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Severe Acute Respiratory Syndrome (SARS) in Pregnancy: a Case Report

Posted on: Tuesday, 8 February 2005, 03:00 CST

Objective: To describe a clinical case of severe acute respiratory syndrome (SARS) in pregnancy.

Study design: This is a case study of one patient, who was a 33- year-old G^sub 1^ P^sub 0^ with a previously uncomplicated pregnancy. At 30 weeks' gestation she had direct contact with a family member who was subsequently diagnosed with probable SARS according to the World Health Organization case definition. While on home quarantine the subject of our study developed a fever of 38.0, and was therefore admitted to hospital and isolated in a negative pressure room. She started therapy with azithromycin and cefuroxime but no antiviral medication.

Results: An initial chest radiograph demonstrated unilateral airspace disease. While in hospital, the subject experienced daily elevations in temperature and developed a dry cough, but with no shortness of breath. On the 11th day in hospital her chest radiograph demonstrated bilateral lung involvement, and she began intravenous steroid therapy. Over the next 48 h her temperature became normal, and she remained afebrile thereafter. Daily non- stress tests were performed and were always within normal limits. Ultrasound revealed a normally grown fetus with normal anatomy. There was increased amniotic fluid volume but no evidence of fetal hydrops or placentomegaly. Following discontinuation of steroids and antibiotics, the woman remained in hospital with no fever or respiratory symptoms for 48 h, and was then discharged home. Cultures and serology for respiratory pathogens are negative to date. Her total time in hospital was 21 days, and she was at 34 weeks' gestation at discharge. The woman is currently still pregnant, and details regarding the remainder of pregnancy, labor and delivery, and postpartum and neonatal courses, will be provided at the annual scientific meeting.

Conclusion: Severe acute respiratory syndrome (SARS) is a new entity which is highly contagious and has an estimated 4% mortality rate. There is preliminary evidence that it may be associated with worse outcome when it occurs in pregnancy. It is still not known whether there are any long-term effects on fetuses when women are infected during pregnancy. In this case the patient responded well to antibiotics and steroids, without the use of antiviral medications.

M.H. Yudin1, D. Steele1, P. Kopplin2, M. Sgro3 and K. Gough2

Departments of 1 Obstetrics and Gynecology, 2 Internal Medicine and 3 Pediatrics, University of Toronto, St. Michael's Hospital, Toronto, Canada

Copyright CRC Press Sep-Dec 2004

Source: Infectious Diseases in Obstetrics and Gynecology

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