Fetomaternal Outcome in Covid 19 Positive Pregnancies-A Prospective Study (original) (raw)
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Observational study of fetomaternal outcome in pregnancy with COVID-19 infection
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2022
Background: According to World Health Organization (WHO) COVID-19 is declared as an infection of international health emergency on 11 March 2020. It is not clear whether clinical characteristics of pregnant women with COVID-19 infection differ from those of non-pregnant women and whether it aggravates its symptoms.Methods: This is a prospective observational study of 75 cases based on compiled clinical data of pregnant women with COVID-19 infection admitted to Hi-Tech Medical College from June 2020 to July 2021. All laboratory confirmed positive cases were included.Results: The most common symptoms reported was fever (24%) followed by myalgia, cough and shortness of breath, while 60% patients were asymptomatic. there were total 57 deliveries, out of which 46 were live birth. The incidence of preterm birth was 26.3%. Maternal mortality was maximum between 25-34 weeks of GA. 96.9% of new-born were tested for SARS CoV-2 and only 10 were found to be positive (17.5%).Conclusions: At pres...
Taiwanese Journal of Obstetrics and Gynecology, 2021
Objective: To evaluate the clinical characteristics and outcomes of pregnant women with Covid-19. Materials and methods: This case series study was performed to investigate demographic, clinical and obstetric characteristics of 26 pregnant women with COVID-19 referring to a university hospital of Kashan during the epidemic of COVID-19 (March to May 2020). Results: The mean gestational age of the patients at admission and delivery was 31.8 ± 5.2 and 36.3 ± 3.4 weeks, respectively. The most common symptoms were fever (96.2%) followed by dyspnea and cough (30.8%). The findings of lung CT scan showed abnormalities confirming the pneumonia in 22 patients (84.6%). Cesarean section was performed in 69.2% of the mothers. The most common maternalefetal outcome was preterm delivery (38%). Two mothers were transferred to the ICU due to deterioration in clinical condition and they underwent mechanical ventilation without any maternal death. The most common neonatal outcomes were prematurity (38%) and low birth weight (34.6%). No cases of confirmed COVID-19 were observed in the neonates. Conclusion: Clinical manifestations and laboratory and radiographic findings in pregnant women with COVID-19 are similar to the general population. Common outcomes of pregnancy and delivery in mothers included increased rate of preterm delivery and cesarean section. The most prevalent neonatal outcomes included prematurity and LBW. Careful monitoring of pregnant women with COVID-19 is recommended.
COVID 19 IN PREGNANCY: CLINICAL MANIFESTATIONS, MAIN COMPLICATIONS AND OBSTETRIC OUTCOMES (Atena Editora), 2023
Introduction: Covid-19 is a disease that became popularly known in the year 2020, its etiological agent being Sars-Cov-2, a positive RNA virus from the coronavirus family, causing infections in the respiratory tract. Easy to spread, Covid soon spread around the world and, on March 11, 2020, the World Health Organization decreed the state of a pandemic. Clinical manifestations can range from asymptomatic to severe pneumonia, requiring admission to intensive care units and ventilatory support. Pregnancy is a condition that involves several physiological changes in the woman's body, requiring monitoring by health services for a good outcome for the maternal-fetal binomial. Pregnant women fall into the risk group for Covid-19 and require attention when infected by the Sars-Cov-2 virus. Objectives: Discuss the clinical manifestations, main complications and obstetric outcomes in pregnant women with Covid-19. Methods: The study consists of an integrative review of the existing literature through Google Scholar, Scielo and PubMed databases. Discussion: The main clinical manifestations observed in pregnant women infected with Sars-Cov-2 were fever and cough, and may also present dyspnea, diarrhea and anosmia in smaller proportions. With regard to obstetric complications, the ones that stood out the most were the PE LIKE syndrome, which simulates preeclampsia, the main gestational hypertensive disease, and the higher incidence of preterm births. The number of cesarean sections increased in pregnant women infected with the new coronavirus when compared to pregnancies without a diagnosis of Covid-19. Conclusion: The analyzed articles demonstrate that Covid-19 is related to the increase in the number of obstetric complications, mainly in the severe forms of the disease. Faced with this scenario, a rapid diagnosis is of paramount importance so that the demand for health services is encouraged and both the mother and the baby do not suffer any type of sequel.
Pregnancy with Covid-19 Infection and Fetomaternal Outcomes
2021
BACKGROUND: The emergence of the novel coronavirus infection (SARS CoV-2) across the world is one of the most significant public health threats in current times Due to the severity of this outbreak and the potential of international spread, the World Health Organization (WHO) declared it as pandemic in March 2020 Very less data is available over the impact of virus on pregnancy Our objective is to evaluate the clinical features, obstetrical complications and neonatal outcomes in a pregnancy with coronavirus infection METHODS: 125 laboratory confirmed SARS-CoV-2 pregnant women were studied Detailed clinical features, maternal complications, pregnancy and neonatal outcomes were analysed RESULTS: Out of 125 confirmed pregnant women, 57 patients delivered by caesarean section, 40 delivered vaginally while 28 patients were doing well with their ongoing pregnancy 88 patients were asymptomatic, 12 had fever, and 17 patients had cough and sore throat while 08 patients had mild diarrhoea and...
COVID-19 infection in pregnancy: a single center experience with 75 cases
Ginekologia Polska, 2021
Objectives: This study aimed to summarize the clinical features, maternal, fetal, and perinatal outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) proven infections of pregnancies. Material and methods: This retrospective single center study was conducted on 75 pregnant patients diagnosed of coronavirus disease 2019 (COVID-19). Demographic characteristics, clinical courses, laboratory and radiological findings, and maternal and perinatal outcomes were analyzed using medical records. Results: Of the 75 pregnant women infected with COVID-19, 49 had mild infections. The most common initial symptoms were myalgia (61.4%), cough (57.9%), headache (50.9%), and dyspnea (49.1%). More than half of the patients (57.3%) on admission were in their third trimester. Three patients had pre-existing chronic illnesses (hypothyroidism, asthma and rheumatoid arthritis) and three patients had gestational diabetes. There were two cases admitted to intensive care unit, one of whom was due to COVID-19 infection. No maternal mortality was recorded. The mode of delivery was a cesarean section in 20 cases among the 35 labors. Six gestations ended in a miscarriage and 11 women gave birth prematurely. One stillbirth occurred at the 38th week of gestation. Among 37 neonates, 14 necessitated 2 admission to neonatal intensive care unit. Neonatal mortality, congenital malformation, and mother to child transmission were not seen in the newborns. Conclusions: The results of our study suggest that the clinical course of COVID-19 infection in pregnant women was mostly asymptomatic/mild. There was also no evidence of vertical transmission of COVID-19 infection.
JAMA Pediatrics
IMPORTANCE Detailed information about the association of COVID-19 with outcomes in pregnant individuals compared with not-infected pregnant individuals is much needed. OBJECTIVE To evaluate the risks associated with COVID-19 in pregnancy on maternal and neonatal outcomes compared with not-infected, concomitant pregnant individuals. DESIGN, SETTING, AND PARTICIPANTS In this cohort study that took place from March to October 2020, involving 43 institutions in 18 countries, 2 unmatched, consecutive, not-infected women were concomitantly enrolled immediately after each infected woman was identified, at any stage of pregnancy or delivery, and at the same level of care to minimize bias. Women and neonates were followed up until hospital discharge. EXPOSURES COVID-19 in pregnancy determined by laboratory confirmation of COVID-19 and/or radiological pulmonary findings or 2 or more predefined COVID-19 symptoms. MAIN OUTCOMES AND MEASURES The primary outcome measures were indices of (maternal and severe neonatal/perinatal) morbidity and mortality; the individual components of these indices were secondary outcomes. Models for these outcomes were adjusted for country, month entering study, maternal age, and history of morbidity. RESULTS A total of 706 pregnant women with COVID-19 diagnosis and 1424 pregnant women without COVID-19 diagnosis were enrolled, all with broadly similar demographic characteristics (mean [SD] age, 30.2 [6.1] years). Overweight early in pregnancy occurred in 323 women (48.6%) with COVID-19 diagnosis and 554 women (40.2%) without. Women with COVID-19 diagnosis were at higher risk for preeclampsia/eclampsia (relative risk [RR], 1.76; 95% CI, 1.27-2.43), severe infections (RR, 3.38; 95% CI, 1.63-7.01), intensive care unit admission (RR, 5.04; 95% CI, 3.13-8.10), maternal mortality (RR, 22.3; 95% CI, 2.88-172), preterm birth (RR, 1.59; 95% CI, 1.30-1.94), medically indicated preterm birth (RR, 1.97; 95% CI, 1.56-2.51), severe neonatal morbidity index (RR, 2.66; 95% CI, 1.69-4.18), and severe perinatal morbidity and mortality index (RR, 2.14; 95% CI, 1.66-2.75). Fever and shortness of breath for any duration was associated with increased risk of severe maternal complications (RR, 2.56; 95% CI, 1.92-3.40) and neonatal complications (RR, 4.97; 95% CI, 2.11-11.69). Asymptomatic women with COVID-19 diagnosis remained at higher risk only for maternal morbidity (RR, 1.24; 95% CI, 1.00-1.54) and preeclampsia (RR, 1.63; 95% CI, 1.01-2.63). Among women who tested positive (98.1% by real-time polymerase chain reaction), 54 (13%) of their neonates tested positive. Cesarean delivery (RR, 2.15; 95% CI, 1.18-3.91) but not breastfeeding (RR, 1.10; 95% CI, 0.66-1.85) was associated with increased risk for neonatal test positivity. CONCLUSIONS AND RELEVANCE In this multinational cohort study, COVID-19 in pregnancy was associated with consistent and substantial increases in severe maternal morbidity and mortality and neonatal complications when pregnant women with and without COVID-19 diagnosis were compared. The findings should alert pregnant individuals and clinicians to implement strictly all the recommended COVID-19 preventive measures.
COVID-19 Infection in Pregnancy: A Descriptive Cross-sectional Study
Birat Journal of Health Sciences
Introduction: There is diverse evidence regarding the maternal and fetal effect of coronavirus disease 2019 (COVID-19) in pregnancy. Objectives: The objective of this study was to assess the effect of COVID-19 in mother and fetus during pregnancy. Methodology: A descriptive cross-sectional study was conducted during the second wave of COVID-19 in the Department of Obstetrics and Gynaecology at Birat Medical College Teaching Hospital from April 3 to July 3, 2021. All pregnant women admitted in the antenatal ward were sent real-time reverse transcription polymerase chain reaction (RT-PCR) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The patients with RT-PCR confirmed SARS-CoV-2 infection were enrolled in the study and followed up until discharged. Results: The COVID-19 positivity rate was 18.0%.The mean age was 24.38 years. Majority of the patients were asymptomatic (79.7%) Among symptomatic patients, 73.3% had fever and respiratory symptoms and 95.9% of...
Clinical course of novel COVID-19 infection in pregnant women
The Journal of Maternal-Fetal & Neonatal Medicine
Objectives: Evaluation of clinical course of COVID-19 during pregnancy and maternal and perinatal outcomes of this pregnancy. Methods: 66 women with polymerase chain reaction (PCR)confirmed SARS-CoV-2 and their 42 neonates were included in the prospective observational study. Demographic, epidemiological, clinical, laboratory and instrumental data of pregnancy, delivery, postpartum period, including pharmacotherapy and neonatal outcomes were analyzed. Results: 15 (22.7%) women were asymptomatic, 25 (38%) had mild disease, while moderate and severe forms were detected in 20 (30.2%) and 6 (9.1%) cases, respectively. Additional oxygenation was required in 6 (9%) cases: 4 (6%) received CPAP therapy and 2 (3%)mechanical ventilation. Main clinical symptoms were cough (51.5%), anosmia (34.9%), and hyperthermia (33.3%). Laboratory changes included increased levels of lactate dehydrogenase (LDH), creatinine, D-dimer, and C-reactive protein (CRP), anemia, and leukopenia. All pregnant women received low molecular weight heparin and interferon alfa-2b according to the National clinical recommendations. Antimicrobial drugs included Amoxicillin/Clavulanic acid (46%) and macrolides (28%) or carbapenems in severe cases of disease. Spontaneous abortion was reported in 6.1% of cases. Eight preterm (19%) and 34 term deliveries (81%) occurred. The mean weight of neonates was (3283 ± 477) g, 1-and 5-min Apgar score was (7.8 ± 0.6) and (8.7 ± 0.5), respectively. No cases of neonatal COVID-19 infection were reported. Conclusions: Mostly, the manifestations of COVID-19 were mild. However, 9% of cases were severe, and could contribute to preterm delivery or maternal morbidity. Main predictors of severe COVID-19 course in pregnant women were a decrease in the levels of erythrocytes and lymphocytes and increase in the levels of alanine aminotransferase and CRP. Elimination of the virus in pregnant women required more time due to altered immunity. No evidence of vertical transmission during pregnancy and delivery was found. However, the possibility of this cannot be excluded.
COVID-19 infection in pregnancy: a review of existing knowledge
Hormone Molecular Biology and Clinical Investigation, 2022
The world has been coping up with the grave pandemic of COVID-19 since its inception into the human race in December, 2019. By entering the host through the spike (S) glycoprotein, it paves way for its own survival and multiplication. Respiratory tract being the point of entry causes pulmonary compromise and leads to development of ARDS. Having non-specific clinical features that resemble flu makes the clinical diagnosis much more difficult. Pregnancy being an immunocompromised and a hypercoagulable state is prone to be a high-risk group for COVID-19. This study is an attempt to understand the maternal and fetal outcomes in COVID-19 and the vertical transmissibility of the virus. Evidence suggests that the contribution of COVID-19 is not very significant in maternal morbidity and mortality. However, due to some factors such as the immunological response in the mother, certain complications may arise in the neonate in the post-natal period. No vertical transmission of the virus has b...
Study of Pregnant Women Infected with COVID-19 During Pregnancy: A Case Report
Journal of Advances in Medical and Biomedical Research
This case study includes three pregnant women with COVID-19 diagnosed during pregnancy or delivery between March 28 and May 13, 2020. All cases were confirmed by a positive pharyngeal reverse transcription polymerase chain reaction (RT-PCR) test and one case by computed tomography scan (CT Scan) in addition to the (RT-PCR). Clinical and laboratory information was extracted from hospital records during pregnancy and delivery. The adverse effects during pregnancy and after the birth of the newborn, the possibility of vertical transmission from positive pregnant mothers to the neonates were investigated.Of the three women with COVID-19 infection, one patient was diagnosed two weeks before delivery and two were diagnosed during delivery and hospitalization. No adverse effects including preeclampsia, gestational hypertension, rupture of the amniotic sac during pregnancy and premature delivery were observed but one of the patients suffered from intrauterine fetal death (IUFD). in this study, adverse pregnancy outcome was not observed in pregnant women with Covid-19 infection based on hospital observations. No vertical transmission was observed following vaginal delivery or cesarean section and during pregnancy. As the effect of the virus on different people in society varies according to their individual characteristics, our conclusion in this study on pregnant women is also affected by these individual differences, which requires further studies in this field with more samples.