skip to main content

Adverse Outcome in a Near Term, High-Risk Twin Pregnancy Complicated by COVID-19: A case report

*Razmaeda Sarastry orcid  -  Department of Obstetrics and Gynecology,, Indonesia
Crismanto Layarta orcid  -  Department of Obstetrics and Gynecology,, Indonesia
Ussisti Aladini  -  Department of Obstetrics and Gynecology,, Indonesia
Alini Hafiz  -  Department of Obstetrics and Gynecology,, Indonesia
Besari Adi Pramono orcid  -  Department of Obstetrics and Gynecology,, Indonesia
Open Access Copyright (c) 2020 Diponegoro International Medical Journal
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Citation Format:
Abstract

Background: COVID-19 affecting the outcome of pregnancy is still under investigation. Here we report a case of primigravida with monochorionic diamniotic twin pregnancy with superimposed preeclampsia who develop symptoms of COVID-19 infection on her near term pregnancy and was confirmed later on as COVID-19 positive after cesarean section. The pregnancy was terminated abdominally due to the intrauterine fetal demise of both twins using COVID-19 standard equipment.

Case Presentation: A 29-year-old female, gravida 1, para 0 presented with a twin pregnancy at the gestational age of 36 weeks was referred to our emergency department for further management of intrauterine fetal death of both twins. Six days before admitted to our emergency department, she has been experienced a remittent fever which followed by a mild cough. Four days before admission, she complained of decrease movement of the babies. She went to the Secondary Hospital to check her pregnancy and both fetal heart rates were not found.  The patient is obese (BMI 49.2 kg/m2) and had prior uncontrolled hypertension but no other medical history, including epilepsy, allergies, asthma, heart disease as well as Diabetes Mellitus.

Conclusion: A research about placental pathology in pregnancy with confirmed case of COVID-19 infection showed no pathognomonic feature in the histopathologic examination but mostly, there were maternal vascular malperfusion (decidual arteriopathy in particular) and intervillous thrombi. In the end, a further examination is suggested to evaluate the course and causal factors pertaining to this case.

Fulltext View|Download
Keywords: Covid-19; Primigravida; Pregnancy; Twin Pregnancy
Funding: Faculty of Medicine, Diponegoro University

Article Metrics:

  1. Infecting CS-, Graham AL. Potential Maternal and Infant Outcomes from Coronavirus 2019-nCoV (SARS-CoV-2) Infecting Pregnant Women: Lessons from SARS, MERS, and Other Human Coronavirus Infections. 2020;1-16
  2. Karimi-zarchi M, Neamatzadeh H, Dastgheib SA, Abbasi H, Mirjalili SR, Behforouz A, et al. Vertical Transmission of Coronavirus Disease 19 ( COVID-19 ) from Infected Pregnant Mothers to Neonates : A Review Vertical Transmission of Coronavirus Disease 19 ( COVID-19 ) from Infected Pregnant Mothers to Neonates : A Review. Fetal Pediatr Pathol. 2020;0(0):1-5. https://doi.org/10.1080/15513815.2020.1745970
  3. Page JM, Pilliod RA, Snowden JM, Caughey AB. additional week of expectant management in twin pregnancies. Am J Obstet Gynecol. 2015;212(5):630.e1-630.e7. https://doi.org/10.1016/j.ajog.2015.03.033
  4. Burgess JL, Unal ER, Nietert PJ, Newman RB. Risk of late-preterm stillbirth and neonatal morbidity for monochorionic and dichorionic twins. Am J Obstet Gynecol. 2014;210(6):578.e1-578.e9. https://doi.org/10.1016/j.ajog.2014.03.003
  5. Ortiz JU, Martinez JM. A Systematic Approach to the Differential Diagnosis and Management of the Complications of Monochorionic Twin Pregnancies. 2012;145-55. https://doi.org/10.1159/000342751
  6. Harmon QE, Huang L, Umbach DM, Engel SM, Magnus P, Zhang J, et al. HHS Public Access. 2016;125(3):628-35. https://doi.org/10.1097/AOG.0000000000000696
  7. Xiong T, Mu Y, Liang J, Zhu J, Li X, Li J, et al. Hypertensive disorders in pregnancy and stillbirth rates : a facility- based study in China. 2018;(May):531-9. https://doi.org/10.2471/BLT.18.208447
  8. Shanes ED, Mithal LB, Otero S, Azad HA, Miller ES, Goldstein JA. Placental Pathology in COVID-19. Am J Clin Pathol. 2020;1-10. https://doi.org/10.1101/2020.05.08.20093229

Last update:

No citation recorded.

Last update:

No citation recorded.