Vaginal delivery in a woman infected with SARS-CoV-2 – The first case reported in Portugal

Abstract

Although birth rate in Portugal is the fourth lowest in Europe and the number of COVID-19 cases in our country is one of the lowest, we already managed a case of a pregnant woman at term infected with SARS-CoV-2 who went into labor at term [1]. On March 17th 2020, in a level III hospital in Porto, a Caucasian 31-year-old woman with 38 weeks' gestation was admitted at the obstetrical emergency department. She was a healthy gravida 2 para 1, with no complications during pregnancy. At admission, she was complaining of mild painful uterine contractions for a few hours. She was in home isolation as her husband was diagnosed with COVID-19 and hospitalized on March 12th 2020. At admission, she presented dry cough, with no fever, chills or shortness of breath. Because she was a close contact of a confirmed COVID-19 case, she was attended as a suspected case and settled in an isolation room. SARS-CoV-2 was detected by reverse-transcription polymerase chain reaction (RT-PCR) analysis on nasal and oropharyngeal swabs. After obstetric evaluation, latent phase of labor was diagnosed, the cervix was 3 cm dilated and 30 % effaced. Care in labor continued in the same isolation room. All health care workers in contact with the pregnant woman wore appropriate personal protective equipment for contact and airborne precautions with eye protection. Epidural analgesia was performed as

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“…After assessment of abstracts and methods to determine eligible articles; Total 57 articles were excluded (the reasons either no cases included, review articles or symptoms and outcomes were not investigated). The remaining 25 articles are found to be eligible (Breslin et al, 2020a;Breslin et al, 2020b;Cao et al, 2020;Chen et al, 2020a;Chen et al, 2020b;Chen et al, 2020c;Fan et al, 2020;Govind et al, 2020;Hantoushzadeh et al, 2020;Hirshberg et al, 2020;Khan et al, 2020;Liu et al, 2020a;Liu et al, 2020b;Liu et al, 2020c;Lokken et al, 2020;Lu et al, 2020;Pierce-Williams et al, 2020;Polónia-Valente et al, 2020;Wang et al, 2020;Wen et al, 2020;Wu et al, 2020;Xu et al, 2020;Yu et al, 2020;Zambrano et al, 2020;Zhu et al, 2020); they consist of letters, case reports or series, and research articles.…”

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“…BF w/ mask Rec. no NR NR* Polónia-Valente et al, 2020 95 Portugal 5/11/20 1 0 0 0 NR NR Mild 0 Formula Yes NR DOL 3 Baergen & Heller, 2020 96 U.S. (NY) 5/12/20 21 6 4 0 NR NR Mild to moderate 0 NR NR NR NR* Taghizadieh et al., 2020 97 Iran 5/13/20 1 1 1 0 NR NR Severe NR NR NR NR NR* Kirtsman et al, 2020 62 Canada 5/14/20 1 1 1 1 3 NR Mild symptoms Recovered Moderate 0 BF with mask No NR DOL 30 Dória et al., 2020 98 Portugal 5/15/20 10 6 0 0 NR NR Asx to mild 0 NR NR NR NR* Mehta et al., 2020 35 U.S. (NJ) 5/16/20 2 2 ...…”

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