Scientists say that the 35-year-old woman developed Covid-19 symptoms – including a fever and cough – 22 weeks into her pregnancy.
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Around a week later, her symptoms began to worsen and she also reported experiencing muscular pain, nausea and diarrhoea.
But then a few days after that, she woke up suffering from stomach pain and noticed she had suffered a bleed.
The woman, who was previously healthy, went to hospital where medics carried out a series of tests, including a swab for coronavirus – which came back positive.
An ultrasound showed the fetus was healthy and active, however, there appeared to be a clot between the placenta and the wall of the uterus.
Further tests indicated she may be suffering from pre-eclampsia – a condition which can be life-threatening for both mum and baby if it's not treated.
The exact cause isn't known but it's thought to occur when there's a problem with the placenta, which links the baby's blood supply to the mother's.
Medics began administering the woman with blood plasma treatment, which helped stem the bleed but her blood pressure remained high and blood platelet was low.
They determined that her case was severe and told her that the only definitive treatment would be to deliver the fetus.
What is pre-eclampsia and what are the symptoms?
Pre-eclampsia, once known as toxemia, is a condition that affects pregnant women, usually after the 20-week mark or straight after their baby is delivered.
Early signs include having high blood pressure (hypertension) and protein in their urine (proteinuria).
Mild pre-eclampsia affects up to six per cent of pregnancies, while severe cases develop in up to two per cent.
The exact cause of the condition is currently unknown, but it’s thought to occur when there’s a problem with the placenta.
There are also several factors that increase the chance of developing the condition, including having a family history of it, being over 40 or expecting multiple babies.
Symptoms of pre-eclampsia include:
- swelling of the feet, ankles, face and hands
- severe headache
- vision problems
- pain just below the ribs
However many people don’t notice the signs of pre-eclampsia, which means it’s usually picked up during routine antenatal appointments.
She had a series of consultations with experts from various departments but ultimately decided to terminate the pre-viable pregnancy.
Experts from the Yale School of Medicine said in the pre-print paper, which is yet to be peer-reviewed, that this was to "reduce the risk of serious maternal morbidity or death".
They said that during the surgery, they found the retroplacental clot between the wall of the uterus and the placenta.
The day after her surgery she was extubated and weaned to room air, however, she developed a condition known as lymphopenia – or a drop in white blood cells, which can indicate infection.
She was given hydroxychloroquine – an arthritis drug – as an investigational treatment for Covid-19.
Her condition improved and she was discharged to self-isolation three days after the operation.
Doctors asked the woman to continue monitoring her blood pressure from home and to check in with them on the phone.
The woman gave her consent for her tissue to be released for research testing by the US scientists.
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Their findings were published on MedRxiv – an online archive – and not in a journal as the research is yet to be peer-reviewed by other academics.
Prof Marian Knight, Professor of Maternal and Child Population Health, University of Oxford, said: “Pre-eclampsia is a relatively common complication of pregnancy, and it remains unclear whether the presence of Covid-19 virus in the placenta as described in this single report is related to the development of the pregnancy complications.
"Pre-eclampsia can be detected early during routine antenatal visits and the most important message for women must be that they should continue to attend for their antenatal check-ups while being vigilant about social distancing, particularly in the third trimester of pregnancy.”
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