Obstetric and perinatal outcomes in the first wave of COVID-19 infected pregnant women

Abstract

Objective: The COVID-19 pandemic continues to be a rapidly evolving situation with limited data on its impact on pregnancy. The study was conducted to evaluate the maternal and perinatal outcomes of pregnant women in the first wave of COVID-19 infection Materials and Methods: Clinical records were retrospectively reviewed for 129 pregnant women with laboratory confirmed COVID-19 infection admitted in the Department of Obstetrics and Gynecology, Regional Institute of Medical Sciences, Imphal (Manipur, India) from 27th July to 27th November 2020. The maternal and perinatal outcomes were collected and analyzed. Evidence of perinatal transmission of the virus was assessed with SARS-Cov-2 Reverse transcriptase polymerase chain reaction testing done on oropharyngeal swab of neonate taken 24 to 48 hours after delivery.Results: Of the 129 cases, 119 (92.24%) were asymptomatic and two (1.55%) had severe symptoms with one necessitating intensive care unit (ICU) admission and ventilatory support, subsequently causing maternal death. There were three cases (2.33%) of abortion, two ectopic pregnancies (1.55%) and ten preterm deliveries (8.54%). Two cases of neonatal asphyxia were observed, both requiring admission with one resulting in neonatal death. Furthermore, two out of 83 neonates were tested positive for COVID-19 on oropharyngeal swab. Conclusion: Majority of the COVID-19 positive pregnant women were asymptomatic in the first wave and associated with good obstetric and perinatal outcome, however, severe case was associated with increased risk of ICU admission and mechanical ventilation ultimately leading to maternal death. Probable chances of vertical transmission of COVID-19 infection could not be ruled out at present.