Liječnički vjesnik (Jan 2023)
Treatment and outcome of pregnant women with COVID-19: a single-center descriptive study
Abstract
This study aims to describe the clinical characteristics, radiological and laboratory results, therapy and outcome of pregnancies complicated by COVID-19 infection. Methodology. A retrospective descriptive study included all pregnant women with COVID-19 who gave birth in our hospital from April 2020 to January 2022. Exclusion criteria were: incomplete or unclear medical documentation, suspected COVID-19 infection without confirmation by PCR or rapid Ag test, previously diagnosed autoimmune diseases, positive history of malignant diseases, and started oxygen support in another institution before admission to our hospital. Results. Our study included 186 pregnant women who gave birth at KBC “Dr. Dragiša Mišović – Dedinje” in the mentioned period. Of these, 69 had no symptoms of COVID-19 infection, and 67 developed a milder clinical picture. In comparison, 41 pregnant women were diagnosed with bilateral pneumonia. A total of 38 pregnant women were admitted to the intensive care unit, of which 32 pregnant women needed oxygen support, 20 pregnant women were on an oxygen mask, 2 of them on a high-flow nasal canal, four pregnant women on non-invasive mechanical ventilation and six pregnant women on invasive mechanical ventilation. Of the total number of patients, 111 had a natural vaginal delivery, while 75 underwent cesarean section. Of 111 pregnant women who had a vaginal delivery, 92 (83%) received epidural analgesia, while 19 (17%) did not. Among pregnant women undergoing cesarean section, nine pregnant women (12%) received epidural anesthesia, 51 of them (68) received spinal anesthesia, while a cesarean section in 15 pregnant women (20%) was performed under general balanced anesthesia. Of 186 hospitalized and delivered pregnant women, 183 (98.4%) were discharged home in good general condition, while three (1.6%) had a fatal outcome. Conclusion. The clinical manifestations of pregnant women suffering from COVID-19 infection corresponded to the symptoms of the general population to the greatest extent. In contrast, the excessive use of antibiotics, even for asymptomatic patients, is very worrying.
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