COVID-19 por SARS-CoV-2: la nueva emergencia de salud en la embarazada. Lo que médicos y obstetras necesitan saber
COVID-19 by SARS-CoV-2: the new health emergency in the pregnant. What doctors and obstetrics need to know

María Noguera, Manuel Santos, Nazira Monsalve, Juan Avendaño, Juan Avendaño-Noguera

Resumen


La actual pandemia COVID-19, causada por SARS-CoV-2, se está propagando a un ritmo acelerado. Las embarazadas y sus fetos representan una población de alto riesgo debido a los cambios fisiológicos y mecánicos en el embarazo. Existe poca evidencia del compromiso materno fetal, y de transmisión vertical. El equipo de salud encargado de atender a la mujer durante su etapa prenatal, natal y postnatal debe estar al tanto de esta infección y su manejo.  Se realizó una revisión sistemática de las publicaciones de mayor relevancia, de países que ya han presentado esta enfermedad y protocolos de organismos mundialmente facultados. Una de las principales fortalezas de la atención prenatal es su insistencia en la prevención y el diagnóstico oportuno. Las medidas de distanciamiento social, y/o cuarentena, hacen imperativo tomar decisiones sobre: cuándo y cómo realizar el control prenatal en tiempo de pandemia, y cómo es el manejo de la paciente embarazada COVID-19+, durante el tercer trimestre, trabajo de parto, parto, y puerperio; garantizando siempre, el bienestar materno fetal y del personal de  salud. Se concluye que estamos ante un desafío único, que exigen un enfoque multidisciplinario. La evolución de este nuevo agente infeccioso es totalmente impredecible, falta mucho por conocer, las investigaciones futuras arrojarán luces sobre el comportamiento clínico del SARSCoV-2 en las diferentes etapas del embarazo, complicaciones, además de la posibilidad de transmisión vertical. Se recomienda  la atención obstétrica y perinatal de pacientes gestantes en nuestro medio, de una manera consensuada, uniforme y basada en la evidencia científica actual.

The current COVID-19 pandemic, caused by SARS-CoV-2, is spreading at an accelerated rate. Pregnant women and their fetuses represent a high-risk population due to the physiological and mechanical changes in pregnancy. There is little evidence of fetal maternal engagement and vertical transmission. The health team responsible of caring woman during her prenatal, natal and postnatal stage should be aware of this infection and its management. A systematic review of the most relevant publications was made from countries that have already suffered from this disease and protocols from globally empowered agencies. One of the main strengths of prenatal care is its insistence on prevention and timely diagnosis. Social distancing measures, and/or quarantine, make it imperative to make decisions about: when and how to perform prenatal monitoring at pandemic time, and what the management of the pregnant patient COVID-19+ is like, during the third trimester, labor, delivery, and postpartum; always ensuring maternal fetal and health personnel well-being. It concludes that we are facing a unique challenge, which require a multidisciplinary approach.  The evolution of this new infectious agent is totally unpredictable, there is much to learn, and future research will shed light on the clinical behavior of SARSCoV-2 at different stages of pregnancy, complications, in addition to the possibility of vertical transmission. Obstetric and perinatal care of pregnant patients in our environment is recommended, in a consensual, uniform manner based on current scientific evidence.


Palabras clave


Atención Prenatal; Cuarentena; COVID-19; Parto; Periodo Postparto, Prenatal Care; Quarantine; COVID-19; Childbirth; Postpartum Period

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Referencias


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