Há Mais “Vida” para Além da COVID-19

Abstract

A COVID-19 tornou-se a principal hipótese diagnóstica em muitas consultas. Este caso enaltece a necessidade de manter a abordagem holística, característica da Medicina Geral e Familiar. Mulher de 43 anos, com antecedentes de perturbação de ajustamento, fibromialgia e miomas uterinos, habitualmente medicada com: duloxetina; lorazepam; desogestrel. Foi avaliada numa “ADR-Comunidade” por cefaleias, náuseas, disgeusia, odinofagia, tosse, dispneia, mialgias e astenia, sem febre. Foi-lhe prescrito teste para COVID-19 e aconselhadoisolamento. Foi contactada no âmbito do “Trace COVID-19®”, constatando-se esquecimentos na toma do anticoncecional e amenorreia. Equacionou-se uma gravidez, negada pela utente. O teste para COVID-19 deu negativo, todavia, houve agravamento sintomático que motivou referenciação à urgência, onde se diagnosticou uma gravidez de 11 semanas. A COVID-19 mimetiza várias situações clínicas. A desvalorização da amenorreia e a abordagem direcionada na ADR conduziram ao atraso diagnóstico, impossibilitando a interrupção voluntária da gravidez perante uma gravidez não-desejada.

Impact of covid-19 pandemic on pregnant women and nursing mothers: integrative review

“…A significant increase in publications related to this group with the COVID-19 pandemic has been observed in all databases since the end of 2020. Despite the advances in scientific literature, we noticed gaps and divergences in some information, for example, related to vertical transmission during pregnancy, at the time of delivery or even the contagion of the virus from mother to newborn through breast milk, 6,[23][24][25] subjects that are not delimited and confirmed by science and instigate us to launch future research.…”

“…The levels of health care have been impacted by the COVID-19 pandemic due to the greater complexity involved in the pathology, demanding greater effort and overloading health professionals. 25,26 This new disease has gained prominence in the health-disease process, often diminishing the importance of other clinical diagnoses and treatments. Studies have shown that in the majority of situations in which an individual goes to the health unit, the professionals' actions are always directed towards the diagnosis and treatment of COVID-19 infection.…”

“…This is possibly due to the diversity of signs and symptoms that the disease can present, contributing to misdiagnosis and, consequently, unnecessary treatment. 25,27 One example mentioned is that during the pandemic many women of childbearing age showed up symptomatic at the care units and the main diagnosis made was COVID-19 infection, consequently prenatal care was postponed due to the pregnancy not being discovered, which has a direct impact on the quality of care. 25,27 On the other hand, women who were diagnosed according to their condition had to undergo adapted prenatal care, since the pandemic required measures to contain the spread of the virus, with hygiene and social distancing being the main measures to ensure the safety of pregnant women, as well as professionals.…”

“…25,27 One example mentioned is that during the pandemic many women of childbearing age showed up symptomatic at the care units and the main diagnosis made was COVID-19 infection, consequently prenatal care was postponed due to the pregnancy not being discovered, which has a direct impact on the quality of care. 25,27 On the other hand, women who were diagnosed according to their condition had to undergo adapted prenatal care, since the pandemic required measures to contain the spread of the virus, with hygiene and social distancing being the main measures to ensure the safety of pregnant women, as well as professionals. 25,28,29 Prenatal care was also impacted by a reduction in the number of pregnant women seen, a reduction in the number of appointments and many reported that when they were seen, they were not allowed to be with a companion, in order to avoid crowding and the spread of the virus, and collective and group appointments had to be suspended.…”

“…25,27 On the other hand, women who were diagnosed according to their condition had to undergo adapted prenatal care, since the pandemic required measures to contain the spread of the virus, with hygiene and social distancing being the main measures to ensure the safety of pregnant women, as well as professionals. 25,28,29 Prenatal care was also impacted by a reduction in the number of pregnant women seen, a reduction in the number of appointments and many reported that when they were seen, they were not allowed to be with a companion, in order to avoid crowding and the spread of the virus, and collective and group appointments had to be suspended. 26,[30][31][32][33] The absence of pregnant women's groups limits the process of health education that can be positive in terms of preparation and empowerment about pregnancy, childbirth and breastfeeding, which has a direct impact on the well-being of these mothers, as well as on the care of their newborn, leaving them more alone to face this moment.…”