article = {CROGR-2021-1-103}
title = {Puerperal Infections Complicated by COVID-19 Co-Infection: Two Independent  Case Reports with Need for Intensive Care}
journal = {Case Reports in Obstetrics Gynecology and Reproductive}
year = {2021}
issn = {2674-5070}
doi = {http://dx.doi.org/10.31487/j.CROGR.2021.01.03}
url = {https://www.sciencerepository.org/puerperal-infections-complicated-by-covid-19-co-infection_CROGR-2021-1-103 
author = {Janis  Kinkel,Thomas Rduch,Katharina  Putora,Christian R. Kahlert,Tina Fischer,}
keywords = {COVID-19, SARS-CoV-2, puerperium, co-infection}
abstract ={Introduction: The current SARS-CoV-2 pandemic affects all medical fields. In obstetrics, the focus is on 
the effects on pregnancy and fetuses. Here we present two cases of parturient women that demonstrate the 
high risk of postpartum SARS-CoV-2 co-infections.
Materials and Methods: Patients` data were obtained from their medical records after confirmation of 
written informed consent. Literature review was conducted across PubMed.
Case Report: i) A 33-year-old Caucasian Gravida II, Para I was transferred to our tertiary hospital at 23+1 
weeks of pregnancy with previous preterm premature rupture of membranes (PPROM) at 17+5 weeks of 
gestation. During antenatal corticosteroid therapy for fetal lung maturation with 24+0 weeks, intrauterine 
fetal death was diagnosed in the course of amniotic infection. Due to progressive hemodynamic instability 
and confirmed SARS-CoV-2 co-infection, our patient had to be treated with catecholamines for 24 hours 
and stayed at the intensive care unit (ICU) for 72 hours. An acute myocardial injury occurred during septic 
shock. Immediate intensive care prevented permanent damage. ii) A 27-year-old Caucasian Gravida III, 
Para III was admitted to our tertiary hospital, 11 days after her third caesarean section. After circulatory 
collapse at home, the patient arrived with signs of hemorrhagic shock. Emergency curettage was performed, 
and because of cardiopulmonary worsening pulmonary embolism was suspected. Computed tomography 
revealed typical signs of COVID-19 pneumonia. Our patient was treated by nasal oxygen in the ICU for 24 
hours. Similar to the first patient, acute myocardial injury occurred without any lasting harm. 
Conclusion: Our two cases show rapid and worse clinical courses in parturient women with SARS-CoV-2 
co-infection. Rapid diagnosis and availability of intensive care were crucial for the prevention of long-term 
harm. In peri- and postpartum situations of acute clinical worsening, exclusion of SARS-CoV-2 co-infection 
is an important diagnostic step.}