COVID-19 and preeclampsia with severe features at 34-weeks gestation

John N. Hansen, Department of Emergency Medicine, Maine Medical Center, 22 Bramhall Street, Portland, ME 04102, United States of America. Electronic address: Jhansen@mmc.org.
Jason Hine, Southern Maine Healthcare, Department of Emergency Medicine, Tufts University School of Medicine, 1 Medical Center Drive, Biddeford, ME 04005, United States of America. Electronic address: jfhine@smhc.org.
Tania D. Strout, Maine Medical Center, Department of Emergency Medicine, Tufts University School of Medicine, 22 Bramhall Street, Portland, ME 04102, United States of America. Electronic address: Strout@mmc.org.

Abstract

The evolving coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to a rapid expansion of knowledge on the disease's clinical manifestations, laboratory and radiographic abnormalities, and patient trajectories. One area of particular focus is the effect that this illness may have on pregnancy and maternal-fetal disease. As of April 24, 2020, we identified 55 English language reports in the scientific literature summarizing data for 339 women and 258 fetuses and neonates. The majority of these data have focused on maternal-fetal transmission and neonatal outcomes. One systematic review and meta-analysis including the spectrum of coronaviruses [Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS), and COVID-19] in pregnancy noted increased rates of adverse outcomes associated with this group of infections. Here, we report the case of a COVID-19 positive woman presenting to our emergency department (ED) at 34 weeks gestation with preeclampsia. This case highlights the unique diagnostic and therapeutic challenges associated with treating patients with these concomitant diseases.