Abstract
To analyze the clinical and obstetric aspects of pregnant women with COVID-19. A systematic literature review in the MEDLINE/PubMed, LILACS, SCIELO, and CNKI databases was performed from March to May 2020, with the descriptors: Pregnancy; 2019-nCov; Coronavirus; SARS-Cov-2, Covid-19. Of those chosen were original titles, without language and period restriction and that addressed pregnant women with a clinical and/or laboratory diagnosis of COVID-19. Revisions, editorials, and duplicate titles were excluded. The Newcastle-Ottawa (NOS) and Murad et al. scales were used to assess the quality of the studies. We included 34 articles with 412 pregnant women infected with severe acute respiratory syndrome (SARS-Cov-2), with an average age of 27.5 years of age and 36.0 gestational weeks. The most common symptom was fever (205 [49.7%]), and 89 (21.6%) pregnant women progressed to severe viral pneumonia. Laboratory tests showed an increase in C-reactive protein (154 [37.8%]), and radiological tests showed pneumonia with peripheral ground-glass pattern (172 [51.4%]). Emergency cesarean delivery was indicated for most pregnant women, and the most common gestational complication was premature rupture of ovarian membranes (14 [3.4%;]). We detected 2 (0.5%) neonatal deaths, 2 (0.5%) stillbirths, and 1 (0.2%) maternal death. Pregnant women with COVID-19 presented a clinical picture similar to that of non-infected pregnant women, with few obstetric or neonatal repercussions. There was a greater indication of cesarean deliveries before the disease aggravated, and there was no evidence of vertical transmission of the infection.
Highlights
At the end of December 2019, in Wuhan, capital of the Hubei province, located in China, there was an outbreak by a virus that suddenly worried the authorities, due to their lack of knowledge and the rapid spread of the virus to other countries
There was a greater indication of cesarean deliveries before the disease aggravated, and there was no evidence of vertical transmission of the infection
One hundred and sixty-five titles and abstracts were read, and, of these, 56 manuscripts were chosen to be read in full. After eliminating those that did not meet the object of the study, 34 studies were selected for analysis, according to the flowchart (►Fig. 1)
Summary
At the end of December 2019, in Wuhan, capital of the Hubei province, located in China, there was an outbreak by a virus that suddenly worried the authorities, due to their lack of knowledge and the rapid spread of the virus to other countries. The virus, belonging to the coronavirus family, was named severe acute respiratory syndrome (SARS-CoV2), and the illness caused by it was called coronavirus disease 2019 (COVID-19). Based on the information referring to the other aforementioned coronaviruses, SARS-CoV and middle east respiratory syndrome coronavirus (MERS-CoV), we noted a higher incidence of abortions, growth restriction, preterm births, and fetal death. These viruses in pregnant women determined a high number of complications, such as hospitalization in intensive care units (ICU), the need for assisted ventilation, renal failure, and death.[3]
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