Coronavirus disease 2019 on routine testing in eclampsia: a case report

Area of Science:

• Obstetrics and Gynecology
• Infectious Diseases
• Critical Care Medicine

Background:

• Coronavirus disease 2019 (COVID-19) is linked to adverse pregnancy outcomes, including preeclampsia.
• Differentiating COVID-19 from preeclampsia is challenging due to similar clinical presentations.
• Routine COVID-19 testing is not standard for pregnant women, necessitating testing for those with preeclampsia/eclampsia.

Observation:

• A 23-year-old primigravida at 36 weeks gestation presented with eclampsia and a concurrent COVID-19 infection.
• The patient experienced tonic-clonic seizures, hypertension, tachycardia, and tachypnea.
• Initial management included magnesium sulfate, labetalol, and supportive care, followed by an uncomplicated vaginal delivery.

Findings:

• The patient tested positive for COVID-19, while the neonate tested negative.
• Postpartum, the mother developed respiratory distress and fluid overload, managed with furosemide.
• The mother received a course of various medications, including ivermectin, azithromycin, and zinc.

Implications:

• Eclampsia and preeclampsia diagnoses in pregnant women should trigger COVID-19 testing.
• Prompt identification and management of COVID-19 in pregnancy are vital for maternal and fetal well-being.
• This case highlights the importance of considering infectious etiologies in hypertensive disorders of pregnancy.