Comparative Study of Maternal Mortality in SARS-CoV-2 Infected Pregnant Women in the First and Second Waves of COVID-19 Pandemic in Tertiary Care at Madhya Pradesh, India (original) (raw)
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Annals of the National Academy of Medical Sciences (India)
Objectives The aim of this study was to evaluate the clinical presentation, course of disease, and management of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in pregnant women. We also aimed to evaluate the fetomaternal outcomes in these women. Material and Methodology This was a single-center, retrospective study performed in a tertiary care hospital for pregnant women with coronavirus disease 2019 (COVID-19) in India. The medical records of all antenatal or postnatal women who were admitted to COVID-19 facility from April 1 to June 30, 2021, were reviewed. The demographic characteristics, obstetric parameters, presence of comorbidities, disease severity, investigations, management, and fetal outcome were recorded. Statistical Analysis The data were entered in MS Excel spreadsheet and analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0. Result A total of 94 women were admitted to the COVID-19 facility; 54 (57.45%) were antenatal and 4...
Cureus, 2022
Background The ongoing coronavirus 2019 (COVID-19) pandemic is the most devastating health care crisis of our times. Pregnant women with COVID-19 infection belong to a vulnerable group with concerns about the effect of the disease on maternal and neonatal health. As we are dealing with a new disease, we must study the changing trend of disease presentation, diagnosis, and treatment to successfully manage such pregnancies. Objective The purpose of the present study was to evaluate the differences in presenting features, comorbidities, the fetal and maternal outcomes in COVID-19 positive pregnant women in the first and second wave of the pandemic in a tertiary care institute in eastern India. Methodology This study was a retrospective observational cohort study conducted at Tata Main Hospital, Jamshedpur, a tertiary care hospital in eastern India. All COVID-19 positive by reverse transcription-polymerase chain reaction or rapid antigen (RTPCR) test pregnant women (249 women) admitted ...
2022
Importance: Following the outbreak of SARS-CoV-2 infection, it is unclear whether there is any difference in clinical presentation, disease severity, pregnancy complications, and maternal outcomes in pregnant and postpartum women during the third wave of COVID-19 as compared to the earlier two waves of COVID-19. Objective: To assess the clinical presentation, disease severity, pregnancy complications, and maternal outcomes in women affected with COVID-19 during the third wave in India and compare these parameters with the first wave and second wave of COVID-19.Design: Retrospective observational cohort study Setting: Tertiary care, dedicated COVID-19 hospital catering to Mumbai Metropolitan Region, India Participants: A total of 2,028 pregnant and postpartum women were admitted during three-wave periods: first wave - 1st April 2020 to 31st January 2021, second wave - 1st February 2021 to 10th December 2021; and third wave - 18th December 2021 to 19th January 2022. Exposures: SARS-Co...
Journal of South Asian Federation of Obstetrics and Gynaecology, 2021
Aim and background: Coronavirus disease-2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), how it affects pregnancy very little is known. To identify maternal and neonatal risks associated with COVID-19 in pregnancy and to describe outcome a matched case-control study was done. Materials and methods: In this study, COVID-19 reverse transcription polymerase chain reaction (RT-PCR) positive women who delivered from May 1, 2020, to August 31, 2020, were included. Cases were classified according to their severity and investigations. Controls were selected from COVID-19 negative women in a 1:1 ratio who delivered in the study period. Data were collected, analyzed in terms of maternal and neonatal outcomes. Results: Of the total 181 COVID-19 cases delivered during the study period, there were 97.23% mild, 2.76% moderate, and 0.55% severe cases. A total of 178 (98.34%) were diagnosed in the third trimester. More COVID-19 cases were from urban areas. Mean gestational age in the mild category was 38.1 weeks and the moderate/severe category was 37.5 weeks. Around 154 (85.08%) were asymptomatic. Cases had more medical and pregnancy morbidity than controls, which was statistically significant. About 52.49% of cases and 33% of controls had cesarean. Length of hospital stay was more in cases. Mean birth weight was 2.7 ± 0.59 kg in cases and 2.5 ± 0.56 kg in control. There were 7 stillbirths in each group. A total of 14 in cases and 16 in controls were transferred to the newborn intensive care unit (NICU). Conclusion: The majority of COVID-19 infected women who are asymptomatic are in the mild category and there are no adverse maternal and neonatal outcomes due to the disease. The adversity of maternal and neonatal outcomes depends on the severity and severity of the disease is dependent on advanced maternal age and presence of comorbidities.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: By the end of 2019, WHO had identified COVID-19 disease as a public health emergency. Research has focused on the impact of SARS-CoV-2 infection during pregnancy, including symptoms, disease severity, risk of vertical transmission, and perinatal and neonatal prognosis. Methods: This was a cross sectional prospective observational study, conducted at Gynae and Obstetric Department, in Bangabandhu Sheikh Mujib Medical University, between July 2020 to August 2021. 75 pregnant women who tested positive for COVID-19 were included in this study. Results: Most of the patients 29(38.7%) were aged 25-29 years. Majority 96% (72) of the cases were asymptomatic, symptomatic cases with cough were 4% (3). On the basis of our data, 94.7% (71) of the cases were Antenatal, while Postnatal and Abortion were 4% (3) and 1.3% (1) respectively. Complications such as fetal distress 25.3% (19), scar tenderness 17.3% (13), pre-eclampsia 12% (9), post-dated pregnancy 9.3% (7), previous 2LSCS with...
Maternal Mortality and COVID-19 Pandemic: Looking Beyond SARS CoV-2 Infection
The Journal of Obstetrics and Gynecology of India (January–February 2024) 74(1):45–52 2024
Objective To study the impact of COVID-19 pandemic on maternal mortality ratio, aetiological and modifiable factors for maternal mortality and key interventions performed. Method Retrospective exploratory study evaluating maternal mortality between April to November 2020 (study group) and 2019 (control group). Results Demographic variations existed in the two groups. Increased maternal age and illiteracy were significantly more in the study group. Maternal mortality ratio (MMR) was significantly high in the study group (792 vs. 296 p value = 0.0). Hemorrhage accounted for 20% and COVID-19-related maternal deaths accounted for 15% deaths in the study group. Level 3 delay (delay in receiving care/inadequate care) was observed in 35% in the study group and 28% in control group (p value = 0.349). 17.5% of mothers in the study group as compared to 8% of control group were dead on arrival to hospital though not statistically significant (p value = 0.28). Significantly more women in study group died within 24 h of admission (45% vs. 20%, p value 0.04). Among the key interventions, the use of supplemental oxygen was significantly high in study group (p value = 0.02). Conclusion Maternal mortality ratio was high in the pandemic year because of a significant decline in hospital delivery rate. The lesson learnt from this pandemic needs to be documented to guide better planning in the future to face similar situations.
COVID-19 and pregnancy- review of cases from a tertiary public hospital in Mumbai
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2021
Background: In December 2019 a novel strain of coronavirus, was first isolated by the Chinese Center for Disease Control and Prevention. This strain connected to the cluster of acute respiratory illness cases from Wuhan, China was later officially named as severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2). On 30th January 2020, WHO declared the outbreak of SARS-Cov-2 a public health emergency of international concern, and on 11th March 2020 declared it to be a pandemic. Pregnant women are known to be at higher risk of severe morbidity and mortality from respiratory infections such as influenza and SARS, making a strong case for pregnant women to be considered an at-risk population for COVID-19. This study aimed to assess the clinical picture, obstetric outcome and neonatal outcome in COVID positive pregnant cases.Methods: We did a retrospective observational cohort study in the department of Obstetrics and Gynecology at a tertiary teaching hospital in Mumbai.Results: In t...
Indian Journal of Biochemistry & Biophysics, 2020
SARS-CoV-2 infection in pregnancy and its adverse outcome on the mother as well on the fetus is emerging as an important concern, but knowledge about the prognosis is limited In our prospective observational study total of 56 pregnant women admitted in the isolation ward of our institution were included All women were presented with common symptoms like fever, tiredness, headache, sore throat, and cough Three women diagnosed SARS-CoV-2/COVID-19 positive by Reverse Transcription Polymerase Chain Reaction (RTPCR) examination of the nasopharyngeal swab All three neonates were tested negative for SARS-CoV-2 infection The three mothers also recovered with routine care and returned home after 7 days with advice for a safe home for further 7 days SARS-CoV-2 infection in pregnancy mostly appears inthe later part of pregnancy and management is almost like the general population There is no increased risk of severe disease during pregnancy Neonates are mostly protected from disease transmissi...