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Preeclampsia-Like Syndrome in a Pregnant Patient With Coronavirus Disease 2019 (COVID-19)
Amir Naeh1, Alexandra Berezowsky1, Mark H Yudin1
1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, St. Michael's Hospital, Toronto, ON.
Insights
Coronavirus disease 2019 (COVID-19) in pregnancy can mimic preeclampsia, presenting with hypertension and organ dysfunction. Placental growth factor (PlGF) testing helps distinguish between these conditions for effective management.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Critical Care Medicine
Background:
- Coronavirus disease 2019 (COVID-19) can manifest with hypertension, proteinuria, and hepatic dysfunction, mirroring symptoms of preeclampsia in pregnant individuals.
- Differentiating between COVID-19 and preeclampsia is crucial due to their overlapping clinical presentations and implications for maternal and fetal outcomes.
Observation:
- A case study involving an otherwise healthy pregnant patient experiencing COVID-19 infection.
- The patient presented with secondary hypertension, proteinuria, and significant hepatic dysfunction, complicating the clinical picture.
Findings:
- Maternal placental growth factor (PlGF) testing was instrumental in ruling out preeclampsia.
- The patient received supportive care and demonstrated significant clinical improvement.
- The patient successfully delivered a healthy male infant via spontaneous vaginal term delivery.
Implications:
- COVID-19 infection during pregnancy can present as a preeclampsia-like syndrome, posing diagnostic challenges.
- Placental growth factor (PlGF) testing serves as a valuable tool to differentiate preeclampsia from COVID-19.
- Accurate differentiation facilitates timely and appropriate management strategies for pregnant patients with COVID-19.
Background:
Hypertension, proteinuria, and hepatic dysfunction have been described as manifestations of coronavirus disease 2019 (COVID-19) and are generally accepted as poor prognostic factors. However, these same findings can also occur in pregnant women with preeclampsia, thus creating a diagnostic challenge.
Case:
We report a case of COVID-19 infection in an otherwise healthy pregnant patient with secondary hypertension, proteinuria, and significant hepatic dysfunction. Maternal placental growth factor (PlGF) testing was used to rule out preeclampsia. The patient received supportive care and improved significantly. She went on to have a spontaneous vaginal term delivery of a healthy male baby.
Conclusion:
COVID-19 infection in pregnancy may present as preeclampsia-like syndrome. PlGF testing can be used to differentiate preeclampsia from COVID-19 and facilitate appropriate management.
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