Many pregnant women suffer from post-Covid-19 complications silently, without knowing it

Circulatory arrest from thromboembolic sequelae

Recently, many mothers contracted Covid-19 and were instructed to take care of their health at home. However, due to not being detected early, some pregnant women fell into a state of death during childbirth due to complications of Covid-19 that had manifested throughout the body.

Dr. Doctor Nguyen Thi Sim – Deputy Director of the Center for Prenatal and Neonatal Diagnostic Screening and Diagnosis, Hanoi Obstetrics and Gynecology Hospital, said that post-Covid-19 in pregnant women is very dangerous. Dr. Sim has treated many post-Covid-19 cases in good health, the ultrasound indicators for the fetus are completely normal. But the post-Covid-19 sequelae are silent.

For example, 42-year-old pregnant woman Nguyen LT (Hanoi) is 36 weeks pregnant and hospitalized in the following condition: fetal growth retardation, breech position. The patient’s history has been infected and cured of Covid-19 1 month ago.

After examining and questioning the patient, the woman was prescribed a caesarean section by the doctor. The situation before and during the operation was completely smooth, and the mother L. welcomed her baby weighing 1.8kg into the world.

After 10 minutes of surgery, the patient appeared to have stopped circulating. Immediately, the Department of Anesthesiology and Resuscitation turned on the red alert throughout the Hospital. Under the direction of Dr. BS. Tran Van Cuong, Head of Anesthesia and Resuscitation Department, the surgical and resuscitation team immediately gave first aid and successfully saved the mother’s life.

The rate of circulatory arrest in pregnant women during pregnancy is extremely rare, accounting for 1 in 300,000 cases. There are many causes of circulatory arrest in pregnant women such as: bleeding, coagulopathy, embolism,… In this case, the pregnant woman is completely healthy.

Pregnant women who stopped circulating blood after Covid-19 were lucky to be saved.

Dr. Sim said that the patient has a high D-Dimer factor: 4762 ng/ml because the pregnant woman has had Covid 19 and this factor can increase the risk of embolism, leading to circulatory arrest.

Missing amniotic fluid after Covid-19

In another case, a pregnant woman went to the doctor when her amniotic fluid ran out and the baby was tightly bound. Fetal heart beat is weak, heart is enlarged and 99% diagnosis is abortion. Pregnant women have visited many maternity hospitals. When entering the Hanoi Obstetrics and Gynecology Hospital, the doctor showed symptoms of the fetus due to lack of amniotic fluid.

Dr. Sim plans to give amniotic fluid to the pregnant woman. From a tightly bound fetus that has been infused with amniotic fluid, in the process of amniotic fluid transmission, the fetus looks like a stranded fish released in water, the fetus’ limbs stretch, the fetus opens its mouth to drink water. Dr. Sim said if delay the fetus will die. This pregnant woman has been infected with Covid-19.

Another case Hoang V., Ung Hoa, Hanoi was pregnant at 24 weeks, when infected with Covid-19 was also completely healthy, without severe symptoms. Therefore, pregnant women subjectively do not go to the doctor, but only go to check their pregnancy according to the schedule.

When pregnant women come to the clinic 3 weeks after being infected with Covid-19, the fetus does not gain weight. Dr. Sim said that the doctor discovered that the pregnant woman ran out of amniotic fluid, the D-dimer index (diagnosis of thrombotic diseases) was very high, 7 times higher than that of a normal person. In this case, even amniocentesis cannot correct the clotting mechanism.

Dr. Sim said that with cases of postpartum blood clotting disorders, doctors recommend giving birth in large hospitals that have adequate emergency conditions during childbirth to avoid danger to pregnant women.

According to Dr. Sim, amniotic fluid is the fluid that surrounds the fetus, the liquid environment that helps the fetus develop during pregnancy.

Amniotic fluid plays an extremely important role such as helping to protect the fetus from injury while in the womb, being a sterile environment to avoid special infections in the lungs, providing nutrition for the fetus, and helping to keep the fetus healthy. The fetus has a stable body temperature.

Amniotic fluid is mostly of fetal origin, as the repeated excretion of urine produces the right amount of amniotic fluid.

Oliguria is a phenomenon where the amount of amniotic fluid is less than the normal physiological level, when the amniotic index AFI is less than 5cm and the amniotic membrane is intact.

There are potential risks of oligohydramnios such as pulmonary hypoplasia, umbilical cord compression, clubfoot… More serious is amniotic fluid depletion when the amount of amniotic fluid measured by ultrasound (AFI) is less than 3cm.

Khanh Chi