Feto-maternal outcome in COVID-19 positive patients with hypertensive disorders in pregnancy

Niranjan N. Chavan, Hera S. Mirza, Priyanka Sonawane, Umme Ammara Iqbal


Background: Since the first confirmed case in December 2019, the data pertaining to the COVID-19 pandemic has been rapidly evolving. In current study, the relation of COVID-19 and its effect on pregnant women with hypertensive disorders in pregnancy, including symptoms and foetomaternal outcome were studied.

Methods: Women with hypertensive disorders in pregnancy consecutively admitted for delivery and tested via nasopharyngeal swab for SARS-CoV-2 using reverse transcriptase polymerase chain reaction (RT-PCR) from 1 April 2020 to 30 September 2020 were included in the study.

Results: In our study, 56 women having hypertensive disorders in pregnancy with COVID-19 infections delivering 60 babies (4 twins), 46.43% were in the age group of <25 years, 51.78 % were <37 weeks gestation. Delivery was by caesarean section in 76.78%. Out of these, 33.92% patients required ICU admission. 40% babies delivered had birth weight of <2.5 kg out of which 13.33% had IUGR and 26.66% were preterm. There was 13.33% stillbirth and 6.66% neonatal deaths. 4 maternal death has been reported.

Conclusions: With the current data available it does not appear that pregnant women are at increased risk of severe infection than the general population, but clinicians should be aware of high-risk groups. Women will need to be monitored in their booking maternity units and should be transferred to centres with appropriate neonatal intensive care facilities for delivery. In pregnant women with COVID-19 infection, if maternal illness is not severe, the considerations should be based more on obstetric indications for delivery.


Coronavirus, Pre-eclampsia, COVID-19, Hypertensive disorders in pregnancy

Full Text:



Cui J, Li F, Shi Z. Origin and evolution of pathogenic coronaviruses. Nat Rev Microbiol. 2019;17:181-92.

Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;6736(20):30211-7.

Mackenzie JS, Smith DW. COVID-19: a novel zoonotic disease caused by a coronavirus from China: what we know and what we don’t. Microbiol Aust. 2020.

Kerala Defeats Coronavirus; India’s Three COVID-19 Patients Successfully Recover. The Weather Channel. Archived from the original on 18 February 2020. Available at:

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(2):194.

Uludag SZ, Karasu AFG, Kutuk MS, Takmaz T. Incidence and outcomes of eclampsia: a single-center 30-year study. Hypertens Pregnancy. 2019;38(2):119-23.

Kwon J, Romero R, Mor G. New insights into the relationship between viral infection and pregnancy complications. Am J Reprod Immunol. 2014;71(5):387-90.

Yan R, Zhang Y, Li Y, Xia L, Guo Y, Zhou Q. Structural basis for the recognition of SARS-CoV-2 by full-length human ACE2. Science. 2020;367(6485):1444-8.

Yan J, Li RQ, Wang HR, Chen HR, Liu YB, Gao Y, et al. Potential influences of COVID19/ACE2 on female reproductive system. 2020;26(6):367-73.

Khan MM, Khan MN, Mustagir MG, Rana J, Haque MR, Rahman MM. COVID-19 infection during pregnancy: a systematic review to summarize possible symptoms, treatments, and pregnancy outcomes. Medrxiv. 2020.

Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 2020;395(10229):1033-4.

Lau SY, Guild SJ, Barrett CJ, Chen Q, McCowan L, Jordan V, et al. Tumor necrosis factor-alpha, interleukin-6, and interleukin-10 levels are altered in pre-eclampsia: a systematic review and meta-analysis. Am J Reprod Immunol. 2013;70(5):412-27.