Features of the pregnancy and delivery course, fetal and newborn status in women with COVID-19

Abstract

Research objective. To evaluate the features of pregnancy and delivery course, fetal and newborn status in women with confirmed COVID-19.Materials and methods. A retrospective clinical and statistical analysis of 106 pregnancy and delivery case histories and medical records of newborn from women with a gestation period of 22–41 weeks with a confirmed diagnosis of COVID-19 was carried out. Women were treated and delivered on the temporarily converted beds for providing obstetric care to pregnant women, women in labor and postpartum women with suspected and infected COVID-19 and gynecological patients of Municipal Non-Profit Enterprise “Kyiv City Maternity Hospital No. 3” from September 2020 to May 2021.Results. Delivery took place in 48 women. Women with A (II) blood group were significantly predominant – 51 (48.1%) and rhesus-positive factor – 85 (80.2%) (p < 0.05). One third of pregnant women sought medical help on their own – 34 (32.1%). 94 (88.7%) women had a positive PCR test, in 6 (11.3%) cases the diagnosis was confirmed by a rapid test in the admission department; in 6 (11.3%) cases the test results were negative. The leading complaints when pregnant women were hospitalized were fever, cough and fatigue in 85 (80.2%), 90 (84.9%) and 73 (68.9%) pregnant women respectively (p < 0.05). Almost every third woman (39, 36.8%) had a subfebrile temperature – 37.0–37.5 oC. In 15 (14.1%) patients the temperature was 38.0–38.5 oC, in 6 (5.7%) patients over 38.5 oC. At the lung ultrasound the signs of bilateral and polysegmental pneumonia were diagnosed in 44 (53.6%) and 36 (43.9%) cases. Lower and upper lobe pneumonia was diagnosed in 20 (24.4%) pregnant women. Severe lung damage was detected in 29 (35.4%) pregnant women in the form of partial “hepatization” of lung tissue, pleural effusion in the form of black areas of various sizes in the pleural cavity.Conclusions. The main typical SARS CoV-2 complaints in hospitalized pregnant women were fever, cough, fatigue and shortness of breath at rest and during exercise. Such neurological manifestations of SARS CoV-2 as headache, anosmia were noted by almost every third pregnant woman, and parosmia and myalgia were noted by every fourth pregnant woman. The average level of C-reactive protein was above normal in 97.2% of women. Lung ultrasound allowed clearly identifying areas of damage and determining the degree of lung tissue damage.