Clinical analysis of maternal and fetal outcomes in COVID-19 pregnant women undergoing cesarean section in a tertiary care center in Hyderabad, India

Abstract

The outbreak of coronavirus disease 2019(COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is spreading globally at an accelerated rate. A serious public health threat, it has caused a major impact on health care systems with a significantly high mortality and morbidity. Physiological changes and immuno-compromised state make pregnant women vulnerable during infectious disease outbreaks and hence need a more cautious approach. With this report we aim to share our experience regarding clinical characteristics, management and outcomes of 10 diagnosed COVID-19 pregnant women undergoing cesarean section at Medicover hospital, a tertiary-care center in Hyderabad, India between July to September 2020. All 10 pregnant women were referred in their third trimester with diagnosis of COVID-19. 2 out of 10 patients had severe COVID-19 and were managed in the ICU. All patients underwent emergency cesarean sections and none of the infants were infected with COVID-19. At discharge, all patients and the newborns were in a clinically stable condition. Effective management strategies incorporating integrated team approach, early cesarean section and low-threshold for mechanical ventilation has been shown to be associated with favorable outcomes for mothers diagnosed with COVID-19 and their infants. Also, the present data does not support any evidence of vertical transmission of SARS-CoV-2 virus in those manifesting during the third trimester of pregnancy.