to-face visits to the clinic, when possible, by virtual ones, minimizing risks to exposure and providing a vehicle for direct communication with the doctor, which, in a way, offers pregnant women more peace of mind, essential to avoid possible complications by psychological stress that can generate inflammatory responses for mother and fetus, causing possible neuropsychiatric consequences. The objective of this narrative review study was to present an update of the data on the disease, as well as a change in management of the pregnant population. Despite being of great importance, virtual assistance does not replace face-to-face, and to get the most out of this new approach, there is a set of guidelines that can help health professionals. It is also important to warn of: changes in hospital management; reconciling ultrasound consultations with medical appointments, reducing the number of pregnant women leavings; telephone tracking of patients' symptoms before faceto-face attendance; and testing recommendations for covid-19, before entering hospitals.
应对Covid-19的母胎方法:
Covid-19的病理生理具有细胞因子风暴,导致炎症病变加重,主要是肺和血管内皮。进入人体细胞的机制是利用血管紧张素转换酶2作为细胞表面受体。其中风险最大的人群是孕妇,由于妊娠周期的生理、解剖和免疫变化,导致易感感染。此外,安全母乳喂养和可能的垂直传播也存在不确定性。这一群体在大流行的情况下有持续的产科随访,需要尽量减少在医疗环境中暴露的风险,通过远程保健作为一种辅助手段进行护理。在可能的情况下,可以用虚拟的方式代替一些面对面的诊所访问,将暴露的风险降到最低,并提供与医生直接沟通的工具,这在某种程度上为孕妇提供了更多的安心,这对于避免可能由心理压力引起的并发症至关重要,心理压力可能会对母亲和胎儿产生炎症反应,导致可能的神经精神后果。本叙述性综述研究的目的是提供关于该疾病的最新数据,以及怀孕人群管理的变化。尽管虚拟援助非常重要,但它并不能取代面对面的援助,为了最大限度地利用这种新方法,有一套指导方针可以帮助卫生专业人员。同样重要的是要注意:医院管理的变化;协调超声检查与医疗预约,减少孕妇离开的人数;当面就诊前对患者症状进行电话跟踪;并在进入医院之前检测covid-19的建议。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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