DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20210334

Clinical analysis of maternal and fetal outcomes in COVID-19 pregnant women undergoing cesarean section in a tertiary care center in Hyderabad, India

Prabha Agrawal, Rahul Agrawal, Ganshyam Jagathkar

Abstract


The outbreak of coronavirus disease 2019(COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is spreading globally at an accelerated rate. A serious public health threat, it has caused a major impact on health care systems with a significantly high mortality and morbidity. Physiological changes and immuno-compromised state make pregnant women vulnerable during infectious disease outbreaks and hence need a more cautious approach. With this report we aim to share our experience regarding clinical characteristics, management and outcomes of 10 diagnosed COVID-19 pregnant women undergoing cesarean section at Medicover hospital, a tertiary-care center in Hyderabad, India between July to September 2020. All 10 pregnant women were referred in their third trimester with diagnosis of COVID-19. 2 out of 10 patients had severe COVID-19 and were managed in the ICU. All patients underwent emergency cesarean sections and none of the infants were infected with COVID-19. At discharge, all patients and the newborns were in a clinically stable condition. Effective management strategies incorporating integrated team approach, early cesarean section and low-threshold for mechanical ventilation has been shown to be associated with favorable outcomes for mothers diagnosed with COVID-19 and their infants. Also, the present data does not support any evidence of vertical transmission of SARS-CoV-2 virus in those manifesting during the third trimester of pregnancy.


Keywords


Cesarean section, COVID-19, Pregnancy, Vertical transmission

Full Text:

PDF

References


D'Cruz RJ, Currier AW, Sampson VB. Laboratory Testing Methods for Novel Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2), Front Cell Dev Biol. 2020;8(468):1-11.

Lyra J, Valente R. Cesarean Section in a Pregnant Woman with COVID-19: First Case in Portugal, Acta Med Port 2020;33(6):429-31.

Yongwen Luo, Kai Yin. Management of pregnant women infected with COVID-19. Lancet. 2020;20(5):P513-4.

López M, Gonce A, Meler E. Coronavirus Disease 2019 in Pregnancy: A Clinical Management Protocol and Considerations for Practice. Fetal Diagn Ther. 2020;47:519-28.

Upadhyay J, Tiwari N, Ansari MN. Role of inflammatory markers in corona virus disease (COVID-19) patients: A review. SAGE J. 2020;245(15):1368-75.

Dashraath P, Wong JLJ, Lim MXL. Coronavirus disease 2019 (COVID-19) pandemic and pregnancy. Am J Obstet Gynecol. 2020;222(6):521-31.

Ryan GA, Purandare NC, McAuliffe FM, Hod M, Purandare CN. Clinical update on COVID‐19 in pregnancy: A review article. J Obstetr Gynaecol Res. 2020;46(8):1235-45.

Berghella V. Coronavirus disease 2019 (COVID-19): Pregnancy issues, Available at https://www.uptodate.com/contents/coronavirus-disease-2019-covid-19-pregnancy-issues. Accessed on 12 Nov, 2020.

Zaigham M, Andersson O. Maternal and perinatal outcomes with COVID‐19: A systematic review of 108 pregnancies. Acta Obstet Gynecol Scand. 2020;99(7):823-9.

The effect of COVID-19 on pregnancy still a priority for research, Published 08 June 2020, Available at https://www.focusonreproduction.eu/article/ESHRE-News-Coronavirus-3. Accessed on 12 Nov, 2020.

Tingting Z. Medicine: Coronavirus disease 2019 (COVID-19) in pregnancy: 2 case reports on maternal and neonatal outcomes in Yichang city. Hubei Province, China, 2020;99(29):e21334

Yan J, Guo J. Coronavirus disease 2019 in pregnant women: a report based on 116 cases. Am J Obstetr Gynecol. 2020;223(1):111.e1-4.