CONTROVERSIAL ISSUES IN OBSTETRIC MANAGEMENT OF WOMEN WITH NOVEL CORONAVIRUS DISEASE COVID-19 DURING PREGNANCY AND CHILDBIRTH


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Abstract

The new coronavirus infection, which was identified in Wuhan (Hubei province, China) in late 2019, caused an outbreak of severe pneumonia. The disease quickly spread throughout China and was followed by a dramatic increase in number of new cases in other countries of the world. Certain population groups that require particular attention include pregnant women due to the fact that pneumonia is the third-leading indirect cause of maternal mortality. Among the controversial issues in the management of pregnant women with COVID-19, special attention should be paid to the tactics of prolonging pregnancy and approaches to childbirth. The available scientific and clinical data are currently insufficient to perform a complete assessment of perinatal outcomes in pregnant women with COVID-19. Researchers and practical healthcare specialists have more questions than answers due to the limited time and number of studies, lack of evidence of vertically transmitted infection from mother to fetus, absence of clear understanding of viral pathogenesis during pregnancy, as well as the level and degree of initiation of SARS- CoV-2 pathological processes in the mother and fetus that can have a negative influence on the perinatal outcome. This review is devoted to the analysis of pregnancy and childbirth outcomes, presentation of current approaches to the management of women with novel coronavirus infection COVID-19 during pregnancy and childbirth on the basis of the available literature data in the domestic and foreign clinical guidelines.

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About the authors

Vitaliy F. BEZHENAR

First Pavlov State Medical University of St. Petersburg, Ministry of Health of Russia

Email: bez-vitaly@yandex.ru
MD, PhD, professor, Head of Obstetrics and Gynecology Department, Chief expert in obstetrics and gynecology of Saint-Petersburg Healthcare Committee and Ministry of Health in North-Western Federal Region of Russian Federation St. Petersburg, Russia

Irina E. ZAZERSKAYA

Almazov National Medical Research Centre, Ministry of Health of Russia

Email: zazera@almazovcentre.com
MD, PhD, professor, Head of Obstetrics and Gynecology Department St. Petersburg, Russia

Ofelia A. BETTIKHER

Almazov National Medical Research Centre, Ministry of Health of Russia

Email: ophelia.bettikher@gmail.com
MD, professor assistant at Obstetrics and Gynecology Department, Research scientist of the Laboratory of Women’s Health and Reproduction St. Petersburg, Russia

Igor M. NESTEROV

First Pavlov State Medical University of St. Petersburg, Ministry of Health of Russia

Email: ignester@yandex.ru
MD, PhD, Associate professor at Obstetrics and Gynaecology Department St. Petersburg, Russia

Andrey E. BAUTIN

Almazov National Medical Research Centre, Ministry of Health of Russia

Email: abautin@mail.ru
MD, PhD, professor, Research Laboratory of anesthesiology and reanimatology St. Petersburg, Russia

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