{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T15:43:11Z","timestamp":1767973391471,"version":"3.49.0"},"reference-count":28,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T00:00:00Z","timestamp":1635724800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: The multiple pregnancies associated with COVID-19 is a new and difficult condition to manage. The prognosis for rapid deterioration after the cesarean delivery is difficult to assess and needs close interdisciplinary follow-up due to pregnancy and postpartum-related changes. Materials and Methods: We report the case of a 37-year-old primigesta primipara patient who was admitted to \u201cElena Doamna\u201d Clinical Hospital of Obstetrics and Gynecology at 33 weeks and 3 days of gestation with high-grade multiple pregnancies (triplets) for threatened premature birth associated with COVID-19. The patient had a history of surgically corrected atrial septal defect during childhood and currently is known to have paroxysmal supraventricular tachycardia. Tocolysis was ineffective and the decision to perform a cesarean operation was made. The diagnosis was established: primigesta, primipara, at 34 weeks of gestation, high-grade multiple pregnancy with triplets, intact membranes, threatened premature birth, surgically corrected atrial septal defect, paroxysmal supraventricular tachycardia, infection with COVID-19. The patient underwent a cesarean intervention and treatment for COVID-19 pneumonia. The intervention took place at 33 weeks and 4 days of gestation resulting in four newborns with weights between 1400 g and 1820 g and Apgar scores between 6\u20138. All newborns were transferred to a third-degree Neonatology ICU service due to their prematurity. The fourth newborn was not identified in any of the ultrasounds performed during pregnancy. During the postpartum period, the patient had a fulminant evolution of COVID-19 pneumonia, with rapid deterioration, needing respiratory support and antiviral treatment. Discussions: Managing high-risk obstetrical pregnancies associated with COVID-19 requires a multidisciplinary team consisting of obstetricians, anesthesiologists, neonatologists, and infectious disease doctors. Conclusion: Our case is the first to our knowledge in Romania to present an association of high-grade multiple pregancy with COVID19 moderate form, rapidly evolving postpartum, needing rapid intensive care admission, and specific treatment with Remdesivir, with good post-treatment evolution.<\/jats:p>","DOI":"10.3390\/medicina57111186","type":"journal-article","created":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T22:22:24Z","timestamp":1635805344000},"page":"1186","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The Rare Case of a COVID-19 Pregnant Patient with Quadruplets and Postpartum Severe Pneumonia. Case Report and Review of the Literature"],"prefix":"10.3390","volume":"57","author":[{"given":"R\u0103zvan","family":"Socolov","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Elena Doamna Obstetrics and Gynecology University Hospital, 700398 Iasi, Romania"},{"name":"Department of Obstetrics and Gynecology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mona","family":"Akad","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Elena Doamna Obstetrics and Gynecology University Hospital, 700398 Iasi, Romania"},{"name":"Department of Obstetrics and Gynecology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maricica","family":"P\u0103v\u0103leanu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Elena Doamna Obstetrics and Gynecology University Hospital, 700398 Iasi, Romania"},{"name":"Department of Obstetrics and Gynecology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana","family":"Popovici","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Elena Doamna Obstetrics and Gynecology University Hospital, 700398 Iasi, Romania"},{"name":"Department of Obstetrics and Gynecology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M\u0103d\u0103lina","family":"Ciuhodaru","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Elena Doamna Obstetrics and Gynecology University Hospital, 700398 Iasi, Romania"},{"name":"Department of Obstetrics and Gynecology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7386-0859","authenticated-orcid":false,"given":"Roxana","family":"Covali","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Elena Doamna Obstetrics and Gynecology University Hospital, 700398 Iasi, Romania"},{"name":"Department of Obstetrics and Gynecology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fawzy","family":"Akad","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioana","family":"P\u0103v\u0103leanu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Elena Doamna Obstetrics and Gynecology University Hospital, 700398 Iasi, Romania"},{"name":"Department of Obstetrics and Gynecology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2598","DOI":"10.1093\/humrep\/16.12.2598","article-title":"Trends in the incidence of births and multiple births and the factors that determine the probability of multiple birth after IVF treatment","volume":"16","author":"Engmann","year":"2001","journal-title":"Hum. Reprod."},{"key":"ref_2","unstructured":"Centers for Disease Control and Prevention (2000). Contribution of assisted reproductive technology and ovulation-inducing drugs to triplet and higher-order multiple births-United States, 1980\u20131997. Morb. Mortal. Wkly. 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