Outcome of Pregnancy in COVID19 Positive Pregnant Women: A Retrospective Observational Study

Abstract

Introduction: Pregnant women have also been affected globally due to the Coronavirus Disease 2019 (COVID19) pandemic. As feto-maternal unit is involved, hence it is important to know possible manifestations and outcome of COVID-19 affected pregnant women. The findings of the study can guide for betterment of COVID-19 affected Antenatal patients care. Aim: To find out the outcome of pregnancies affected by the COVID-19 infection of the ANC patients who presented to the tertiary care hospital in terms of laboratory parameters, treatment of the infection, mode of delivery, adverse outcome if and presence of documented infection in newborn. Materials and Methods: This was a retrospective observational study done from May 2020 to December 2020 conducted on the admitted pregnant women to the tertiary care hospital who tested positive for the COVID-19 virus were included in the study. Data collection (symptoms, reports and treatment) from these pregnant COVID-19 positive patients was done. Patients who were discharged before delivery were contacted telephonically and were asked the relevant information. Results: During the study period, total 1150 COVID-19 positive patients were admitted to the hospital. Amongst these, there were 441 female patients including pregnant and non pregnant women. Amongst the 441 COVID-19 infected female patients, 20 were pregnant. Majority of the patients were in the age group of 21-30 years. An 85% of women were in their third trimester at the time of admission. Pre-eclampsia and Hypothyroidism were the major co-morbidities observed. Six maternal Intensive Care Unit (ICU) admissions were noted. Breathlessness was the main symptom seen followed by sore throat, fever and cough. Previous Lower Segment Caesarean Section (LSCS) and foetal distress were cited as the main reasons for undergoing LSCS. No vertical transmission of virus was seen in the study. There were two neonatal ICU admission. Low Molecular Weight Heparin (LMWH) was administered to 33% patients. Fifty percent of the patients were prescribed steroids. Conclusion: Advanced gestational age, pre-eclampsia, hypothyroidism, elevated levels of d- dimer, Neutrophil/Lymphocyte (NL) ratio and C-reactive protein were seen as the main findings. Mother to child transmission was not observed in this study.

Keywords

• c-reactive protein
• d-dimer
• ferritin
• inflammatory markers
• vertical transmission