Tom 8, Nr 2 (2023)
Artykuł przeglądowy
Opublikowany online: 2023-10-05
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Zakażenie SARS-CoV-2 w okresie ciąży
1, 1
Ginekologia i Perinatologia Praktyczna 2023;8(2):74-80.
Streszczenie
Choroba koronawirusowa 2019 (COVID-19) to ostra choroba zakaźna wywołana koronawirusem zespołu ostrej niewydolności
oddechowej 2 (SARS-CoV-2). Kobiety w ciąży są bardziej narażone na ciężki przebieg choroby i śmierć
w przebiegu COVID-19 niż kobiety niebędące w ciąży: 3-krotnie częściej rozwija się niewydolność oddechowa i są
obciążone 1,7-krotnie wyższym ryzykiem zgonu. Zakażenia SARS-CoV-2 w okresie ciąży wiążą się z podwyższonym
ryzykiem wystąpienia stanu przedrzucawkowego, porodu przedwczesnego, urodzenia noworodka z niską
masą oraz zgonu płodu lub noworodka. Ponadto COVID-19 jest czynnikiem ryzyka choroby zakrzepowo-zatorowej
w okresie ciąży. Szczególnie wysokie ryzyko powikłań występuje w ciężkim przebiegu COVID-19. Ryzyko transmisji
wertykalnej wynosi około 3%. Nie stwierdza się więc ochronnego wpływu cięcia cesarskiego na ryzyko zakażenia
noworodka. W leczeniu zaleca się odpowiednie nawodnienie, leki przeciwbólowe i przeciwgorączkowe, stosowanie
nirmatrelwiru z ritonawirem, remdesiwiru, a w przypadku ciężkiego przebiegu z koniecznością stosowania tlenoterapii
— deksametazonu. W ciąży rekomendowane jest podawanie szczepionek przeciwko SARS-CoV-2 opartych
na technologii mRNA lub wektorowych.
Słowa kluczowe: ciążakoronawirusSARS-CoV-2COVID-19leczenieszczepienia
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