Coronavirus infection (Pandemic), which started in China and spread rapidly around the world since December 2019, is defined as COVID-19 by the World Health Organization (WHO), and the causative virus is SARS-Cov-2 (Severe acute respiratory syndrome coronavirus-2). It is named.
SARS-Cov-2 is a virus from the same lineage as the SARS virus, which emerged in the Far East in 2003, and the MERS virus, which emerged in 2012. It is thought to have jumped from bats to humans.
It has currently infected 1.5 million people in the world. The mortality rate is between 2-4%. Its rapid spread, lack of a definitive treatment, and the fact that a vaccine has not yet been found increase its impact.
The virus can be transmitted through droplets released by coughing or sneezing from individuals who carry the virus even though they are sick or asymptomatic, or from contaminated surfaces on the person's hands. The virus is transmitted through mouth-nose or eye contact. It has been reported that droplets can reach up to 2 meters in length.
The incubation period is 2-14 days. Although the average age is 49-56, it can be seen at any age.
Nearly half of the cases also have an additional disease (such as hypertension, diabetes, rheumatic disease).
Common symptoms of infection are fever, cough and is shortness of breath. In severe cases, pneumonia, kidney failure and death occur.
There are 3 diagnostic tests. The most commonly applied one is the PCR (Polymerase chain reaction) test, which allows the detection of a piece of the virus from the cells in the swab taken from the nose and mouth and taken from the back (nasopharyngeal region). The accuracy rate is around 60%. If it comes back negative, it should be repeated one or two more times with a few days interval. There is also an antigen test and an antibody test in those who have had the disease, but the antigen test has not been found reliable.
Lymphopenia is observed in 83.2% of cases.
In severe cases, shortness of breath and oxygen saturation in arterial blood is 95%. If it falls below , typical “ground glass opacities” are seen on lung CT (in 56.4% of cases). If this appearance is present, Covid 19 treatment is started without waiting for the test result.
The average hospital stay of the cases is 12 days.
Recently, cases without serious symptoms have begun to be followed with home isolation. ir.
In the treatment, Hydroxychloroquine, which is an antimalarial drug and used in rheumatic diseases, remdesivir, which is an antiviral agent and was used in previous SARS and MERS, and Letonavir-ritonavir, which was used in the epidemic in China, and azithromycin if there is a secondary bacterial infection.
The use of these drugs in the treatment of Covid 19 in pregnant women should be done after consultation with Infectious Diseases and Gynecology physicians. However, although there is not enough data regarding the drugs mentioned above, it is known that they do not increase the frequency of fetal anomalies.
There is no study showing that pregnant women are more susceptible to Covid 19 infection. However, pregnant women are more susceptible to diseases than other people, their morbidity and mortality are higher, and the high death rates seen in pregnant women in previous SARS and MERS epidemics require the ISOLATION of pregnant women and, in case they become ill, a more careful and competent team.
Infected pregnant women are treated like other people. In some cases, fetal distress and premature birth have been observed. In pregnancy and birth management, appropriate treatment should be provided together with infectious diseases, intensive care specialists and related branches. Hospitalized patients should be taken to negative pressure rooms, and oxygen therapy and mechanical ventilation should be applied to those with respiratory distress. Excessive fluid therapy should be avoided and strict fetal and uterine monitoring should be performed.
The gynecologist will decide the time of birth. In case of premature birth, consultation should be made with the infectious diseases department regarding the glucocorticoid to be administered to the mother for the child's lung development.
If the birth method will be normal, the second period of birth is facilitated by episiotomy to prevent straining. In cesarean section, epidural and spinal anesthesia methods should be applied instead of general anesthesia.
Direct contamination has not been observed during pregnancy and birth.
While there are those who want the newborn to be removed from the mother for 14 days after birth, there are also those who recommend that the mother be isolated with a mask and breastfeed her child. There are also people who give the milk taken from the mother through a pump to the baby. If they will stay in the same room, the 2 meter rule should be applied.
Our advice to pregnant women and other patients with gynecological complaints is to stay at home unless there is a serious problem.
And of course, our hope is that a vaccine will be found and that the virus will not mutate in the meantime, but in such a way that its virulence will decrease.
Read: 0
