DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20214644

A comparative review of maternal and neonatal outcome among pregnant women with COVID-19 in first and second wave in a tertiary care centre of South Rajasthan

Divya Chaudhary, Madhubala Chauhan, Diksha Gupta, Shivraj Jat

Abstract


Background: Corona virus disease 2019 has taken a huge toll over health infrastructure and care all across the world. This article depicts our experience of COVID-19 in pregnant women and analyses maternal and neonatal outcome of same in first and second wave of this pandemic. Aim and objectives of the study were to compare the demographic characteristics, presenting features and fetomaternal outcome in COVID positive pregnant women in first v/s second wave in a tertiary care hospital.

Methods: The RTPCR COVID-19 positive pregnant women admitted during the period April-2020 to March-2021 were considered in 1st wave of COVD-19 and that from April-2021 till June-2021 as 2nd wave of COVID-19. Data like baseline characteristics, past medical, obstetric history, clinical presentation, laboratory results, imaging findings, management modalities, maternal and neonatal outcome were analysed and compared.

Results:  Peak of 1st wave of COVID-19 was found during the months of July-September 2020, while of 2nd in April-June 2021. Most women presented with COVID-19 RTPCR positive were asymptomatic both in 1st and 2nd wave. Though most patients were managed on room air in both waves, 6.52% and 9.38% were on oxygen, 1.09% and 10.94% were managed with mechanical ventilation and BIPAP in 1st and 2nd wave respectively. There was significant (p<0.05) increase in maternal deaths in the 2nd wave (7.03%) as compared to 1st wave (1.09%).

Conclusions: A significantly large number of patients were affected in 2nd wave of COVID-19 pandemic with more morbidity and mortality. Neonatal population remained relatively unaffected in both waves.


Keywords


COVID-19, Maternal mortality, 2nd Wave of COVID-19, Pregnancy in COVID

Full Text:

PDF

References


WHO. Rolling updates on coronavirus disease (COVID19). 2020. Available at: https:/www.who.int/emergencies/diseases/novel-coronavirus-2019/events-asthey-happen. Accessed on

https://coronavirus.jhu.edu/map.html. Accessed on March 25, 2020.

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395:1038-54.

Tan EK, Tan EL. Alterations in physiology and anatomy during pregnancy. Best Pract Res Clin Obstet Gynaecol. 2013;27(6):791-802.

WHO Laboratory testing for 2019 novel coronavirus (2019-nCoV) in suspected human cases. Interim guidance. Available at: https://www.who.int/publications-detail/laboratory-testing-for-2019-novel-coronavirus-in-suspected-human-cases-20200117. Accessed on Jan 17, 2020.

Ellington S, Strid P, Tong VT, Woodworth K, Galang RR, Zambrano LD et al. Characteristics of women of reproductive age with laboratory-confirmed SARS-CoV-2 infection by pregnancy status-United States, January 22-June 7, 2020. MMWR Morb Mortal Wkly Rep. 2020;69:769-75.

Naccasha N, Gervasi MT, Chaiworapongsa T, Berman S, Yoon BH, Maymon E et al. Phenotypic and metabolic characteristics of monocytes and granulocytes in normal pregnancy and maternal infection. Am J Obstet Gynecol. 2001;185(5):1118-23.

Kalafat E, Yaprak E, Cinar G, Varli B, Ozisik S, Uzun C. Lung ultrasound and computed tomographic findings in pregnant woman with COVID-19. Ultrasound Obstet Gynecol. 2020;55(6):835-7.

Karami P, Naghavi M, Feyzi A, Aghamohammadi M, Novin MS, Mobaien A. Mortality of a pregnant patient diagnosed with COVID-19: A case report with clinical, radiological, and histopathological findings. Travel Med Infect Dis. 2020;101665.

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-9.

Buonsenso D, Raffaelli F, Tamburrini E, Biasucci DG, Salvi S, Smargiassi A. Clinical role of lung ultrasound for the diagnosis and monitoring of COVID-19 pneumonia in pregnant women. Ultrasound Obstet Gynecol. 2020;22055.

Iqbal SN, Overcash R, Mokhtari N, Saeed H, Gold S, Auguste T. An Uncomplicated Delivery in a Patient with COVID-19 in the United States. N Engl J Med. 2020;382(16):e34.

Juan J, Gil M, Rong Z, Zhang Y, Yang H, Poon LC. Effects of coronavirus disease 2019 (COVID-19) on maternal, perinatal and neonatal outcomes: a systematic review. China Ultrasound in Obstet Gynae. 2020;56(1):15-27.