Management of pregnant women in times of COVID-19 our experience from Kashmir valley

Syed Naseer, Syed Uzma Andrabi, Syed Ishfa Andrabi, Humaira Tabasum


Background: The coronavirus disease 2019, caused by severe acute respiratory syndrome coronavirus 2, is a global public health emergency. COVID-19 is a rapidly evolving situation, and there is limited data reporting its impact on pregnant women. Our study aimed to find the symptomatology, clinical courses and outcome of pregnant women with COVID-19 and to assess the vertical transmission potential of COVID-19 in pregnancy.

Methods: This prospective observational study was conducted at Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Medical College, Department of Gynaecology and obstetrics, Srinagar from May 2020 to September 2020. All COVID-19 positive pregnant patients admitted in our institution were included in our study.

Results: The study included 100 Covid-19 positive pregnant women. Most of them were between 30 to 40 years of age. Median gestational age was 32.8 weeks. Comorbidity was present in 18 of our patients. 7 patients had gestational diabetes and 1 with overt diabetes, 5 were hypertensive, 3 had hypothyroidism, 1 with anti-phospholipid antibody syndrome (APLA) and 1 with asthma.44 patients were primigravidae and 56 were multigravidae. 27 patients delivered preterm and 44 with term pregnancy. 47 had undergone caesarean section and 24 normal vaginal delivery.88% of our patients were asymptomatic for covid-19 disease while as 12 patients had Covid-19 disease symptoms. The main complaints reported by patients related to covid-19 disease was mild dry cough and fever (9%). Two patients developed severe covid-19 pneumonia with ARDS and were put on ventilator, expired after 20 days of illness. All neonates were subjected to RT-PCR with none producing positive results.

Conclusions: Appropriate and timely management of Covid-19 positive pregnant women is a principle for safe motherhood and healthy offspring in times of global pandemic. The present data do not suggest an increased risk of severe disease among pregnant women. We encourage the breast feeding immediately after delivery as benefits overweigh any potential risks of virus transmission if any.


COVID-19 disease, Pregnancy, Delivery, Perinatal outcome

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WHO.Summary of probable SARS cases with onset of illness from 1 November 2002 to 31 July 2003. Available at: table2004 _04_21/en/. Accessed on 16th April, 2020.

Hui DS, EIA, Madani TA, Ntoumi F, Kock R, Dar O et al. The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health - the latest 2019 novel coronavirus outbreak in Wuhan, China. Int J Infect Dis. 2020;91:264-6.

WHO. WHO Director-General's remarks at the media briefing on 2019-nCoV on 11 February 2020. Available at: detail/whodirector-general-s-remarks-at-the-media-briefing-on-2019-ncov-on-11february-2020. Accessed on 16th April, 2020.

Scottish Intercollegiate Guidelines Network. Implementation Support. Implementation Support. Available at: implementation-support.html. Accessed on 15th July 2019.

Al-Tawfiq JA. Middle East Respiratory Syndrome Coronavirus (MERS-CoV) and COVID-19 infection during pregnancy. Travel Med Infect Dis. 2020; Available at: pmc/artic les/PMC71 18624. Accessed on 26th May, 2020.

Dashraath P, Jeslyn W, Karen MXL, 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 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;395:809-15.

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. Journal of Infection. 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.

Cabinet Office. Guidance. Staying alert and safe (social distancing). Coronavirus (COVID-19) Guidance and support. Updated 22 May 2020. Available at: publications/staying-alert-and-safe-social-distancing/staying-alert-and-safe-social-distancing. Accessed on 24th May, 2020.

Naccasha N, Gervasi MT, Chaiworaponga T. Phenotype and metabolic characteristics of monocytes and granulocytes in normal pregnancy and maternal infection. Am J Obstet. Gynaecol. 2001;185;1118-23.

Clinical Characteristics of Pregnant Women with COVID-19 in Wuhan, China. The New England J Med. 2020;382:e100.

Ferrazzi EM, Frigerio L, Cetin I. COVID-19 obstetrics task force, Lombardy, Italy: Executive management summary and short report of outcome. Int J Gynaecol Obstet. 2020b;149(3):377-8.

Di Mascio D, Khalil A, Saccone G. 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.

Zaigham M, Andersson O. Maternal and perinatal outcomes with COVID-19: A systematic review of 108 pregnancies. Acta Obstet Gynecol Scand. 2020.

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;395(10226):809-15.

Breslin N, Baptiste C, Gyamfi-Bannerman C. COVID-19 infection among asymptomatic and symptomatic pregnant women: Two weeks of confirmed presentations to an affiliated pair of New York City hospitals. Am J Obstet Gynecol MFM. 2020;100118.

Ferrazzi E, Frigerio L, Savasi V. Vaginal delivery in SARS-CoV-2 infected pregnant women in Northern Italy: a retrospective analysis. BJOG. 2020a.

Davanzo R, Moro G, Sandri F, Agosti M, Moretti C, Mosca F. Breast feeding and coronavirus disease-2019: Ad interim indications of the Italian Society of Neonatology endorsed by the Union of European Neonatal & Perinatal Societies. Matern Child Nutr. 2020:e13010.

FIGO. Safe motherhood and COVID. 2020. Available at: Accessed on 14th May 2020.