COVID-19 e Gravidez. Quando são esperadas complicações?
DOI:
https://doi.org/10.25753/BirthGrowthMJ.v31.i3.27741Palavras-chave:
COVID-19, desfecho obstétrico, feto, gravidez, neonato, r, SARS-CoV-2, transmissão verticalResumo
Introdução: A síndrome respiratória aguda grave – coronavírus 2 (SARS-COV-2) é um vírus de RNA que causa a doença COVID-19. O espectro clínico da doença varia desde assintomática a infeção crítica e potencialmente fatal. A expressão de recetores que permitem a entrada do vírus na placenta e a identificação do vírus no tecido placentar sugere que a infeção pode afetar a gravidez. Atualmente, existe já alguma evidência do impacto da COVID-19 nos desfechos obstétricos e fetais.
Objetivos: O objetivo deste estudo foi avaliar o estado da arte relativamente à infeção por SARS-COV-2 na gravidez e o risco de desfechos maternos, obstétricos e fetais adversos e, ainda, analisar em que situações esses desfechos são mais prováveis de ocorrer.
Texto principal: A infeção assintomática na gravidez é comum. Quando presentes, os sinais e sintomas são similares aos da população geral. Grávidas infetadas têm maior risco de rápida deterioração clínica e grávidas infetadas sintomáticas têm maior risco de doença grave e morte. Não há evidência de risco aumentado de anomalias congénitas ou perda gestacional em grávidas com COVID-19. A transmissão vertical não parece ser comum. Existe evidência da associação entre COVID-19 na gravidez e parto pré-termo, cesariana, pré-eclampsia e morte fetal intrauterina.
Conclusões: Desfechos maternos adversos são mais prováveis de ocorrer em grávidas com infeção por SARS-COV-2 e idade avançada, comorbilidades, obesas ou não vacinadas. Desfechos obstétricos e fetais adversos são mais prováveis de ocorrer em grávidas infetadas sintomáticas, sobretudo doença grave, e quando a infeção ocorre após as 20 semanas de gestação.
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Direitos de Autor (c) 2022 Daniela Reis Gonçalves, Ana Andrade, Joana Dias, Marta Moreira, António Braga, Luísa Ferreira, Jorge Braga
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