COVID-19 in pregnant women: Clinical manifestations and management

Abstract

Introduction: The clinical presentation of COVID-19 varies from asymptomatic to severe complications, raising concerns about transmission risks and maternal- fetal outcomes in pregnant women. This study describes the clinical manifestations and management of severe SARS-CoV-2 infections in pregnancy. Methods: A retrospective descriptive study was conducted at Menzel Temime Regional Hospital, Tunisia, from January to August 2021, including seven pregnant women with severe SARS-CoV-2 infection. Data on clinical presentation, diagnostic findings, treatment, and maternal-neonatal outcomes were collected from medical records. Results: All cases presented in the third trimester with pneumonitis, with 71.4% classified as moderate to severe and 28.6% as critical. Fever (71.4%), cough (57.1%), and lymphopenia (71.4%) were common. Cesarean delivery was performed in 57.1% of cases. Three newborns tested positive for SARS-CoV-2, requiring pediatric hospitalization for respiratory distress, with no neonatal deaths. One maternal death occurred due to multi-organ failure. All patients received oxygen, antibiotics, corticosteroids, and anticoagulants, with one requiring mechanical ventilation. Conclusion: Management of severe COVID-19 in pregnancy aligns with general population protocols, emphasizing multidisciplinary care. Vertical transmission appears rare, with minimal neonatal impact. Enhanced screening and preventive measures are crucial to reduce maternal morbidity.