A prospective study of maternal and fetal outcome in patients with hypertensive disorders of pregnancy and COVID-19 infection in a tertiary care center

Authors

  • Niranjan Chavan Department of Obstetrics and Gynaecology, LTMMC, Sion, Mumbai, Maharashtra, India
  • Sonam Simpatwar Department of Obstetrics and Gynaecology, LTMMC, Sion, Mumbai, Maharashtra, India
  • Deepali Kapote Department of Obstetrics and Gynaecology, LTMMC, Sion, Mumbai, Maharashtra, India
  • Prasad Deshmukh Department of Obstetrics and Gynaecology, LTMMC, Sion, Mumbai, Maharashtra, India
  • Ashwini Sakhalkar Department of Obstetrics and Gynaecology, LTMMC, Sion, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20220184

Keywords:

Hypertensive disorders, COVID-19, Maternal and fetal outcome

Abstract

Background: During the current COVID-19 epidemic, managing pregnant patients is an issue. Pregnant women with coronavirus infection have an increased risk of miscarriage, preclampsia, caesarean delivery, and neonatal mortality. The additive effect of COVID-19 infection and preclampsia in pregnancy may affect the fetal and maternal outcome in a more complicated way. There have been only a few studies till now to observe the combined effect of both in pregnancy. Our study aims to observe and analyse the maternal and fetal outcomes in pregnancy complicated by preclampsia and COVID-19 infection.

Methods: This is a prospective study at a tertiary referral facility. This research included women with hypertension who were hospitalized for delivery and screened for SARS-RTPCR using a nasopharyngeal swab from April 2020 to September 30, 2021. The maternal and neonatal outcomes were studied and analyzed.

Results: In our study of 65 women with COVID-19 infection and hypertensive disorders in pregnancy, about 6 (9.2%) had eclampsia, 6 (9.2%) had abruptio placenta, 5 (7.6%) had DIC, 3 (4.6%) had HELLP, 2 (3.07%) had acute kidney injury, 2 (3.07%) had ARDS, and 1 (1.5%) had PRESS. 4 (6.1%) had chronic hypertension. Further, 12 (18.4%) of patients needed ICU admission with ventilatory support; about 5 (7.6%) was the rate of maternal deaths in our study. 43 (65%) of neonates were appropriate for gestational age, while 20 (32%) were low birth weight and 2 (3%) were extremely low birth weight. 45% of women with preclampsia develop complications.

Conclusions: Our study concluded that complications from preclampsia are more common in women with COVID-19 infection, but a larger sample size is necessary for statistical significance.

References

Shah PT, Shah SR, Shah SR, Yadav PA, Patel BS, Chudasama TJ. Fetomaternal outcome in COVID-19 infected pregnant women: a preliminary clinical study. Int J Reprod Contracept Obstet Gynecol. 2020;9:3704-10.

COVID-19. Available at: https://covid19.who.int/ region/searo/country/in. Accessed on 20 October 2021.

Chavan NN, Mirza HS, Sonawane P, Iqbal UA. Feto-maternal outcome in COVID-19 positive patients with hypertensive disorders in pregnancy. Int J Reprod Contracept Obstet Gynecol. 2021;10: 1846-50.

Nayak AH, Kapote DS, Fonseca M, Chavan N, Mayekar R, Sarmalkar M, Bawa A. Impact of the Coronavirus Infection in Pregnancy: A Preliminary Study of 141 Patients. J Obstet Gynaecol India. 2020;70(4):256-61.

Lotfi M, Hamblin MR, Rezaei N. COVID-19: Transmission, prevention, and potential therapeutic opportunities. Int J Clin Chem. 2020;508:254-66.

Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020; 395(10223):507-13.

Allotey J, Stallings E, Bonet M, Yap M, Chatterjee S, Kew T, et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: Living systematic review and meta-analysis. BMJ. 2020;370:45-9.

Nankali A, Malek-khosravi S, Zangeneh M. Maternal complications associated with severe preeclampsia. J Obstet Gynecol India. 2013;63:112-5.

Brichant G, Dewandre PY, Foidart JM, Brichant JF. Management of severe preeclampsia. Acta Clin Belg. 2010;65(3):163-9.

Kotlar B, Gerson E, Petrillo S, Langer A, Tiemeier H. The impact of the COVID-19 pandemic on maternal and perinatal health: a scoping review. Reprod Health BioMed Central. 2021;18:70-6.

Papageorghiou AT, Deruelle P, Gunier RB, Rauch S, García-May PK, Mhatre M, et al. Preclampsia and COVID-19: results from the INTERCOVID prospective longitudinal study. Am J Obstet Gynecol. 2021;225(3):289.e1-17.

Karimi-Zarchi M, Schwartz DA, Bahrami R, Dastgheib SA, Javaheri A, Tabatabaiee RS, et al. A meta-analysis for the risk and prevalence of preclampsia among pregnant women with COVID-19. Turk J Obstet Gynecol. 2021;18(3):224-35.

Rosenbloom JI, Raghuraman N, Carter EB, Kelly JC. Coronavirus disease 2019 infection and hypertensive disorders of pregnancy. Am J Obstet Gynecol. 2021; 224(6):623-4.

Mendoza M, Garcia-Ruiz I, Maiz N, Rodo C, Garcia-Manau P, Serrano B, et al. Pre-eclampsia-like syndrome induced by severe COVID-19: a prospective observational study. BJOG 2020;127: 1374-80.

Conde-Agudelo A, Romero R. SARS-CoV-2 infection during pregnancy and risk of preeclampsia: a systematic review and meta-analysis. Am J Obstet Gynecol. 2022;226(1):68-89.

Downloads

Published

2022-01-28

Issue

Section

Original Research Articles