Termination of Pregnancy in a Woman with COVID‐19: Case Report

ABSTRACT

Background. The present paper aims to describe the case of a 28-year-old pregnant woman infected with COVID-19 who underwent hysterectomy following uterine rupture.
Case presentation. A 28-year-old pregnant woman (24 weeks) was admitted with the chief complaint of abdominal and pelvic pain, fever, and cough. The ultrasound assessments revealed a significant decrease in fetal movement. PCR test confirmed that she was positive for COVID-19. The patient was treated with intravenous Vitamin C, intravenous Ceftriaxone, and oral Azithromycin. During this time, a decrease in hemoglobin level and severe oligohydramnios forced surgeons to decide in favor of pregnancy termination. Misoprostol (100 μg/3h up to three doses) was given sublingually. After the third dose, she presented with abdominal pain, nausea and vomiting, she also developed tachycardia. Free intraperitoneal fluid was detected in ultrasonography, and ultrasound examination revealed the strong possibility of uterine rupture. She was taken to the operating room immediately for an emergency laparotomy. An intact amniotic sac with fetus and placenta, separated from the uterus, was extracted from the abdominal cavity. Because of heavy bleeding, a hysterectomy was performed. The patient was transferred to the covid-19 unit for further support.
Conclusions. It seems in our case that the combination of pregnancy with COVID has led to an uncontrolled situation for physicians, and COVID has deteriorated the circumstances. It needs further research to prove whether there is a correlation between COVID-19 and uterine rupture in pregnant women.