Dyspnea and COVID-19: A Review of Confounding Diagnoses During the Postpartum Period

Overview

Journal Rev Bras Ginecol Obstet

Specialty Gynecology & Obstetrics

Date 2021 Dec 6

PMID 34872145

Citations 1

Authors

Clara Nunes Castro

Pedro Paulo Machado Lopes

Jussara Mayrink

Affiliations

Soon will be listed here.

Abstract

The puerperium is a complex period that begins with placental delivery and lasts for 6 weeks, during which readaptation of the female organism and redistribution of blood volume occur. This period is conducive to the occurrence of thromboembolic events. In the context of the SARS-CoV-2 pandemic, the virus responsible for COVID-19, the attention of the scientific community and health professionals has been focused on obtaining insights on different aspects of this disease, including etiology, transmission, diagnosis, and treatment. Regarding the pregnancy-postpartum cycle, it is opportune to review the clinical conditions that can occur during this period and to investigate dyspnea as a postpartum symptom in order to avoid its immediate association with COVID-19 without further investigation, which can lead to overlooking the diagnosis of other important and occasionally fatal conditions.

Citing Articles

Unknown rheumatic cardiac disease as cause of acute onset post-partum dyspnea: a case report.

Pinho A, Mota De Sousa A, Melo A, Ferreira A BMC Pregnancy Childbirth. 2023; 23(1):489.

PMID: 37400772 PMC: 10316575. DOI: 10.1186/s12884-023-05809-w.

References

. ACOG Practice Bulletin No. 196: Thromboembolism in Pregnancy. Obstet Gynecol. 2018; 132(1):e1-e17. DOI: 10.1097/AOG.0000000000002706. View

Beigi R . Prevention and management of influenza in pregnancy. Obstet Gynecol Clin North Am. 2014; 41(4):535-46. DOI: 10.1016/j.ogc.2014.08.002. View

Martillotti G, Boehlen F, Robert-Ebadi H, Jastrow N, Righini M, Blondon M . Treatment options for severe pulmonary embolism during pregnancy and the postpartum period: a systematic review. J Thromb Haemost. 2017; 15(10):1942-1950. DOI: 10.1111/jth.13802. View

Hantoushzadeh S, Shamshirsaz A, Aleyasin A, Seferovic M, Kazemi Aski S, Arian S . Maternal death due to COVID-19. Am J Obstet Gynecol. 2020; 223(1):109.e1-109.e16. PMC: 7187838. DOI: 10.1016/j.ajog.2020.04.030. View

Hauswaldt J, Blaschke S . [Dyspnea]. Internist (Berl). 2017; 58(9):925-936. DOI: 10.1007/s00108-017-0276-2. View

Bulut C, Kato Y . Epidemiology of COVID-19. Turk J Med Sci. 2020; 50(SI-1):563-570. PMC: 7195982. DOI: 10.3906/sag-2004-172. View

Grifoni E, Marcucci R, Ciuti G, Cenci C, Poli D, Mannini L . The thrombophilic pattern of different clinical manifestations of venous thromboembolism: a survey of 443 cases of venous thromboembolism. Semin Thromb Hemost. 2012; 38(2):230-4. DOI: 10.1055/s-0032-1301420. View

Dado C, Levinson A, Bourjeily G . Pregnancy and Pulmonary Embolism. Clin Chest Med. 2018; 39(3):525-537. PMC: 8018832. DOI: 10.1016/j.ccm.2018.04.007. View

Zaigham M, Andersson O . Maternal and perinatal outcomes with COVID-19: A systematic review of 108 pregnancies. Acta Obstet Gynecol Scand. 2020; 99(7):823-829. PMC: 7262097. DOI: 10.1111/aogs.13867. View

10.

Meltzer-Brody S, Howard L, Bergink V, Vigod S, Jones I, Munk-Olsen T . Postpartum psychiatric disorders. Nat Rev Dis Primers. 2018; 4:18022. DOI: 10.1038/nrdp.2018.22. View

11.

Turan O, Hakim A, Dashraath P, Jeslyn W, Wright A, Abdul-Kadir R . Clinical characteristics, prognostic factors, and maternal and neonatal outcomes of SARS-CoV-2 infection among hospitalized pregnant women: A systematic review. Int J Gynaecol Obstet. 2020; 151(1):7-16. PMC: 9087651. DOI: 10.1002/ijgo.13329. View

12.

Dashraath P, Wong J, Lim M, Lim L, Li S, Biswas A . Coronavirus disease 2019 (COVID-19) pandemic and pregnancy. Am J Obstet Gynecol. 2020; 222(6):521-531. PMC: 7270569. DOI: 10.1016/j.ajog.2020.03.021. View

13.

OConnor C, Moriarty J, Walsh J, Murray J, Coulter-Smith S, Boyd W . The application of a clinical risk stratification score may reduce unnecessary investigations for pulmonary embolism in pregnancy. J Matern Fetal Neonatal Med. 2011; 24(12):1461-4. DOI: 10.3109/14767058.2011.614652. View

14.

Huang X, Wei F, Hu L, Wen L, Chen K . Epidemiology and Clinical Characteristics of COVID-19. Arch Iran Med. 2020; 23(4):268-271. DOI: 10.34172/aim.2020.09. View

15.

Leung A, Bull T, Jaeschke R, Lockwood C, Boiselle P, Hurwitz L . American Thoracic Society documents: an official American Thoracic Society/Society of Thoracic Radiology Clinical Practice Guideline--Evaluation of Suspected Pulmonary Embolism in Pregnancy. Radiology. 2012; 262(2):635-46. DOI: 10.1148/radiol.11114045. View

16.

Abdul Sultan A, West J, Grainge M, Riley R, Tata L, Stephansson O . Development and validation of risk prediction model for venous thromboembolism in postpartum women: multinational cohort study. BMJ. 2016; 355:i6253. PMC: 5137302. DOI: 10.1136/bmj.i6253. View

17.

Clement S, Schauman O, Graham T, Maggioni F, Evans-Lacko S, Bezborodovs N . What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychol Med. 2014; 45(1):11-27. DOI: 10.1017/S0033291714000129. View

18.

Takemoto M, Menezes M, Andreucci C, Nakamura-Pereira M, Amorim M, Katz L . The tragedy of COVID-19 in Brazil: 124 maternal deaths and counting. Int J Gynaecol Obstet. 2020; 151(1):154-156. PMC: 9087660. DOI: 10.1002/ijgo.13300. View

19.

Touqmatchi D, Cotzias C, Girling J . Venous thromboprophylaxis in pregnancy: the implications of changing to the 2010 RCOG guidelines. J Obstet Gynaecol. 2012; 32(8):743-6. DOI: 10.3109/01443615.2012.711387. View

20.

Haghikia A, Rontgen P, Vogel-Claussen J, Schwab J, Westenfeld R, Ehlermann P . Prognostic implication of right ventricular involvement in peripartum cardiomyopathy: a cardiovascular magnetic resonance study. ESC Heart Fail. 2016; 2(4):139-149. PMC: 5054874. DOI: 10.1002/ehf2.12059. View