Therapeutic and Psychological Challenges Treating Patients in a Covid Maternity

Abstract

On pregnant patients, the SARS COV-2 infection can present a fulminant evolution, because of a small decrease in respiratory volumes and an exacerbation of the systemic inflammatory response. In addition to these pathophysiological mechanisms that cause systemic degradation, neuropsychiatric impairments should also be considered. These are frequently encountered as a result of the modification of the birth plan, the fact that in Romania positive patients with COVID cannot give birth in the maternity hospitals where they were treated before the infection. Another important factor is the deprivation of the newborn mother during hospitalization. A 26-year-old patient with a 30-week pregnancy and a confirmed SARS COV-2 infection two days ago is admitted to our clinic for deteriorating general condition and acute respiratory failure: dyspnea with orthopnea, tachypnea, decrease in oxygen saturation up to 69% in atmospheric air. During the hospitalization, the patient required intensive therapy with respiratory support in various non-invasive ventilation regimens. It is decided to terminate the pregnancy by emergency segmental-transverse cesarean section for acute fetal distress and severe form of SARS COV-2 infection. The patient's evolution was slowly favorable. The patient was discharged with the newborn after 25 days. As presented at the end of this article, the patient showed signs and symptoms of postpartum depression at the time of the 6-week postpartum evaluation, most likely with a mixed component, involving both SARS-COV-2 infection and the fact that the patient did not he was allowed to see the newborn during hospitalization.

Keywords

• sars cov-2
• c-section
• neuropsychic manifestations
• pregnancy.