Proteinuria in Covid-19 pregnant women: preeclampsia or seve
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The case of a severe COVID-19 infection in which the diagnosis of preeclampsia (PE) was wrongly assumed because of proteinuria. The case raises both the question of the predictive value of proteinuria and the differential diagnosis between preeclampsia and the severe form of COVID-19 in pregnant women.

Despite numerous publications related to the pandemic, data remain limited regarding COVID-19 infections in pregnant women. The reported rates of severe infections range between 14% (severe pneumonia) to 5% (severe acute respiratory syndrome/SARS). There are no clear maternal risk factors predicting severe infection in pregnant woman.

A 26-year old woman (gravida 4, para 2) was admitted at 37 weeks of gestation with a 24-hs history of dry cough and headache. One of her relatives was infected by Covid-19. Until then the pregnancy was uneventful. At the time of hospital admission to the Covid-19 unit, her temperature was 37.9°C, her cardiac heart rate 112 beats per minute, her blood pressure 148/83mm/Hg, her respiratory rate 22 breaths per minute and her oxygen saturation 98% (ambient air-breathing). The fetal heart rate was normal. Covid-19 nasopharyngeal tests were positive. On day 2, the 24-h urine protein test was positive and a suspected PE diagnosis was verified accordingly. On day 3 labor was induced on this indication in accordance with national guidelines. A C-section was performed because of arrested labor. A healthy 2700g baby boy was born, with negative Covid-19 nasopharyngeal tests.

This case describes a complicated post-partum period in a woman with Covid-19. Suspected preeclampsia in this patient, which is a common disorder in pregnancy with hypertension and proteinuria related to placental dysfunction. In their recent publication, However, based on the severe condition that developed post-partum in this patient, doctors recommend carefully monitoring proteinuria in pregnant women with Covid-19 infection.

Source:https://www.ejog.org/article/S0301-2115(20)30445-0/fulltext?rss=yes

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