What are the novel findings of this work? This study provides estimates of the risk of coronavirus disease 2019 (COVID-19)-related complications in pregnant compared to non-pregnant women, after propensity score matching based on background demographic and medical factors. Pregnancy emerged as a risk factor for death (odds ratio (OR), 1.84; 95% CI, 1.26-2.69), pneumonia (OR, 1.86; 95% CI, 1.60-2.16) and intensive care unit (ICU) admission (OR, 1.86; 95% CI, 1.41-2.45). What are the clinical implications of this work? Pregnancy per se is a risk factor for several COVID-19-related complications when compared to non-pregnant women. Economic, social, health and political interventions aimed at managing SARS-CoV-2 infection in pregnant women are likely to reduce adverse outcomes, such as death, ICU admission and pneumonia.

What are the novel findings of this work?This is one of the largest cohorts to date on coronavirus disease 2019 (COVID-19) in pregnancy. The findings demonstrate that advanced maternal age, pre-existing diabetes, chronic hypertension, obesity, high social vulnerability and low socioeconomic status are risk factors for COVID-19-related maternal mortality. What are the clinical implications of this work?The findings of this study should help identify high-risk pregnant women who should observe mask-wearing, social distancing and good hand hygiene and ideally get vaccinated in order to reduce the risk of acquiring severe acute respiratory syndrome coronavirus 2 infection, as well as raise awareness of the possibility of selective vaccination in developing countries in which vaccines and resources are scarce.

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Cardiomyocyte injury and troponin T elevation has been reported within COVID-19 patients and are associated with a worse prognosis. Limited data report this association among COVID-19 pregnant patients. Objective: We aimed to analyze the association between troponin T levels in severe COVID-19 pregnant women and risk of viral sepsis, intensive care unit (ICU) admission, or maternal death. Methods: We performed a prospective cohort of all obstetrics emergency admissions from a Mexican National Institute. All pregnant women diagnosed by reverse transcription-polymerase chain reaction (RT-qPCR) for SARS-CoV-2 infection between October 2020 and May 2021 were included. Clinical data were collected, and routine blood samples were obtained at hospital admission. Seric troponin T was measured at admission. Results: From 87 included patients, 31 (35.63%) had severe COVID-19 pneumonia, and 6 (6.89%) maternal deaths. ROC showed a significant relationship between troponin T and maternal death (AUC 0.979, CI 0.500–1.000). At a cutoff point of 7 ng/mL the detection rate for severe pneumonia was 83.3% (95%CI: 0.500–0.100) at 10% false-positive rate. Conclusion: COVID-19 pregnant women with elevated levels of troponin T present a higher risk of death and severe pneumonia.

Oral communication abstracts obstetrical ultrasound for patients in underserved rural and remote communities where this service is not available. The objective of this study is to assess the feasibility of providing obstetrical ultrasound services remotely using a telerobotic ultrasound system in a remote community isolated due to COVID-19. Methods: A telerobotic ultrasound system was used to remotely perform obstetrical ultrasound exams in La Loche, Canada, a remote community without regular access to obstetrical ultrasound. Using a telerobotic ultrasound system, a sonographer 605km away remotely controlled an ultrasound probe and ultrasound settings. 21 exams were performed in a 5-week period during a COVID-19 outbreak, including limited first, second and third trimester exams (n = 11) and complete second trimester exams (n = 10). Radiologists interpreted all exams and determined adequacy of images for diagnosis. Results: Of 11 limited obstetrical exams, radiologists indicated images were adequate in 9 (81%) cases, adequate with some reservations in 1 (9%) case and inadequate in 1 (9%) case. Of 10 second trimester complete obstetrical exams, radiologists indicated images were adequate in 2 (20%) cases, adequate with some reservations in 3 (30%) cases and inadequate in 5 (50%) cases. Second trimester complete obstetrical exams were limited due to a combination of body habitus, fetal lie and telerobotic technology. Conclusions: A telerobotic ultrasound system may be used to answer focused clinical questions such as fetal viability and fetal presentation in a timely manner while minimising patient travel to larger centres and potential exposure to SARS-CoV-2 during the COVID-19 pandemic. The COVID-19 pandemic may catalyse the implementation of telerobotic sonography to bring greater accessibility and equity in the delivery of obstetrical ultrasound to patients in rural and remote communities.