سزارین موفق در یک خانم مبتلا به ویروس کرونا و اسکلرودرمی: یک گزارش موردی

زمینه و هدف: میزان بروز پیامدهای نامطلوب پریناتال در زنان باردار مبتلا به ویروس کرونا بیشتر است. همچنین وجود اسکلرودرمی در این افراد سبب سقط، محدودیت رشد جنین، مرگ داخل رحمی جنین و زایمان زودرس می‌شود.بنابراین این مطالعه با هدف گزارش انجام سزارین موفق در یک خانم مبتلا به ویروس کرونا و اسکلرودرمی انجام شد.معرفی بیمار: بیمار خانم باردار 31 ساله با سن بارداری 29 هفته، با علایم تنگی نفس و دیس‌پنه به بیمارستان بعثت سنندج در آذر ماه سال 1400 مراجعه کرد. با توجه به سه لیتر خونریزی واژینال و تشخیص دکولمان 60% و پره‌اکلامسی شدید تحت سزارین اورژانس قرار گرفت. تشخیص و درمان این بیمار دارای نکات قابل‌توجه می‌باشد که در ادامه ذکر شده است.نتیجه‌گیری: بارداری در خانم‌هایی که اسکلرودرمی دارند در زمان مناسب و نظارت دقیق زایمانی، احتمال موفقیت پیامد بارداری را افزایش خواهد داد و همه بیماران نیاز به مشاوره دارند. 

successful cesarean section in a woman with coronavirus and scleroderma: a case report

background: the incidence of adverse perinatal outcomes including increased risk of miscarriage, preeclampsia, preterm birth and stillbirth is higher in pregnant women with coronavirus. pregnant women who are infected with the coronavirus have placentas that are abnormal compared to the placentas of healthy women. examples of these adverse effects have been observed before and include reduced fetal growth, pre-eclampsia, premature birth and stillbirth. scleroderma is an uncommon connective tissue disease and its most obvious manifestation is skin fibrosis. patients may also have involvement of visceral organs, as a result, their digestive system, kidney and heart are affected. scleroderma also exacerbates miscarriage, fetal growth retardation, intrauterine fetal death, and preterm delivery. pregnant women with these problems need special measures, so this study was performed to report a successful cesarean section in a woman with coronavirus and scleroderma.case presentation: the patient was a 31-year-old pregnant woman with a gestational age of 29 weeks who presented to sanandaj besat hospital in november 2021 with symptoms of shortness of breath and dyspnea. hrct-positive, pcr-positive, bilateral pleural effusion, and pulmonary dilatation corona were diagnosed. due to 3 liters of vaginal bleeding and diagnosis of décollement 60% and severe preeclampsia underwent emergency cesarean section. the live baby was born weighing 1300 g with apgar 7. during surgery, he received 3 units of ffb and 3 units of cryoprecipitate. microcalcifications and fibrin thrombi were reported in the pathology of intermittent nodules. the diagnosis and treatment of this patient has significant points that are mentioned below.conclusion: complications of pregnancy and childbirth in pregnant women infected with corona virus include an increase in premature birth and an increase in the rate of cesarean section. pregnancy in women with scleroderma at the right time and careful delivery monitoring will increase the probability of successful pregnancy outcome and all patients need counseling.