DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20205244

Evaluation of maternal and fetal outcome in corona positive pregnant women

Bharti Maheshwari, Preeti Sharma, Kamini Panwar, Kirti Giri Goswami

Abstract


Background: COVID-19 has spread globally at an accelerated rate with rapid increases in cases and mortality. Viral pneumonia is one of the leading causes of pregnancy deaths worldwide. Physiological changes during pregnancy, such as reduced functional residual volumes, diaphragm elevation, and oedema of respiratory tract mucosa, as well as changes in cell immunity can lead to increased susceptibility to viral infections and can have worsened outcomes.

Methods: The study was conducted after clearance from Board of Studies and Ethical committee in the Department of obstetrics and gynaecology, Muzaffarnagar medical college, Muzaffarnagar. It was a retrospective study. Out of total 1500 covid positive patients admitted in 3 months, 33 pregnant women were included which were covid positive.

Results: The study population consisted of 16 (48.5%) women from 20-25 years, 12 (36.4%) women from 26-30 years and 5 (15.2%) women from above 30 years. There was history of exposure among all (100.0%) pregnant women with only 2 (6.1%) having symptoms of COVID-19.Out of 33, 8 patients were severelyanemic, 4 had preeclampsia, 2 cases had previous 2 LSCS, 5 previous 1 LSCS, 1 leaking pervaginum, 3 cases had fetal distress at admission. As per gestational age, 9 (27.3%) women had pre-term delivery, 21 (63.6%) had normal term delivery and 3 (9.1%) had post-term delivery. 13 women were primigravida and 20 were multigravida. The mode of delivery was LSCS among 24 (73%) and normal delivery among 1 (3.0%) women.

Conclusions: In our study, there were no maternal and fetal complications among pregnant women with COVID-19.


Keywords


COVID-19, Infants, Perinatal transmission, Pregnant women

Full Text:

PDF

References


Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497-506.

Abuelgasim E, Saw L, Shirke M, Zeinah M, Harky A. COVID-19: Unique public health issues facing Black, Asian and minority ethnic communities. Curr Prob Cardiol. 2020;45(8):100621.

Dashraath P, Jing Lin Jeslyn W, Mei Xian Karen L, Lim ML, Li S, Biswas A, et al. Coronavirus disease 2019 (COVID-19) pandemic and pregnancy. Am J Obstet Gynecol. 2020;222(6):521-31.

Liu W, Wang Q, Zhang Q, Chen L, Chen J, Zhang B, et al. Coronavirus disease 2019 (COVID-19) during pregnancy: a case series. Preprints. 2020; 2020020373.

Chen L, Li Q, Zheng D, Jiang H, Wei Y, Zou L, et al. Clinical characteristics of pregnant women with Covid-19 in Wuhan, China. N Engl J Med. 2020;382:e100.

Della Gatta AN, Rizzo R, Pilu G, Simonazzi G. Coronavirus disease 2019 during pregnancy: a systematic review of reported cases. Am J Obstet Gynecol. 2020;223(1):36-41

Kimberlin DW, Stagno S. Can SARS-CoV-2 infection be acquired in utero? more definitive evidence is needed. JAMA. 2020;323(18):1788-9.

Schwartz DA, Graham AL. Potential maternal and infant outcomes from (Wuhan) coronavirus 2019-nCoV infecting pregnant women: lessons from SARS, MERS, and other human coronavirus infections. Viruses 2020;12:1-16.

Khan S, Siddique R, Ali A, Xue M, Nabi G. Novel coronavirus, poor quarantine, and the risk of pandemic. J Hosp Infect. 2020;104(4):449-50.

Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet. 2020;6736:1-7.

Fan C, Lei D, Fang C, Li C, Wang M, Liu Y, et al. Perinatal transmission of COVID-19 associated SARS-CoV-2: should we worry? Clin Infect Dis. 2020.

Rasmussen SA, Jamieson DJ, Uyeki TM. Effects of influenza on pregnant women and infants. American J Obstet Gynecol. 2012;207(3):S3-8.

Zhu H, Wang L, Fang C, Peng S, Zhang L, Chang G, et al. Clinical analysis of 10 neonates born to mothers with 2019-nCov pneumonia. Transl Pediatr. 2020;9:51-60.

Liu Y, Chen H, Tang K, Guo Y. Clinical manifestations and outcome of SARS-CoV-2 infection during pregnancy. J Infect. 2020.

Zhang L, Jiang Y, Wei M, Chen BH, Zhou XC, Li J, et al. Analysis of the pregnancy outcomes in pregnant women with COVID-19 in Hubei Province. Zhonghua Fu Chan Ke Za Zhi. 2020;55:166.

Lei D, Wang C, Li C, Fang C, Yang W, Chang B, et al. Clinical characteristics of COVID-19 in pregnancy: analysis of nine cases. Chin J Perinat Med. 2020;23(03):159-65.

Yan J, Guo J, Fan C, Juan J, Yu X, Li J, et al. Coronavirus disease 2019 (COVID-19) in pregnant women: a report based on 116 cases. Am J Obstet Gynecol. 2020;223(1):111.e1-14.

Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. China Medical Treatment Expert Group for Covid-19. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-20.

Zaigham M, Andersson O. Maternal and perinatal outcomes with COVID-19: A systematic review of 108 pregnancies. Acta Obstet Gynecol Scand. 2020;99(7):823-9.

Aylward B, Liang W, Dong X, Eckmanns T, Fisher D, Ihekweazu C. Report of the WHO China joint mission on coronavirus disease 2019 (COVID-19). Beijing: World Health Organisation; 2020.

Liu H, Liu F, Li J, Zhang T, Wang D, Lan W. Clinical and CT imaging features of the COVID-19 pneumonia: focus on pregnant women and children. J Infect. 2020;80(5):e7-13.

Coronavirus (COVID-19) Coronavirus infection in pregnancy. Royal College of Obstetrician and Gynaecologist. 2020. Available from: https://www.rcog.org.uk/globalassets/documents/guidelines/2020-10-14-coronavirus-covid-19-infection-in-pregnancy-v12.pdf. Accessed on 29 April 2020.

Khan S, Jun L, Nawsherwan, Siddique R, Li Y, Han G, et al. Association of COVID-19 with pregnancy outcomes in health-care workers and general women. Clin Microbiol Infect. 2020;(26):788-90.

Wong SF, Chow KM, Leung TN, Ng WF, Ng TK, Shek CC, et al. Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome. Am J Obstet Gynecol. 2004;191:292-7.

Shanes ED, Mithal LB, Otero S, Azad HA, Miller ES, Goldstein JA. Placental pathology in COVID-19. Am J Clin Pathol. 2020;154(1):23-32.

Di Mascio D, Khalil A, Saccone G, Rizzo G, Buca D, Liberati M, et al. Outcome of Coronavirus spectrum infections (SARS, MERS, COVID 1-19) during pregnancy: a systematic review and meta-analysis. Am J Obstet Gynecol MFM. 2020:100107.

Elshafeey F, Magdi R, Hindi N, Elshebiny M, Farrag N, Mahdy S, et al. A systematic scoping review of COVID‐19 during pregnancy and childbirth. Int J Gynecol Obstet. 2020;150(1):47-52.

Muhidin S, BehboodiMoghadam Z, Vizheh M. Analysis of maternal coronavirus infections and neonates born to mothers with 2019-nCoV: a systematic review. Arch Acad Emerg Med. 2020;8(1):e49.

Liang H, Acharya G. Novel corona virus disease (COVID‐19) in pregnancy: What clinical recommendations to follow? Acta Obstet Gynecol Scand. 2020 Apr;99(4):439-42.

Favre G, Pomar L, Qi X, Nielsen-Saines K, Musso D, Baud D. Guidelines for pregnant women with suspected SARSCoV-2 infection. Lancet Infect Dis. 2020;S1473-3099(20)30157-2.

Li Y, Zhao R, Zheng S, Chen X, Wang J, Sheng X, et al. Lack of vertical transmission of severe acute respiratory syndrome coronavirus 2, China. Emerg Infect Dis. 2020;26(6).

Shaoshuai W, Lili G, Ling C, Weiyong L, Yong C, Jingyi Z, et al. A case report of neonatal COVID 19 infection in China. Clin Infect Dis. 2020.

Zambrano LI, Fuentes-Barahona IC, Bejarano-Torres DA, Bustillo C, Gonzales G, Vallecillo-Chinchilla G, et al. A pregnant woman with COVID-19 in Central America. Travel Med Infect Dis. 2020;101639.

Gidlöf S, Savchenko J, Brune T, Josefsson H. COVID-19 in pregnancy with comorbidities: more liberal testing strategy is needed. Acta Obstet Gynecol Scand. 2020.

Breslin N, Baptiste C, Miller R, Fuchs K, Goffman D, Gyamfi-Bannerman C, et al. COVID-19 in pregnancy: early lessons. Am J Obstet Gynecol MFM. 2020; 100111.

Iqbal SN, Overcash R, Mokhtari N, Saeed H, Gold S, Auguste T, et al. An uncomplicated delivery in a patient with COVID-19 in the United States. N Engl J Med. 2020;382(16):e34.

CDC. Considerations for Inpatient Obstetric Healthcare Settings. Available at: www.cdc.gov/coronavirus/2019-ncov/hcp/inpatient-obstetric-healthcare-guidance.html.

WHO. Clinical management of severe acute respiratory infection when COVID-19 is suspected. Available at: www.who.int/publications-detail/clinical-management-of-severe-acute-respiratory-infection-when-novel-coronavirus-(ncov)-infection-is-suspected.