Drug Use in Pregnant Women Infected with COVID-19

Year 2020, , 51 - 58, 20.03.2020

Zeynep Tırmıkçıoğlu

https://doi.org/10.21673/anadoluklin.710736

Cited By: 8

Abstract

Coronaviruses include some of the agents
that produce the common cold and some viruses that produce more severe
respiratory syndromes. There have been case reports of normal and abnormal
pregnancy outcomes after infection with Coronaviruses. Malformations have not
been described. A new respiratory tract infection caused by coronaviruses was
identified in 2019 and called COVID- 19. The virus causing COVID-19 has been
named 2019- nCoV. There is no specific antiviral treatment for COVID-19.
Oseltamivir and hydroxychloroquine have been used in the treatment of COVID-
19. In patients with pneumonia, azithromycin has also been used in combination
with antiviral treatment. Lopinavir/ ritonavir can be used as second-line
treatment for patients not responding to oseltamivir and hydroxychloroquine
therapy. As yet, there is no evidence that pregnant women who get COVID-19 are
more at risk of serious complications than any other healthy individuals.
Clinicians normally hesitate in treating pregnant women by fear of causing
damage to both the mother and baby. Meanwhile, many pregnant women think the
treatment may be harmful to the baby. Drugs used for COVID-19 should be accurately
evaluated for teratogenic risks. This paper presents a literature review
regarding pregnancy outcomes after the use of therapeutic agents selected in
COVID-19 treatment. After evaluation possible teratogenic effects, symptomatic
prengnant patients with COVID-19 can also be treated with drugs used for other
adult patients. There
is a need for large-scale epidemiological studies in which the course of the
infection during pregnancy and the effects of the drugs used on pregnancy and
the fetus will be evaluated.

Keywords

COVID-19, pregnancy, drug, teratogen

COVID-19 Enfeksiyonu Olan Gebelerde İlaç Kullanımı

Abstract

Coronavirus ailesi, basit soğuk algınlığından
ciddi solunum yolu sendromlarına kadarçeşitli hastalıklara neden olabilen bir
virüs ailesidir. Gebelikte Coronavirus enfeksiyonlarını takiben normal ve
anormal sonuçlar bildirilmiş olup bebeklerde herhangi bir malformasyon
tanımlanmamıştır. 2019 yılında Coronaviruse bağlı yeni bir solunum yolu
enfeksiyonu tanımlanmış ve COVID-19 adı verilmiştir. COVID-19’a neden olan
virüs ise 2019- nCoV olarak isimlendirilmiştir. COVID-19’un spesifik bir
tedavisi bulunmamakla birlikte semptomatik hastaların tedavisinde oseltamivir
ve hidroksiklorokin kullanılmaktadır. Pnömonili olgularda antiviral tedaviye
azitromisin de eklenebilmektedir. Oseltamivir ve hidroksiklorokine yanıt
vermeyen hastalarda, ikinci seçenek tedavi olarak lopinavir/ ritonavir
kullanılabilmektedir. Bugüne kadar gebe kadınların COVID-19 enfeksiyonuna daha
duyarlı oldukları veya COVID-19 enfeksiyonu olanların daha şiddetli pnömoni
geliştirmeye yatkın olduğuna dair bir kanıt yoktur. Klinisyenler anneye ve
bebeğe zarar verir miyim düşüncesiyle gebe hastayı tedavi etmekten ve ilaç
kullanmaktan çekinebilirler. Aynı zamanda pek çok gebe kadın, tedavinin bebeği
için zararlı olabileceğini düşünebilir. COVID-19 tedavisinde kullanılan ilaçlar
teratojenik riskleri açısından doğru değerlendirilmelidir. Bu literatür
derlemesi, COVID-19 tedavisi için seçilen ilaçların gebelikte kullanımını ve
gebelik sonuçlarını sunmaktadır. Olası teratojenik etkilerin
değerlendirilmesinden sonra, semptomu olan gebe hastalar da diğer yetişkin
bireylere uygulanan ilaçlarla tedavi edilebilir. Enfeksiyonun gebelikte seyri ve kullanılan ilaçların gebelik
ve fetus üzerine etkilerinin değerlendirileceği geniş çaplı epidemiyolojik
çalışmalara gereksinim vardır. 

Keywords

gebelik, COVID-19, ilaç, teratojen

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