Kavita Narang, M.D., a fellow in Maternal and Fetal Medicine at Mayo Clinic in Minnesota, reviews her article in the August 2020 issue of Mayo Clinic Proceedings. The article examines the potential effects of COVID-19 infection in pregnancy. Because of physiological, metabolic and vascular changes in both typical and high-risk pregnancies, pregnant patients may be at higher risk of SARS-CoV-2 infection. Furthermore, pregnancy may modify or exacerbate the clinical presentation of COVID-19. If infected, pregnant patients may also experience increased risk of other pregnancy complications, including preeclampsia and preterm birth.
Mm hmm. Mm Physiologic metabolic and vascular changes that occur to a normal and high risk pregnancies may affect the risk of SARS cov two infection and modify or exacerbate the clinical presentation of Covid 19 in pregnant patients based on data from prior repent and makes pregnant women may be at risk for worse outcomes. Worldwide population based studies have identified age and co morbid conditions as predictors of poor outcomes. However, data on pregnant patients are currently still limited. I'm Kavita and Iron, a second year fellow in the division of maternal and fetal medicine at Mayo Clinic. We recently published our paper titled SARS Cov two Infection and Covid 19 in Pregnancy, which will be published in the August 2020 issue of Mayo Clinic proceedings. And we will be focusing on a multidisciplinary review on the mechanistic pathway and management of Covid 19. In pregnancy, Sars-cov-2 enters the cell by the angiotensin converting enzyme two receptor, also known as the East two receptor, which is up regulated in normal pregnancies. Regulation of Ace two mediates the conversion of angiotensin two, which is a visa constrictor to angiotensin 1 to 7, which is a visa dilator, resulting in overall decreased blood pressure in pregnancy as a result of up regulation of ACE two receptors in pregnancy. Pregnant women may be at an elevated risk of complication from SARS. Cov two. Upon pointing to a stew, Sars-cov-2 results in its down regulation and therefore lower levels of angiotensin 1 to 7, which can make vessel constriction, inflammation and Proco aglow path e as seen in pre eclampsia, a condition of high blood pressure in pregnancy. Due to these overlapping mechanical pathway and clinical features and lab abnormalities, including Trump's Agrippina and Liver function arrangements that can be seen in both pre eclampsia and covid 19, they may make it a little bit more challenging to make the distinction between these two conditions. Pharmacologic therapy in pregnancy is limited to those with proven clinical safety, which is often unavailable for medications early in the clinical trials. Larger multi center studies are going to be a critical part in helping us to understand the path of physiology and clinical features of covid 19 in pregnancy and therefore optimizing our preventive and treatment strategies for covid in normal and high risk pregnancies. We hope you found this presentation from the content of our website valuable. Our journal's mission is to promote the best interests of patients by advancing the knowledge and professionalism of the physician community. If you are interested in more information about us, our homepage is www dot mayo clinic proceedings dot org. There you'll find access to information for our social media content, such as additional videos on our YouTube channel or general updates on Facebook. You can also follow us on Twitter. More information about health care. Mayo Clinic is available at www dot mayoclinic dot org. This video content is copyrighted by Mail Foundation for medical education and research.