Clinical case of non-immune hydrops in a preterm infant with IgG to SARS-CoV-2 at birth

Abstract

Non-immune hydrops of the fetus is a heterogeneous pathology, which is accompanied by excessive accumulation of fluid in two or more serous cavities (pericardial cavity, abdominal cavity, pleural cavity) and fetal tissues in the absence of signs of immune sensitization. This pathology in most cases leads to high mortality in both the antenatal and postnatal periods. The incidence of this disease ranges from 0.05 to 5%. Perinatal mortality in nonimmune hydrops fetalis accounts for about 80%, but with the manifestation of the disease in the early stages of pregnancy, the frequency of deaths is already about 95%. Most often, fetal death occurs due to severe heart failure and hypoxia. The most common causes of the development of nonimmune hydrops fetalis are: chromosomal abnormalities, pathology of the cardiovascular system and infectious diseases. Due to the emergence of a new coronavirus infection COVID-19, the question arises how the SARS-CoV-2 virus affects the course and outcome of pregnancy, as well as what effect it has on fetal development. And is it possible to assume that the SARS-CoV-2 virus can be attributed to the etiological factor of the occurrence of nonimmune hydrops fetalis. The article describes a clinical case of non-immune hydrops in a premature baby with a burdened obstetric and gynecological history against the background of COVID-19 during pregnancy, a severe course of the neonatal period. The review of current literature data on the pathogenesis, classification and features of clinical manifestations, diagnosis and treatment of such newborns is carried out.