DOI: https://dx.doi.org/10.18203/2320-1770.ijrcog20215078
Published: 2021-12-28

Study of maternal deaths with COVID-19 infection in a tertiary care centre

Niranjan Chavan, Shikhanshi ., Deepali Kapote, Prasad Deshmukh, Ashwini Sakhalkar

Abstract


Background: COVID-19 has been a major speed braker not only for world economy and development but also for health sector. The susceptible population including elderly, co-morbid adults and pregnant females were likewise affected in both major COVID-19 waves in India. Association between COVID-19 cases and pregnancy has been studied throughout the world.COVID-19 is associated with substantial risk of morbidity and mortality in postpartum patients and their infants world-wide, compared with their not-infected pregnant counter-parts, especially if these individuals were symptomatic or have comorbidities.

Methods: This single-centre prospective observational study, included all consecutive maternal mortalities with COVID-19 infection admitted to Lokmanya Tilak municipal medical college and general hospital (Mumbai, India), a tertiary referral hospital, from 1 April 2020, to June 2021.In this study, a total of 390 patients were included who were found COVID-19 positive during the study period and 17 patients who died during their admission in hospital. The relation of risk factors and demographics were studied for all the patients.

Results: The COVID-19 related maternal mortality was more in women of age group 20-30 years (89%). Most women presented to our centre with complaints of fever, cough, cold or breathlessness (55.5%). Patients who succumbed to COVID-19 were mostly primiparous patients (52.9%) and died within 5 days of delivery (46%). 64% of patients died following 5 days of diagnosis of COVID-19.The co-morbidity present in most patients with COVID-19 associated maternal mortality was pre-eclampsia (31.5%). Most patients were referred with only 17% patients registered at our centre and the type of delay involved in management was mostly Type 1 and 2 (82.2%)

Conclusions: Multi-centre retrospective analysis with larger population size is required in order for this to be statistically significant.


Keywords


COVID-19, Maternal mortality, Pandemic, ARDS, Fever, Virus, Corona

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References


Villar J, Ariff S, Gunier R, Thiruvengadam R, Rauch S, Kholin A. et al. Maternal and Neonatal Morbidity and Mortality Among Pregnant Women With and Without COVID-19 Infection. JAMA. 2021;45:52-9.

La Verde M, Riemma G, Torella M, Cianci S, Savoia F, Licciardi F, Scida S, Morlando M, Colacurci N, De Franciscis P. Maternal death related to COVID-19: A systematic review and meta-analysis focused on maternal co-morbidities and clinical characteristics. Int J Gynaecol Obstet. 2021;154(2): 212-9.

Chavan N, Mahapatra S, Venkateswaran S, Ponkshe,J, Nayak A. Impact of COVID-19 infection on maternal near miss cases in tertiary care centre. Int J Reprod Contracept Obstet Gynecol. 2021;10(7):2671.

The WHO near-miss approach, 2011. Available at: https://www.who.int/reproductivehealth/topics/maternal_perinatal/nmconcept/en/. Accessed on 1 June 2020.

Mor G, Cardenas I. The immune system in pregnancy: a unique complexity. Am J Reprod Immunol. 2010;63(6):425-33.

Knight M, Bunch K, Vousden N, Morris E, Simpson N, Gale C, et al. Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK: national population based cohort study. BMJ. 2020;369:2107.

Martins FPR, Santos VS, Santos HP. To breastfeed or not to breastfeed? Lack of evidence on the presence of SARS-CoV-2 in breastmilk of pregnant women with COVID-19. Rev Panam Salud. 2020; 44:59.

Chavan N, Mirza A, Sonawane P, Iqbal U. Feto-maternal outcome in COVID-19 positive patients with hypertensive disorders in pregnancy. Int J Gynaecol Obstet. 2021;45:451-9.