COVID-19 AND PREGNANCY-OUR EXPERIENCES

  • Marija Cvetanovska University Clinic for Infectious Diseases and Febrile Conditions, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia,
  • Ilir Demiri University Clinic for Infectious Diseases and Febrile Conditions, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia,
  • Krsto Grozdanovski University Clinic for Infectious Diseases and Febrile Conditions, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia,
  • Katerina Spasovska University Clinic for Infectious Diseases and Febrile Conditions, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia,
  • Ana Daneva- Markova University Clinic of Gynecology and Obstetric, Clinical Centre “Mother Theresa”, Faculty of Medicine, University of Ss. Cyril and Methodius in Skopje, R of North Macedonia
  • Tatjana Stojanoska University Clinic for Infectious Diseases and Febrile Conditions, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia,
  • Vlatko Cvetanovski General Hospital Remedika Skopje, R.of North Macedonia

Abstract

A retrospective analysis was made on 35 patients: 25 pregnant women and 10women in the early postpartum period with clinical and laboratory confirmed COVID 19. On admission demographic, clinical, lab parameters, comorbidities, complications and parameters correlated with the pregnancy and the mode of delivery were observed. Sars Cov 2 was confirmed in a nasopharyngeal swab with a molecular method of RT-PCR. The average age was 30.7 years old. 21(84%) were in their third trimester and 16 (45.7%) had comorbidities. The most common complication was pneumonia 31 (88.57%) and the most frequent symptoms were: fever 26 (74.2%), cough 25 (71.4%), malaise 19 (54.28%) and dyspnea 15 (42.85%). 20 (57.4%) patients displayed severe clinical condition with need of oxygen support and they were all treated in the  intensive care unit. 3 (15% ) were placed on non-invasive ventilation, and 4 (20%) needed mechanical ventilation, all of them in the postpartum period. Mortality rate was 3 (8.57%) and it was registered only in the postpartum period.Covid 19 in pregnancy and among the general population shares the same clinical manifestations. Pregnant women having pneumonia, more than one comorbidity, are in the third trimester of their pregnancy or in their postpartum period, were pointed out as having the highest risk of getting severe clinical condition and a poor outcome. In the light of the above, these are the patients in need of intensive observation and monitoring, as well asnecessary, strict anti-epidemic measures and prioritized vaccination.


Key words: Covid 19, pregnancy.

References

1. World Health Organization. https://www.who.int/news/item/27-04-2020-who-timeline-covid-19. Accessed 7 Jan 2021.
2. World Health Organization Covid-19 Dashboard. https://covid19.who.int/. Accessed 7 Jan 2021.
3. Komal S.H , Rasha A., Litty P, Nimmi K, Zukaa A, Hozaifah M, Taghrid F.A E, Maryam A, Khalid M, Atif B.F, Amar H, Riad B.Covid-19 infection in pregnant women in Dubai: a case-control study BMC Pregnancy Childbirth, 2021 Sep 28;21(1):658.
4. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, China Novel Coronavirus Investigating and Research Team et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382:727–733.
5. Schwartz DA. An analysis of 38 pregnant women with COVID-19, their newborn infants, and maternal-fetal transmission of SARS-CoV-2: maternal coronavirus infections and pregnancy outcomes. Arch Pathol Lab Med. 2020 Jul 1;144(7):799–805.
6. World Health Organization Clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspected: interim guidance. 2020;28
7. NCDC interim guidance Infection prevention and control recommendations during health care provision for suspected and confirmed cases of COVID-19. NCDC interim guidance. 2020.
8. Harrison A.G., Lin T., Wang P. Mechanisms of SARS-CoV-2 transmission and pathogenesis. Trends Immunol. 2020 doi: 10.1016/j.it.2020.10.004.
9. Figliozzi S., Masci P.G., Ahmadi N., Tondi L., Koutli E., Aimo A., Stamatelopoulos K., Dimopoulos M.A., Caforio A.L.P., Georgiopoulos G. Predictors of adverse prognosis in COVID-19: a systematic review and meta-analysis. Eur. J. Clin. Invest. 2020;50 doi: 10.1111/eci.13362.
10. Goodnight WH, Soper DE. Pneumonia in pregnancy. Crit Care Med. 2005;33:S390‐S397.
11. O’Day MP. Cardio‐respiratory physiological adaptation of pregnancy. Semin Perinatol. 1997;21:268‐275.
12. Wong SF, Chow KM, Leung TN, Ng WF, Ng TK, Shek CC, et al. Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome. Am J Obstet Gynecol. 2004;191:292–297.
13. Jamieson DJ, Honein MA, Rasmussen SA, Williams JL, Swerdlow DL, Biggerstaff MS. Novel Influenza A (H1N1) Pregnancy Working Group et al. H1N1 2009 influenza virus infection during pregnancy in the USA. Lancet. 2009;374:451–458.
14. Siston AM, Rasmussen SA, Honein MA, Fry AM, Seib K, Callaghan WM, Pandemic H1N1 Influenza in Pregnancy Working Group et al. Pandemic 2009 influenza A(H1N1) virus illness among pregnant women in the United States. JAMA. 2010;303:1517–1525.
15. Schwartz DA, Graham AL. Potential maternal and infant outcomes from (Wuhan) Coronavirus 2019-nCoV infecting pregnant women: lessons from SARS, MERS, and other human coronavirus infections. Viruses. 2020;12:194.
16. Kathryn M Moore , Mehul S Suthar: Comprehensive analysis of COVID-19 during pregnancy: BiochemBiophys Res Commun. 2021 Jan 29;538:180-186.
17. Di Mascio D, Khalil A, Saccone G, Rizzo G, Buca D, Liberati M et al. Outcome of Coronavirus spectrum infections (SARS, MERS, COVID-19) during pregnancy: a systematic review and metaanalysis. Am J ObstetGynecol MFM. 2020 May;2(2): 100107.
18. Yan J, Guo J, Fan C, Juan J, Yu X, Li J, Feng L, Li C, Chen H, Qiao Y, Lei D, Wang C, Xiong G, Xiao F, He W, Pang Q, Hu X, Wang S, Chen D, Zhang Y, Poon L, Yang H. Coronavirus disease 2019 (COVID-19) in pregnancy women: A report based on 116 cases.Am J Obstet Gynecol. 2020.
19. Pedro C, Ana P M, Heron W,Flávia P L, Gabriele T, Edward A J: Covid-19 and Pregnancy: An Overview, Rev Bras GinecolObstet 2020;42(7):420–426.
20. Francesca D.T, Mattheus G., Giovanni D.L, Davide D.S, Francesco D.S, Gianpaolo M, Francesco M.R., Federico R., Uri W., Roberto L.-D'Ancona , Luca R. , Giuseppe R. Impact of COVID-19 on maternal and neonatal outcomes: a systematic review and meta-analysis Clin Microbiol Infect. 2021 Jan;27(1):36-46.
21. James , E Michael , U Charles , N Kingsley ,Y Sofiat, A Adedapo.Clinical characteristics and outcomes for pregnant women diagnosed with COVID-19 disease at the University of Benin Teaching Hospital, Benin City, Nigeria. Pan Afr Med J. 2021 Jun 16;39:134.
22. Liu H, Liu F, Li J, Zhang T, Wang D, Lan W. Clinical and CT imaging features of the COVID-19 pneumonia: focus on pregnant women and children. J Infect. 2020 May;80(5).
23. Huang C, Wang Y, Li X, et al. Clinical features of patients infectedwith 2019 novel coronavirus in Wuhan, China. Lancet.2020;395:497-506.
24. Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet. 2020 Mar 7;395(10226):809–815.
25. Adhikari H, Moreno W, Zofkie A, MacDonald L, McIntire D, Collins R, et al. Pregnancy outcomes among women with and without severe acute respiratory syndrome coronavirus 2 Infection. JAMA Netw Open. 2020;3(11).
26. Gao YD, Ding M, Dong X, Zhang JJ, KursatAzkur A, Azkur D, Gan H, Sun YL, Fu W, Li W, Liang HL, Cao YY, Yan Q, Cao C, Gao HY, Brüggen MC, van de Veen W, Sokolowska M, Akdis M, Akdis CA. Risk factors for severe and critically ill COVID-19 patients: A review.Allergy. 2021 Feb;76(2):428-455.
27. Weifeng S, Junwu D, Yali R, Ming T, Wei L, Jianwu H, Yuanyuan L.The value of clinical parameters in predicting the severity of COVID-19.J Med Virol. 2020 Oct;92(10):2188-2192.
Published
2021-12-29
How to Cite
CVETANOVSKA, Marija et al. COVID-19 AND PREGNANCY-OUR EXPERIENCES. Journal of Morphological Sciences, [S.l.], v. 4, n. 3, p. 131-137, dec. 2021. ISSN 2545-4706. Available at: <https://jms.mk/jms/article/view/291>. Date accessed: 20 jan. 2022.
Section
Articles