Foetomaternal Outcomes in COVID-19 Positive Obstetric Patients: An Observational Study

Abstract

Introduction: In Coronavirus Disease-2019 (COVID-19) pandemic, a serious concern has been raised regarding the health of the newborn and the pregnant mother. Limited data is available on the foetomaternal outcomes in this pandemic. Aim: To assess the foetomaternal outcomes in COVID-19 positive pregnant patients. Materials and Methods: A prospective cohort study was conducted from October 2020 to December 2020, at JSS Medical College, Mysuru, Karnataka, India, on 27 COVID-19 positive obstetric patients admitted to the ward who had confirmed COVID-19 on the basis of Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR) or lung opacities. The study period belonged to first wave of COVID-19. The foetomaternal outcomes such as mode of delivery, abortions, foetal admission in Intensive Care Unit (ICU) and mortality among the mother and the baby were recorded. The data was collected and tabulated in Microsoft Excel sheet and frequency (n) and percentages (%) were calculated. Results: Total of 27 COVID-19 positive obstetric patients (age 19-37 years; mean gestational age 34.84±7.75 weeks) formed the sample of the study. The mean age of the study patients were 27.11±4.5 years. The primary symptoms included cough (18.52%) and breathlessness (11.11%). After diagnosis, seven cases (25.92%) continued pregnancy and were lost to follow-up while among those who delivered (n=20), the mode of delivery was Lower Segment Caesarean Section (LSCS) in 12 (44.44%), normal vaginal 6 (22.22%), emergency laparotomy in 1 (3.7%) and incomplete abortion in 1 (3.7%) women. Among the 20 who delivered, 1 was Intrauterine Death (IUD) and the rest of the 19 foetuses were negative for COVID-19. Of the total 20 foetuses delivered, 10 required Neonatal Intensive Care Unit (NICU) admission where one died. Repeat testing was done in 13 female subjects, all of them were negative, while rest of the seven patients did not turn in for repeat testing and were lost. Among the pregnant women, one patient died secondary to COVID-19 bronchopneumonia in the postpartum period. Conclusion: If managed properly without any complications, the outcomes are good for the mother and the baby without a significant risk of transmission. However, the long-term follow-up is needed to assess the mortality of the patients.

Keywords

• coronavirus disease-2019
• newborn
• pandemic
• pregnancy