The aim of the study is to assess the frequency of pregnancy complications and the mode of delivery in COVID-19 women performing delivery in the district clinical hospital in the city of Khanty-Mansiysk. Materials and Methods. The authors retrospectively analyzed 148 medical histories of COVID-19 women, who delivered in Khanty-Mansiysk perinatal center. All patient medical records were divided into 4 subgroups depending on the delivery term, and 3 subgroups depending on the disease severity. Statistical analysis was carried out using analytics software packages Statistica 10 (USA) and StatTech v. 2.8.4 (Stattech, Russia, 2020). Given group heterogeneity, non-parametric statistical methods were used to calculate quantitative and qualitative parameters. Fisher Z transformation and the Mann-Whitney test were used to compare the parameters. Differences were considered statistically significant at p≤0.05, CI 95 %. Results. In all subgroups the most common pregnancy complication in COVID-19 patients was anemia. It was observed in 50.8 % to 74.3 % of cases. The maximum incidence of moderate preeclampsia was 2.7 %, that is below the average population value. Most placental abnormalities were detected in subgroups of women who gave birth during 3rd and 4th waves of COVID-19 (37.1 % and 33.8 % respectively). In the same subgroups, fetal growth retardation (28.6 % and 32.3 %), statistically significant increase in the proportion of preterm births (34.3 % and 38.5 %) and transfers to the neonatal intensive care unit (28.6 % and 26.2 %) were often observed.
Since the beginning of the COVID-19 pandemic, there have been a number of studies related to the impact of SARS-CoV-2 on the course of pregnancy and fetus condition. As observed, the placentas of women who have had a new coronavirus infection often contain more villous agglutination and subchorionic thrombi than placentas in SARS-CoV-2-negative women. To date, several isolated publications have reported clinical cases of fetal death in mothers infected with coronavirus infection. The authors have made an assumption on the association of adverse outcomes with placental lesions. The aim of the study was to analyse a clinical case of a moderate-course new coronavirus infection in a pregnant woman at a long gestation period who underwent an antenatal fetal death, and evaluate the features of placental histopathology and their impact on adverse gestational outcomes. Material and methods. The authors have analysed Russian and international research publications from various sources, including eLIBRARY.RU, CyberLeninka, PubMed databases etc. and, considering the data obtained, investigated a clinical case of intrauterine fetal death in a pregnant woman infected with SARS-CoV-2. The placenta was studied in accordance with the clinical recommendations of the Russian Society of Pathologists "Rules for placental pathological and anatomical examination" and the international classification of placental lesions (Amsterdam, 2015). Results. The results obtained support the association between acute diseases of the upper respiratory tract and developing severe hemodynamic disorders in the "mother-placenta-fetus" system in pregnant women infected with SARS-CoV-2. Systemic inflammation associated with new coronavirus infection appears to be one of the mechanisms for developing placental disorders.
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