Maternal and Fetal Outcomes in Pregnant Women with COVID-19 Infection; A Case Series of 16 Patients at a Tertiary Care Hospital

Abstract

The novel corona virus has initially emerged in Wuhan city of China in December 2019 and then later on has global transmission to other countries. This is a unique virus and hence limited studies and information has been available about their affects on pregnant women. The perinatal adverse effects studied so far included preterm deliveries, miscarriages, fetal growth restriction and intrauterine death. The basic aim of this study was to study the maternal and fetal outcome in the pregnant females affected by COVID-19 infection at any gestational age and the frequency of vertical transmission, and adverse maternal and fetal outcomes. The audit of hospital based data to devise and implement local management guidelines for the pregnant patients. This descriptive case series was conducted at the department of gynecology and obstetrics, at KRL Hospital Islamabad from 1 <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">st</sup> of April to 31 <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">st</sup> of July, 2020 during the first wave of COVID-19 pandemic. A total of 16 patients were included who were found positive for the infection via RT-PCR. Demographic profile, gestational age at the time of presentation, premorbid disease, maternal symptoms and severity of disease and perinatal outcome noted. The data was analyzed using SPSS 21.0. All the females were aged between 25 to 35 years. Amongst these, 6 patients were primigravida, 1 was diagnosed during the first trimester, 3 in the second trimester and remaining in third trimester. Only one patient had severe disease with symptoms of cough, shortness of breath and remained on oxygen support. But majority of patients were either asymptomatic or had symptoms like flu, fever, generalized body weakness. No maternal mortality, venous thromboembolism, or need of ventilatory support noted. Only one of the patients had an intrauterine death while the rest had neonates who were monitored in the postnatal period and only 1 needed admission due to RDS. None of the baby developed COVID infection. Majority of patients had asymptomatic infection that does not appear to affect the obstetrical outcomes. But the adverse outcomes were seen in those patients who did not attend the antenatal clinics due to the lockdown situation. Overall universal screening for pregnant women is recommended to further elucidate the effects of COVID-19 on pregnancy and vice versa.