DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20213471

Maternal and perinatal morbidity and mortality in COVID-19 positive obstetric patients with medical disorders in tertiary care hospital in North India

Gunjan Goyal, Khushboo Tongaria, Sachin Kumar, Brijesh Kumar Thakran, Mohini Yadav

Abstract


Background: Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus. Most people infected with the COVID-19 virus experienced mild to moderate respiratory illness. Coronavirus is known to human kind since 1930. It was first discovered in domesticated chicken with symptoms of pulmonary infection. The aim and objective was to study clinical profile of patients presented with medical disorders in COVID-19 positive pregnant women.

Methods: Present retrospective COHORT study included 50 COVID-19 positive obstetrics patients. The study was conducted in the department of obstetrics and gynaecology, World college of medical sciences and research, Jhajjar (Haryana). Retrospective review of medical records of all pregnant patients with pre-existing medical disorders or those suspected with medical disorders on the basis of clinical and/or laboratory data from 1 April 2020 through 30 September 2020.

Results: Mean age of the women was 27.46±4.16 years with age range of 20-35 years. Mean period of gestation was 33.26±8.35 weeks. A total of 33 (66%) women were found to be COVID-19 positive due to close contact. 29 (58%) women were found to be asymptomatic and 17 (34%) had various other COVID-19 symptoms. In 17 (34%), sore throat was the commonest symptoms followed by cough, myalgia and fatigue, that is, 13 (26%) each. Fever at the time of admission was present in 9 (18%) women and postpartum fever was observed in 4 (8%) women. Mean hospital stay was 9.24±3.25 days. A total of 29 (58%) women underwent caesarean delivery and 21 (42%) had normal vaginal delivery. Mean postoperative hospital stay was 4.48±2.24 days. In 9 women, postoperative complications were seen. A total of 8 babies admitted to NICU due to various complications. Two babies expired during the study period.

Conclusions: In the present retrospective COHORT study, the majority of the pregnant women with COVID-19 infection had mild symptoms with no severe illness. Mother-to-child transmission of COVID-19 cannot be ruled out. The impacts of COVID-19 infection on patients with medical disorders during pregnancy were seen.


Keywords


Maternal, Perinatal, Morbidity, Mortality, Obstetric, Medical disorders

Full Text:

PDF

References


WHO. Fact sheet: Coronavirus disease (COVID-19) Pandemic, 2020. Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019. Accessed on 10 June 2021.

Burrow G, Duffy T, Copel JA. Obstetric management of the high-risk patient. Medical complications during pregnancy. 6th ed. WB Saunders; 2004: 1-12.

Milind CA, Girish PB, Tushar TC, Abhijeet MC, Shashank TC, Hemant NC. A clinical study of medical disorders in pregnancy. Nat J Med Dent Res. 2016;4:257-63.

Shriastava S, Malik N. Medical disorders in pregnancy and pregnancy outcome a retrospective analysis. Int J Reprod Contracep Obstet Gynaec. 2018;7(6).

Clinical management. Available at: https://www.mohfw.gov.in/pdf/ClinicalManagementProtocol forCOVID19 dated 27062020.pdf.

ICMR-National Institute for Research in Reproductive Health. Fact sheet: Guidance for Management of Pregnant Women in COVID-19 Pandemic, 2020. Available at: http://www.nirrh.res.in/wp-content/uploads/2020/04/Guidance-for-Management-of-Pregnant-Women-in-COVID-19-Pandemic.pdf. Accessed on 10 June 2021.

ICMR. Fact sheet: COVID-19 testing, 2020. Available at: documents/2020-03-20covid19testv3.pdf

Good clinical practice recommendation on pregnancy with COVID-19 infection. FOGSI, 2020. Available at: https://www.fogsi.org/wp-content/uploads/covid19/fogsi_gcpr_on_pregnancy_with_COVID_19version1.pdf. Accessed on 10 June 2021.

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

Goodnight WH, Soper DE. Pneumonia in pregnancy. Crit Care Med. 2005;33(10):390-7.

O’Day MP. Cardio-respiratory physiological adaptation of pregnancy. Semin Perinatol 1997;21(4):268-75.

Nelson-Piercy C. Respiratory disease. Handbook of Obstetric Medicine. Boca Raton: CRC Press; 2015: 371.

Chawla D, Chirla D, Dalwai S, Deorari AK, Ganatra A, Gandhi A, et al. Perinatal-neonatal management of COVID-19 infection-guidelines of the federation of obstetric and gynaecological societies of India (FOGSI), National neonatology forum of India (NNF), and Indian academy of pediatrics (IAP). Indian Pediatr. 2020;57(6):536-48.

Breslin N, Baptiste C, Gyamfi-Bannerman C, Miller R, Martinez R, Bernstein K, et al. Coronavirus disease 2019 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;2(2):100118.

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.

Knight M, Bunch K, Vousden N, Morris E, Simpson N, Gale C, et al. Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK: national population based COHORT study. Br Med J. 2020;369:2107.

Ayed A, Embaireeg A, Benawadh A, Al-Fouzan W, Hammoud M, Al-Hathal M, et al. Maternal and perinatal characteristics and outcomes of pregnancies complicated with COVID-19 in Kuwait. BMC Pregnan Childbirth. 2020;20:754.

Smith V, Seo D, Warty R, Payne O, Salih M, Chin KL, et al. Maternal and neonatal outcomes associated with COVID-19 infection: a systematic review. PLoS One. 2020;15(6):0234187.