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لا يبدو أن النساء الحوامل معرضات لخطر إضافي مع covid-19

التاريخ: 2020-05-29 08:51:09
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Holand-today

لا يجب على النساء الحوامل القلق بشأن صحتهن أو صحة طفلهن الذي لم يولد بعد. هذا واضح من المحادثات مع الأطباء والعلماء الذين يبحثون عن الكوفيد 19 والحمل.

منذ 1 مارس ، تم اختبار ما لا يقل عن 211 امرأة حامل لفيروس كورونا الجديد في هولندا.
يقوم أطباء أمراض النساء والتوليد بإبلاغ NethOSS بالأرقام كل أسبوع. تشرح كيتي بلويمينكامب: "هذا تسجيل مستمر للرابطة الهولندية لأمراض النساء والولادة (NVOG) التي نراقب فيها وفيات الأمهات".
وهي أستاذة طب التوليد في UMC Utrecht ورئيسة الفريق الهولندي والدولي الذي يقوم بالتسجيل والبحوث ذات الصلة.

فرصة ضئيلة للعدوى
تعتقد Bloemenkamp أن النساء الحوامل يتبعن الإجراءات جيدًا. "يولد حوالي 185.000 طفل كل عام ، لذا أنجبت حوالي 46000 امرأة حتى 1 مارس / آذار. ولم يكن عدد النساء اللاتي لديهن شكاوى والذي ثبتت إصاباتهن 211 أمرًا سيئًا بالنسبة لي. لذلك كانت فرصة إصابة النساء الحوامل بالفيروس ضئيلة. "

يقول Bloemenkamp: "إن مسار المرض يمكن مقارنته إلى حد ما بعامة السكان". "عادة ما يبقى فقط مع شكاوى خفيفة مثل السعال والحمى ، ولكن في حالات نادرة يمكن أن يكون المرض خطيرًا.
نرى أنه في هولندا حوالي 3 إلى 4 في المائة من النساء الحوامل المختبرات الإيجابيات ينتهي بهن الأمر في وحدة العناية المركزة."

تقول بلويمنكامب أن فرصة وفاة النساء الحوامل بسبب الفيروس أمر صغير للغاية. "حتى الآن ، توفيت امرأة واحدة أثناء الولادة بسبب الكورونا.
هذه صورة مختلفة تمامًا عن ، على سبيل المثال ، بمرض MERS ، الناجم عن فيروس كورونا مختلف. نرى وفاة حوالي 25 نسبه مئويه."

المزيد من الولادات قبل الأوان
ومع ذلك ، هناك المزيد من الولادات قبل الأوان. تقول Bloemenkamp: "إذا مرضت المرأة الحامل بشكل كبير ، فسيتم فحص ما إذا كان عليها أن تلد في وقت مبكر ، خاصة إذا كانت حامل 28 أسبوعًا أو أكثر". "منذ تلك اللحظة ، يمكنك أن تعني شيئًا للطفل ، وستتعافى الأم بشكل أسرع."

"خاصة في الأسابيع الـ 12 الأخيرة ، من المرجح أن تطور النساء الحوامل مسارًا خطيرًا للالتهاب الرئوي. وذلك لأن الجهاز المناعي يتغير أثناء الحمل ولأن الحجاب الحاجز - المهم للتنفس - يتم دفعه في وقت لاحق أثناء الحمل."

تم العثور على أجسام مضادة
وفقًا لـ Bloemenkamp ، فإن فرصة إصابة الطفل بالفيروس في الرحم ضئيلة للغاية. "في حالات قليلة ، تم العثور على جزيئات الفيروس في المشيمة ، كما تم العثور على أجسام مضادة لفيروس الكورونا الجديد عدة مرات في الأطفال الذين ليس لديهم أي علامات على الإصابة بأنفسهم. لذلك قد يحدث شيء في بعض الأحيان."

لذا يريد Bloemenkamp إجراء المزيد من البحث مع الزملاء حول كيفية تطور عدوى covid-19 في الأمهات وأطفالهن الذين لم يولدوا بعد.
هذا هو السبب في أنهم قدموا طلبًا منحة للبحث في التغييرات في نظام مناعة الأمهات والأجسام المضادة في الأم والطفل وما يحدث بالضبط في المشيمة.

Holland

كما أجريت دراسات باثولوجية على المشيمة لدى النساء اللواتي كان لديهن Covid-19 أثناء الحمل أو الولادة.
يقول اختصاصي أمراض الأطفال بيتر نيكلز من UMC Utrecht "حتى الآن ، لم توفر هذه الأسباب للقلق". "لم يتم تحديد أي حالات شاذة تسببها الفيروس بشكل واضح."

الأطفال بالكاد مرضوا
يقول ويليم دي فريس ، طبيب حديثي الولادة في مستشفى فيلهيلمينا للأطفال ونائب رئيس الجمعية الهولندية لطب الأطفال ، مع بعض الاستثناءات القليلة ، أن الأطفال حديثي الولادة الذين يصابون بالفيروس يصابون بالكاد. "حتى الآن ، لم ينته أي رضيع مصاب في المواليد الجدد في هولندا."

ومع ذلك ، يتم اتباع جميع الأطفال الذين تتراوح أعمارهم من 0 إلى 18 عامًا والذين لديهم غشاء 19. منذ بداية شهر أبريل ، قام أطباء الأطفال - إذا أعطى الآباء موافقتهم - بتسجيل جميع الأطفال الذين ثبتت إصابتهم.
يقول دي فريس: "نود أن نعرف كيف يتطور هؤلاء الأطفال". "هل تنمو بشكل جيد ، على سبيل المثال؟ وما هو شكل وظائف الرئة؟"

لا يتم مراقبة الأطفال الذين أثبتت أمهاتهم اختبار إيجابية لـ covid-19 أثناء الحمل.
وفقًا لـ De Vries ، لا يوجد حاليًا سبب للقيام بذلك. "ولكن إذا كان هناك أي مؤشرات على وجود خطأ في هذه المجموعة ، فيمكننا العثور عليها من خلال NethOSS."

سواء كان الحمل أكثر خطورة من فترات أخرى ، فإن Bloemenkamp غير متأكد. "للإجابة على هذا السؤال ، يجب ألا ننظر فقط إلى فرصة الإصابة بالمرض ، ولكن أيضًا إلى مسألة ما إذا كانت النساء الحوامل أقل عرضة للذهاب إلى مقدمي الرعاية الصحية إذا كانت هناك مشاكل. ليس لدينا حتى الآن أي نظرة ثاقبة في هذا."



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