出生时对SARS-CoV-2免疫IgG的早产儿非免疫性积液1例

Olga G. Bets, I. G. Khmelevskaya, Alexandra V. Seriozhkina, A.A. Bulka, Lyubov G. Khodulapova, Olga S. Yavlyanskaya
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引用次数: 0

摘要

胎儿的非免疫性水肿是一种异质病理,在没有免疫致敏迹象的情况下,伴有液体在两个或多个浆液腔(心包腔、腹腔、胸膜腔)和胎儿组织中过度积聚。这种病理在大多数情况下导致高死亡率在产前和产后时期。这种病的发病率从0.05到5%不等。非免疫性水肿胎儿的围产期死亡率约占80%,但随着疾病在妊娠早期的表现,死亡频率已达95%左右。大多数情况下,胎儿死亡是由于严重的心力衰竭和缺氧造成的。非免疫性积水胎儿最常见的原因是:染色体异常、心血管系统病理和感染性疾病。由于新型冠状病毒感染COVID-19的出现,出现了一个问题,即SARS-CoV-2病毒如何影响怀孕的过程和结果,以及它对胎儿发育有什么影响。是否可以假设SARS-CoV-2病毒可归因于发生非免疫性积水胎儿的病因因素?本文介绍了1例妊娠期新生儿重症COVID-19背景下,产科和妇科病史负担过重的早产儿发生非免疫性积液的临床病例。本文对此类新生儿的发病机制、分类、临床表现特点、诊断和治疗等方面的文献资料进行综述。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical case of non-immune hydrops in a preterm infant with IgG to SARS-CoV-2 at birth
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.
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