Fetomaternal outcome in COVID-19 infected pregnant women: a preliminary clinical study

Shah, Parul T.; Shah, Sapana R.; Shah, Sonal D.; Yadava, Pushpa A.; Patel, Brijesh; Chudasama, Tanmay J.

doi:10.18203/2320-1770.ijrcog20203843

Cited by 13 publications

(23 citation statements)

References 10 publications

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“…In our study, the most common symptoms at presentation was Fever among 58.7%, Cough among 76.2%, Sore throat among 87.3%, Headache among 22.2%, Vomiting among 11.1%, Drowsiness among 9.5% and Dyspnea among 4.7%. Similar findings were reported by Shah et al [21] most common symptoms at presentation were cough (61.6%) and fever (46.4%); 38.4% of pregnant patients did not present with symptoms, but most of these patients were diagnosed as having COVID-19 infection by intensive field testing and contact tracing during the initial phase of outbreak in India. FOGSI guidelines recommends that pregnant women residing in containment areas or in large migration gatherings/evacuees centre from hotspot districts presenting in labour or likely to deliver in next 5 days should be tested even if asymptomatic [22] .…”

Section: Symptomssupporting

confidence: 86%

The correlation of chest x-ray findings and clinical parameters with outcome in COVID positive obstetric patients

Maheshwari¹,

Setiya²,

Puri³

et al. 2021

Int. J. Clin. Obstet. Gynaecol.

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Aim and Objectives: The present study was done to study correlation of chest x-ray findings and clinical parameters with outcome in COVID-19 pregnant subjects. Materials and Method:The study was conducted after clearance from Board of Studies and Ethical committee in the Department of obstetrics and gynaecology, Muzaffarnagar medical college, Muzaffarnagar. The study population was selected on the basis of the inclusion and exclusion criteria. The study population consisted of 63 pregnant mothers. Results: Majority of the study population belonged to 26-30 years age group (42.4%) and 20-25 years (41.3%). The most common symptoms at presentation was Sore throat (87.3%) followed by Cough (76.2%) and Fever (58.7. The chest X-ray showed that pneumonitis was seen among 38.1% patients with 23.8% having bilateral pneumonitis, 6.3% having left sided pneumonitis and 7.9% having right sided pneumonitis. Among symptomatic patients 91.6% patients showed chest x-ray findings of pneumonitis however, in asymptomatic patients only 40% showed positive chest x-ray findings. Conclusion: Among the 5 patients who developed adverse outcome as mortality nd ICU admissions all had positive x-ray findings of pneumonitis. Also, majority of symptomatic patients had positive chest x-ray findings thus making chest x-ray an effective tool to predict outcome in COVID positive pregnant females.

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Section: Symptomssupporting

confidence: 86%

The correlation of chest x-ray findings and clinical parameters with outcome in COVID positive obstetric patients

Maheshwari¹,

Setiya²,

Puri³

et al. 2021

Int. J. Clin. Obstet. Gynaecol.

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“…We were amazed to know that none of the samples came out to be positive. 1 Shah et al also studied vertical transmission and their results indicated that 16.67% neonates at birth were positive suggesting the possibility of vertical transmission which is not according to our study. 1 Claudia Fenizia from university of Milan, Italy in 2020 also analysed SARS-CoV-2 vertical transmission in 31 obstetric patients and studied viral genome on maternal and new born nasopharyngeal swab, vaginal swabs, maternal and umbilical cord plasma, placenta and umbilical cord biopsies, amniotic fluid and milk from 31 mothers.…”

Section: Resultscontrasting

confidence: 57%

“…Chest X-ray shows pneumonia in 28 (58%) cases. 1 Asymptomatic patients were 38.4% in a study by Shah et al in 2020. While our study had 96% patients asymptomatic.…”

Section: Resultsmentioning

confidence: 93%

“…2 were admitted in ICU due to very severe COVID. 1 In spite of the fact that 48 (96%) patients were asymptomatic, CRP, D-dimer, IL6 and S. ferritin were carried out in all the patients. CRP was increased in 40 (80%), D-dimer in 50 (100%), IL-6 in 49 (98%) and S. ferritin in 48 (96%) of the patients.…”

Section: Resultsmentioning

confidence: 99%

“…Whole world was affected and everybody was seeking measures to protect themselves from the disease. 1 But how can an unborn fetus in-utero can protect himself, so this study was done to know about the antenatal transmission of disease from mother to fetus so that necessary measure so that necessary measures can take place to save the fetus.…”

Section: Introductionmentioning

confidence: 99%

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Study of vertical transmission of COVID-19 infection in COVID-19 positive obstetrical patients by comparing amniotic fluid and immediate neonatal COVID-19 RT-PCR

Tyagi¹,

Agarwal

et al. 2021

Int J Reprod Contracept Obstet Gynecol

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Background: The objective of this study was to estimate the incidence of vertical transmission COVID-19 by RT-PCR.Methods: In this hospital based prospective study, all COVID-19 positive pregnant women admitted in COVID ward in Muzaffarnagar medical college and hospital from April 2020 to January 2021 were included. A detailed history and examination was done and all routine investigations were done as per protocol. Samples were taken from amniotic fluid during vaginal delivery or caesarean section and collected in viral transport medium. Sample were also collected as nasal and oropharyngeal swab from neonate immediately after birth and sent for COVID 19 RT-PCR.Results: Out of total 50 cases; 43 (86%) neonates were delivered via LSCS and 7 (14%) by normal delivery, out of these 41 (82%) neonates were normal; 4 (8%) were IUGR, 2 (4%) were IUD, 2 (4%) were pre-term and 1 (2%) neonatal death. All 50 amniotic fluid as well as nasal and oropharyngeal samples of all neonates were negative by RT-PCR.Conclusions: Low vertical transmission may be due to the fact that antibodies are produced by mother that crosses the placenta and saves the fetus or there are highly specific immunological mediators in the placenta that do not allow the infection to pass to the fetus.

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COVID-19 in pregnant women: a systematic review and meta-analysis on the risk and prevalence of pregnancy loss

van Baar,

Kostova,

Allotey

et al. 2023

Human Reproduction Update

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BACKGROUND Pregnant women infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are more likely to experience preterm birth and their neonates are more likely to be stillborn or admitted to a neonatal unit. The World Health Organization declared in May 2023 an end to the coronavirus disease 2019 (COVID-19) pandemic as a global health emergency. However, pregnant women are still becoming infected with SARS-CoV-2 and there is limited information available regarding the effect of SARS-CoV-2 infection in early pregnancy on pregnancy outcomes. OBJECTIVE AND RATIONALE We conducted this systematic review to determine the prevalence of early pregnancy loss in women with SARS-Cov-2 infection and compare the risk to pregnant women without SARS-CoV-2 infection. SEARCH METHODS Our systematic review is based on a prospectively registered protocol. The search of PregCov19 consortium was supplemented with an extra electronic search specifically on pregnancy loss in pregnant women infected with SARS-CoV-2 up to 10 March 2023 in PubMed, Google Scholar, and LitCovid. We included retrospective and prospective studies of pregnant women with SARS-CoV-2 infection, provided that they contained information on pregnancy losses in the first and/or second trimester. Primary outcome was miscarriage defined as a pregnancy loss before 20 weeks of gestation, however, studies that reported loss up to 22 or 24 weeks were also included. Additionally, we report on studies that defined the pregnancy loss to occur at the first and/or second trimester of pregnancy without specifying gestational age, and for second trimester miscarriage only when the study presented stillbirths and/or foetal losses separately from miscarriages. Data were stratified into first and second trimester. Secondary outcomes were ectopic pregnancy (any extra-uterine pregnancy), and termination of pregnancy. At least three researchers independently extracted the data and assessed study quality. We calculated odds ratios (OR) and risk differences (RDs) with corresponding 95% CI and pooled the data using random effects meta-analysis. To estimate risk prevalence, we performed meta-analysis on proportions. Heterogeneity was assessed by I2. OUTCOMES We included 120 studies comprising a total of 168 444 pregnant women with SARS-CoV-2 infection; of which 18 233 women were in their first or second trimester of pregnancy. Evidence level was considered to be of low to moderate certainty, mostly owing to selection bias. We did not find evidence of an association between SARS-CoV-2 infection and miscarriage (OR 1.10, 95% CI 0.81–1.48; I2 = 0.0%; RD 0.0012, 95% CI −0.0103 to 0.0127; I2 = 0%; 9 studies, 4439 women). Miscarriage occurred in 9.9% (95% CI 6.2–14.0%; I2 = 68%; 46 studies, 1797 women) of the women with SARS CoV-2 infection in their first trimester and in 1.2% (95% CI 0.3–2.4%; I2 = 34%; 33 studies; 3159 women) in the second trimester. The proportion of ectopic pregnancies in women with SARS-CoV-2 infection was 1.4% (95% CI 0.02–4.2%; I2 = 66%; 14 studies, 950 women). Termination of pregnancy occurred in 0.6% of the women (95% CI 0.01–1.6%; I2 = 79%; 39 studies; 1166 women). WIDER IMPLICATIONS Our study found no indication that SARS-CoV-2 infection in the first or second trimester increases the risk of miscarriages. To provide better risk estimates, well-designed studies are needed that include pregnant women with and without SARS-CoV-2 infection at conception and early pregnancy and consider the association of clinical manifestation and severity of SARS-CoV-2 infection with pregnancy loss, as well as potential confounding factors such as previous pregnancy loss. For clinical practice, pregnant women should still be advised to take precautions to avoid risk of SARS-CoV-2 exposure and receive SARS-CoV-2 vaccination.

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Fetomaternal outcome in COVID-19 infected pregnant women: a preliminary clinical study

Cited by 13 publications

References 10 publications

The correlation of chest x-ray findings and clinical parameters with outcome in COVID positive obstetric patients

The correlation of chest x-ray findings and clinical parameters with outcome in COVID positive obstetric patients

Study of vertical transmission of COVID-19 infection in COVID-19 positive obstetrical patients by comparing amniotic fluid and immediate neonatal COVID-19 RT-PCR

COVID-19 in pregnant women: a systematic review and meta-analysis on the risk and prevalence of pregnancy loss

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