GEBELİK VE GEBELİK SONRASI DÖNEMDE YENİ KORONA VİRÜSÜ HASTALIĞI (COVİD-19)

Dünya Sağlık örgütü, 2020 Şubat’ta hastalığı Covid-19, etken virüsü " Şiddetli Akut Solunum Sendromu Coronavirus-2"şeklinde tanımladı. Covid-19’un diğer insanlara göre gebelerde daha etkili olduğunu gösteren bir kanıt yoktur. Gebelikte Covid-19 yönetimi; enfeksiyon kontrol prosedürleri, erken izolasyon, aşırı sıvı yüklenmesini önleme, oksijen tedavisi, ampirik antibiyotik kullanımı, fetal ve uterus kasılma takibi, laboratuvar testlerinin yapılması, ilerleyen solunum yetmezliği için erken mekanik ventilasyon, bireyselleştirilmiş doğum planlaması ve multidisipliner ekip yaklaşımından oluşmaktadır. Sağlık kuruluşlarında yönetilen gebeliklerde ekip yönetimi önerilir. Gebelerde Covid-19 belirtileri ile birlikte gebeliğin obstetrik komplikasyonlarıda izlenmelidir. Amniyotik sıvı, kordon kanı, yenidoğan boğaz kültürü ve anne sütü örneklerinin sonucunda SARS-CoV-2 negatif olduğu için transplasental bulaşmayı gösteren hiçbir kanıt yoktur. Şüpheli veya kesinleşmiş vakalarda doğum eylemi başladığında doğum ünitesinde negatif basınçlı odalarda izole takip edilmelidir. Covid 19’lu gebede vajinal doğum planlanırsa sürekli elektronik fetal monitorizasyon yapılması daha güvenilirdir. Covid-19’lu tüm gebelerde bilgilendirme ve danışmanlık yapılmalıdır.

Anahtar Kelimeler:

covid-19 virüsü, gebelik, emzirme, doğum, hemşirelik bakımı

New Coronavirus Disease in Pregnancy and Post-Pregnancy (Covid-19)

The World Health Organization (WHO) defined the disease Covid-19, the causative virus as "Severe Acute Respiratory Syndrome Coronavirus-2 in February 2020. There is no evidence to suggest that Covid-19 is more effective than other people. Covid-19 management in pregnancy; application controls, early isolation, prevention of fluid overload, oxygen therapy, empirical antibiotic use, fetal and uterine contraction follow-up, performing laboratory tests, early mechanical ventilation for progressive respiratory failure, individualized birth planning and benefiting from a multidisciplinary team. Party management in pregnancy managed in a healthcare institution. In addition to the symptoms of Covid-19, obstetric complications of pregnancy should be monitored. There is no evidence of transplacental transmission, as amniotic fluid, cord blood, neonatal throat culture and breast milk are negative for SARS-CoV-2. In suspected definite cases, birth or delivery at birth should be followed safely and securely. If vaginal delivery is planned in a pregnant woman with Covid 19, continuous electronic fetal monitoring is more reliable. Information and counseling should be provided to all pregnant women with Covid-19.

Keywords:

Nursing Care, covid-19 virus, pregnancy, birth, breastfeeding,

PDF

___

ACOG. Practice Advisory: Novel Coronavirus 2019 (Covıd-19). (2020) https://www.acog.org/Clinical-Guidance-and-Publications/PracticeAdvisories/Practice-Advisory-Novel-Coronavirus 2019.
Akpınar F, Üstün Y. Kadın Hastalıkları Ve Doğum Pratiğinde SARS-COV-2 (COVID-19) Enfeksiyonu İle İlgili Güncel Bilgiler. 2020, Volume 2 Number 1 p: 13-16. Alzamora MC, Paredes T, Caceres D, Webb CM, Valdez LM, Rosa ML. Severe Covıd-19 During Pregnancy and Possible Vertical Transmission. American Journal of Perinatology, Nisan 2020, s-0040-1710050.
Bbc news 09.06.2020 https://www.bbc.com/turkce/haberler-dunya-51719684.
Centers for Disease Control and Prevention (CDC). Interim Considerations for Infection Prevention and Control of Coronavirus Disease 2019 (COVID-19) in In patient Obstetric Healthcare Settings. https://www.cdc.gov/coronavirus/2019-nCoV/hcp/infec tion-control.html. Accessed Feb 28, 2020.
Chen H, Guo J, Wang C, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet. 2020; Published online February 12, 2020.
Covıd-19 Guıdelıne Watch Covid-19 and pregnancy. British Medical Journal. 2020, 369:m1672 doi: 10.1136/bmj.m1672 erişim tarihi:25.05.2020.
Dashraath P, Jing Lin Jeslyn W, Mei Xian Karen L, Li Min L, Sarah L., Biswas A, Lin SL. Coronavirus Disease 2019 (COVID-19) Pandemic and Pregnancy. American Journal of Obstetrics and Gynecology. 2020, doi: https://doi.org/10.1016/ j.ajog.2020.03.021.
Favre G, LQi X, Nielsen-Saines K, Musso D, Baud D. Guidelines for pregnant women with suspected SARS-CoV-2 infection. Lancet Infectious Diseases, 2020 https://doi.org/10.1016/S1473-3099(20)30157-2.
https://www.cdc.gov/coronavirus/ 2019-nCoV/hcp/index.htm.
Kıncı MF, Yeşilçınar İ, Kıncı ÖŞ, Çoşkun B, Karaşahin KE. Postpartum Plasmapheresis Treatment in a Severe Liver Enzyme Disorder. Journal of Clinical Obstetrics & Gynecology. 2018, 28(4):170-2.
Lapinsky SE. Management of acute respiratory failure in pregnancy. Seminars in Respiratory and Critical Care Medicine. 2017;38:201–7.
Liang H, Acharya G. (2020). Novel corona virus disease (COVID-19) in pregnancy: What clinical recommendations to follow?. Acta Obstetricia et Gynecologica Scandinavica. 2020, 99:439–442. doı: 10.1111/aogs.13836.
Liu D, Li L., Wu X, Zheng D, Wang J, Yang L, Zheng C. Koronavirüs Hastalığı (COVID-19) Pnömonisi Olan Kadınlarda Gebelik ve Perinatal Sonuçlar: Bir Ön Analiz. Amerikan Röntgenoloji Dergisi, 2020, 1-6. doi: 10,2214 / ajr.20.23072.
Maternal and Fetal Experts Committee, Chinese Physician Society of Obstetrics and Gynecology, Chinese Medical Doctor Association, Obstetric Subgroup, et al. Proposed management of 2019-novel coronavirus infection during pregnancy and puerperium. The Chinese Journal of Perinatal Medicine. 2020;23(02):73-79. https://doi.org/10.3760/cma.j.i ssn.1007-9408.2020.02.001.
Mullins E, Evans D, Vine R, O’ Brien P, Moris E. Coronavirus in pregnancy and delivery: Rapid review and expert consensus. medRxiv, 8 March 2020. doi:https://doi.org/10.1101/2020.03.06.20032144.
Özcan, H, Elkoca A,Yalçın Ö. COVID-19 Enfeksiyonu ve Gebelik Üzerindeki Etkileri. Anadolu Kliniği Tıp Bilimleri Dergisi. Ocak 2020, Cilt 25, Ek Sayı 1.
Phelan AL, Katz R, Gostin LO. The novel coronavirus originating in Wuhan, China: challenges for global health governance. JAMA. 2020;323(8):709. https://doi.org/10.1001/jama.2020.1097.
Rasmussen SA, Smulian JC, Lednicky JA, Wen TS, Jamieson DJ. Coronavirus Disease 2019 (COVID-19) and Pregnancy: What Obstetricians Need to Know. American Journal of Obstetrics Gynecolog. May 2020, 222(5):415-426.
RCOG. Coronavirus (COVID-19) infection in pregnancy, 18/03/2020. https://www.rcog.org.uk/globalassets /documents/guidelines/coronaviruscovid-19-infection-in- pregnancy-v3-20-03-18.pdf.
Russell CD, Millar JE, Baillie JK. Clinical evidence does not support corticosteroid treatment for 2019-nCoV lung injury. The Lancet. 2020, 395(10223):473-5.
Schwartz DA. An Analysis of 38 Pregnant Women with COVID-19, Their Newborn Infants, and Maternal-Fetal Transmission of SARS-CoV-2: Maternal Coronavirus Infections and Pregnancy Outcomes. Archives of Pathology & Laboratory Medicine. 2020. doi: 10.5858/arpa.2020-0901-SA.
Sonja A. Rasmussen MD, MS John C, Smulian MD MPH, John A, Lednicky PhD, Tony S, Wen MD, Denise J, Jamieson MD. Coronavirus Disease 2019 (COVID-19) and Pregnancy: What obstetricians need to know. American Journal of Obstetrics and Gynecology. 2020, VOLUME 222, ISSUE 5, P415-426 https://doi.org/10.1016/j.ajog.2020.02.017.
T.C. Sağlık Bakanlığı, Halk Sağlığı Genel Müdürlüğü. COVID-19 Rehberi. https://hsgm.saglik.gov.tr/tr/bulasici-hastaliklar/2019-n-cov.html
Tırmıkçıoğlu Z. COVID-19 Enfeksiyonu Olan Gebelerde İlaç Kullanımı. Anadolu Kliniği Tıp Bilimleri Dergisi, Ocak 2020, Cilt 25, Ek Sayı 1.
World Health Organization. Director-General's remarks at the media briefing on 2019-nCoV on 11 February 2020. https://www.who.int/dg/speeches/detail/who-director-general-s-remarksat-the-media-briefing-on-2019-ncov-on-11-february-2020.
World Health Organization (WHO). Clinical management of severe acute respiratory infection when Novel coronavirus (2019-nCoV) infection is suspected: Interim Guidance. 2020. https://www.who. int/publications-detail/clinical-management-of-severe-acute-respi ratory-infection-when-novel-coronavirus-(ncov)-infection-is-suspe cted. Accessed Feb 28, 2020.
Yang H, Wang C, Poon LC. Novel coronavirus infection and pregnancy. Ultrasound Obstetrics Gynecolog, 5 Mart 2020, doi:10.1002/uog.22006.
Zhu H, Wang L, Fang C, Dişi C, Peng S, Zhang,L. Clinical analysis of 10 neonates born to mothers with 2019-nCoVpneumonia. Translational Pediatrics. 2020, 9:51-60.