Maternal and neonatal outcomes in COVID-19 infected pregnancies : a prospective cohort study

Abstract

Objective: To study maternal and neonatal outcome in COVID -19 positive pregnant women. Methodology: Prospective cohort study was done in a tertiary maternity unit in Hind Institute of Medical Sciences, level 2 COVID care centre. Data was analyzed for a cohort of 49 pregnant women tested positive for COVID-19 between 14/8/2020 and 20/10/2020 to assess the effect of COVID-19 on pregnancy and neonatal outcomes. Results: Among 49 women, 14 women (28.57%) had mild symptoms, while 34 women (69.38%) were asymptomatic, 1 (2.04%) had moderate severity. 6 women had co-morbidities (12.24%). 46 women underwent delivery and 2 women (4.08 %) underwent abortion. Out of the 46 deliveries conducted 38 (82.60%) underwent C - section, 1 (2.17 %) had exploratory laparotomy and 7 (15.21%) had normal delivery. Most frequent indication for performing C-section was fetal distress in 25 women (54.34%). In per-operative findings of C-section conducted 20 women (51.28%) were having meconium stained liquor. Other important per-operative finding was thinned out lower segment in all 11 pregnancies with previous scar, 5 women (12.8%) had atonic PPH. There were two ICU (4.08%) admissions and 1 maternal mortality (2.04%). Amongst 46 delivered neonates, 2 were still born (4.34 %) 2 IUD (4.34%), 13 preterm (28.26%), 3 IUGR (6.52%). 3 (6.52%) neonates required NICU admissions for management. All babies were negative for COVID-19 after 5 days of delivery. Conclusion: In our study we found higher rates of C-section in COVID positive pregnant women, severity of disease was not affected by pregnancy and there was no COVID associated mortality. Serocoversion to COVID negative status was 100% after 10 days. There was higher incidence of preterm, PROM, meconium stained liquor. We found no evidence of vertical transmission.

Keywords

• covid-19
• pregnancy
• antenatal
• symptoms
• c section
• vertical transmission
• mortality