Anesthesia and protection in an emergency cesarean section for pregnant woman infected with a novel coronavirus: case report and literature review

J Anesth. 2020 Aug;34(4):613-618. doi: 10.1007/s00540-020-02796-6. Epub 2020 May 19.

Abstract

An outbreak of novel coronavirus pneumonia occurred worldwide since December 2019, which had been named COVID-19 subsequently. It is extremely transmissive that infection in pregnant women were unavoidable. The delivery process will produce large amount of contaminated media, leaving a challenge for medical personnel to ensure both the safety of the mother and infant and good self-protection. Only rare cases of pregnant women with COVID-19 are available for reference. Here, we report a 30-year-old woman had reverse transcription polymerase chain reaction-confirmed COVID-19 at 36 weeks 2 days of gestation. Significant low and high variability of fetal heart rate baseline and severe variable decelerations were repeated after admission. An emergency cesarean section at 37 weeks 1 day of gestation under combined spinal and epidural anesthesia was performed with strict protection for all personnel. Anesthesia and operation went uneventfully. None of the participants were infected. We can conclude that when confronted with cesarean section in parturient with COVID-19, careful planning and detailed preparation can improve the safety of the mother and infant and reduce the risk of infection for medical staff to help preventing and controlling the epidemic.

Keywords: 2019-nCoV; COVID-19; Cesarean section; Parturient.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Anesthesia, Epidural / methods
  • Anesthesia, Obstetrical / methods*
  • Anesthesia, Spinal / methods
  • Betacoronavirus*
  • COVID-19
  • COVID-19 Testing
  • Cesarean Section*
  • Clinical Laboratory Techniques
  • Coronavirus Infections* / diagnosis
  • Coronavirus Infections* / diagnostic imaging
  • Female
  • Humans
  • Lung / diagnostic imaging
  • Pandemics*
  • Personal Protective Equipment
  • Pneumonia, Viral* / diagnostic imaging
  • Pregnancy
  • Pregnancy Complications, Infectious*
  • Radiography, Thoracic
  • SARS-CoV-2
  • Tomography, X-Ray Computed