SARS-CoV-2 infection during pregnancy is associated with a number of adverse pregnancy outcomes, including preeclampsia, preterm birth, and stillbirth, especially among pregnant women with severe COVID-19. Several fetal complications such as early pregnancy loss, delivery of a premature fetus, preeclampsia, fetal death, vertical transmission, intrauterine growth retardation, and congenital structural anomalies in association with COVID-19 disease have been investigated.Тo review on the fetal adverse outcome that is likely to occur during COVID-19 disease. The fetal detrimental outcomes that have been widely studied in the literature include preterm birth, stillbirth, vertical transmission. The evidence in the literature supports that there is a higher rate of preterm birth and stillbirth in women who tested positive for SARS-CoV-2 but their association with the disease is not completely clear. Furthermore, the emergence of other possible outcomes is not conclusively stated. Hence more studies are required to establish their association with COVID-19 disease to decrease and mitigate the risk of detrimental fetal outcomes through early interventions and preventive measures.
Background: Cesarean section (CS) rate is rising worldwide including in Afghanistan. Access to CS indicates maternal quality care in a healthcare system, but higher rates are associated with increased maternal-fetal mortality due to CS severe complications. The WHO recommends the Robson classification to monitor the rational use of CS. This study aims to analyze the CS rate at Abu Ali Sina Hospital based on the 10-Group Robson classification.Methods: This retrospective cross-sectional study was conducted at Abu Ali Sina Hospital, a tertiary care teaching hospital in Balkh, Afghanistan. The data was collected from medical documents of all women who delivered in February-March 2022. Women were classified into Robson 10 groups then the total rate of CS, absolute, and relative contribution of each group to the overall CS rate was calculated.Results: Among 2858 women delivered during the study period, 567 (19.8%) had CS. Group 5 (35.8%) was the largest contributor to the overall CS rate. 122 (61%) of women in this group had undergone prelabor CS. Group 1 (18.5%), and Group 3 (13.2%) were the second and third largest contributors to the total CS.Conclusion: This study revealed that Group 5 was the main contributor to the overall CS. The previous CS scar was the most common indication of repeated cesarean delivery. Furthermore, high rates of CS were observed in low-risk group women. We also identified that the Robson classification can be implemented as a monitoring tool in all settings in Afghanistan even those with a lack of facilities.
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