A pregnant woman with COVID-19 gives birth to premature triplets: A case report and literature review

To the best of our knowledge, no case report has been published to date concerning the novel coronavirus disease 2019 (COVID-19) treatment plan for pregnant women with triplets, as well as on the possibility of a vertical transmission to triplets delivered prematurely by a pregnant woman with COVID-19. The present study thus describes such as case. A 29-year-old local resident, a woman with COVID-19, who was pregnant with triplets, had not moved from her residence for the past 6 months. The main symptoms mentioned by the patient on the day of admission were the following: The patient was in the 28th week of pregnancy, 2019 novel coronavirus (2019-nCoV) nucleic acid positive test 13 h prior to admission. Additionally, the patient had a high fever and dyspnea after admission. The patient was treated with convalescent plasma from patients with COVID-19 and methylprednisolone, at the same time her anemia, anxiety and insomnia were treated. Subsequently, the patient's condition improved, and normal body temperature was restored. Cesarean section was performed due to severe intrahepatic cholestasis of pregnancy (ICP), and due to the fetuses being located in three chorionic and amniotic cavities, and due to the fact that each of the three infants was in a different position (cephalic, breech and transverse position). Following delivery, total bile acid values and liver function improved gradually, and the 2019-nCoV nucleic acid test was negative consecutively for two tests, and the woman was then discharged from the hospital. Each premature infant born by caesarean section was individually transported to a neonatal intensive care unit for isolation treatment, with the neonatal escorts and transport teams wearing secondary protective clothing. All three premature infants were transitioned gradually from parenteral intravenous nutrition to full oral feeding. 2019-nCoV nucleic acid test results were negative for all infants. 2019-nCoV IgM test results were negative and IgG were positive for all infants. The pregnant woman and the three premature infants were successfully treated and discharged after they felt no discomfort and were negative consecutively for two 2019-nCoV nucleic acid tests. The three premature infants were monitored for growth and development until December, 2021, and eye, lung, heart, brain, liver, kidney, intestine and other organ functions were normal. The present study reports on the treatment and delivery outcomes of a woman with COVID-19, who was pregnant with triplets. The present case report demonstrated that although the pregnant woman with triplets was suffering from COVID-19, all three premature infants delivered by cesarean section did not present with intrauterine vertical infection, and abnormal growth and development were not observed. The convalescent plasma of patients with COVID-19 and methylprednisolone were effective for the treatment of a continuously high fever, and the timely treatment of complications is helpful for the treatment of patients with COVID-19.