بارداری و عفونت کرونا: فیزیولوژی، برخی چالش‌ها و راهکارها: مقاله مروری

نوع مقاله : مروری

نویسندگان

1 دکترای تخصصی فیزیولوژی پزشکی، گروه علوم پایه، دانشگاه فرهنگیان، تهران، ایران.

2 دانشجوی کارشناسی مامایی، دانشکده پرستاری و مامایی، واحد نجف‌آباد، دانشگاه آزاد اسلامی، اصفهان، ایران.

چکیده

مقدمه: عفونت کووید-19، بیماری در حال پیشرفت است که با افزایش سریع مرگ‌ومیر در جهان همراه است. با شیوع عفونت کووید-19، پیشگیری و کنترل آندر بین زنان باردار و خطر بالقوه انتقال به جنین، به یک نگرانی اساسی تبدیل‌ شده است.مطالعه حاضر ضمن معرفی شواهد مربوط به بیماری‎های SARS و MERS در زنان باردار، برخی تغییرات فیزیولوژیک در این جمعیت و راهکارهای درمانی احتمالی را بررسی می‌کند.
روش‌کار: در این مطالعه مروری، 147 مقاله مرتبط تا یک سپتامبر 2020 از پایگاه‌های اطلاعاتی فارسی و انگلیسی زبان Google، Google Scholar، Web of Science، PubmedوScopus؛ با استفاده از کلیدواژه‌هایعفونت، COVID-19، بارداری، جنین و فیزیولوژی استخراج شد. مقالاتی که هدف نگارش این مقاله را در برنداشتند، از روند مطالعه حذف شدند. در نهایت از اطلاعات 66 مقاله برای نگارش مقاله حاضر استفاده شد.
یافته‌ها: با وجود عدم انتقال عمودی ویروس از مادر به جنین طی شیوع قبلی کرونا ویروس‌های SARS-CoV و MERS-CoV، یک مورد انتقال عمودیSARS-COV-2در اواخر بارداری، به جفت و جنین گزارش شده است. تغییر در بیان گیرنده ACE2، تغییرات تنفسی- عروقی و تغییر در سیستم ایمنی، برخی از دلایل حساسیت زنان باردار به SARS-COV-2 هستند. از اقدامات مدیریت و کنترل عفونت کووید-19 می‌توان به غربالگری و مراقبت‌های ویژه، دارودرمانی و درمان هدایت ‌شده اشاره کرد.
نتیجه‌گیری: با توجه به تغییرات ایمنی و فیزیولوژیکی در دوران بارداری و اطلاعات محدود درباره عفونت کووید-19، زنان باردار جمعیت در معرض خطر هستند و به‌عنوان گروه‌های پرخطر معرفی ‌شده‌اند.

کلیدواژه‌ها


عنوان مقاله [English]

Pregnancy and COVID-19: Physiology, some Challenges, and Solutions

نویسندگان [English]

  • Firoozeh Alavian 1
  • Kimia Alavian 2
1 PhD in Medical Physiology, Department of Basic Sciences, Farhangian University, Tehran, Iran.
2 BC Student of Midwifery, School of Nursing and Midwifery, Islamic Azad University, Najafabad Branch, Esfahan, Iran.
چکیده [English]

Introduction: COVID-19 infection is a progressive disease that is associated with a rapidly increasing in global mortality. With the prevalence of COVID-19 infection, its prevention and control among pregnant women, and the potential risk of transmission to the fetus has become a main concern. The present study, while introducing evidence for SARS and MERS in pregnant women, examines some physiological changes in this population and the possible treatment strategies.
Methods: In this review article, 147 related articles up to September 1, 2020 from the Persian and English language databases of Google, Google Scholar, Web of Science, Pubmed, and Scopus were extracted using the keywords of infection, COVID-19, pregnancy, fetus, and physiology. The articles which did not serve the purpose of this study were excluded from the study process. Finally, the information of 66 articles was used to write the present article.
Results: Despite the lack of vertical transmission of the virus from mother to fetus during the previous outbreak of SARS-CoV and MERS-CoV coronaviruses, a case of vertical transmission of SARS-COV-2 to the placenta and fetus in late pregnancy has been reported. Changes in ACE2 receptor expression, respiratory-vascular changes, and changes in the immune system are some of the reasons for pregnant women's sensitivity to the SARS-COV-2. The management and control of COVID-19 infection include screening and intensive care, medication, and guided therapy.
Conclusion: Given the immunological and physiological changes during pregnancy and limited information about COVID-19 infection, pregnant women are at-risk populations and have identified as high-risk groups.

کلیدواژه‌ها [English]

  • COVID-19
  • fetus
  • Physiology
  • pregnancy
  • SARS-CoV-2
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