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

Authors

  • Niranjan Chavan Department of Obstetrics and Gynaecology, LTMMC, Sion, Mumbai, Maharashtra, India
  • Shikhanshi . Department of Obstetrics and Gynaecology, LTMMC, Sion, Mumbai, Maharashtra, India
  • Deepali Kapote Department of Obstetrics and Gynaecology, LTMMC, Sion, Mumbai, Maharashtra, India
  • Prasad Deshmukh Department of Obstetrics and Gynaecology, LTMMC, Sion, Mumbai, Maharashtra, India
  • Ashwini Sakhalkar Department of Obstetrics and Gynaecology, LTMMC, Sion, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20215078

Keywords:

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

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.

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.

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Published

2021-12-28

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Section

Original Research Articles