BACKGROUND Mode of delivery has become an important highlight in managing pregnancy with coronavirus disease 2019 (COVID-19) due to the possible risk of viral transmission from mother to baby, especially during the peripartum period. This study aimed to review the mode of delivery and the possible risk of vertical transmission related to delivery routes in pregnant women with COVID-19. METHODS Literature research was conducted using PubMed, Scopus, Embase, and EBSCO database with the following keywords: SARS-CoV-2, COVID-19, pregnancy, vertical transmission, and delivery. The extracted data were as follows: author, country, study design number of cases, maternal age, mode of delivery, and the SARS-CoV-2 status in neonates. RESULTS Of 11 studies found, vaginal birth was reported in 218 cases (34.53%) and cesarean delivery was reported in 385 women (65.47%). The indication for cesarean delivery was majority due to COVID-19 related condition (53.61%). In total, 8 neonates who confirmed positive for COVID-19 by real-time polymerase chain reaction assay were reported. The pooled odds ratio (95% confidence interval) for SARS-CoV-2-positive neonates in cesarean delivery compared with vaginal birth was 0.622 (0.237–1.633) with p = 0.335. CONCLUSIONS Cesarean delivery is more common than vaginal delivery in patient with SARS-CoV-2 infection. Any delivery route is not related to possible risk of intrapartum vertical transmission, and cesarean delivery should be carried out based on the obstetric indication.

COVID-19 affecting the outcome of pregnancy is still under investigation. Here we report a case of primigravida with monochorionic diamniotic twin pregnancy with superimposed preeclampsia who develop symptoms of COVID-19 infection on her near term pregnancy and was confirmed later on as COVID-19 positive after cesarean section. The pregnancy was terminated abdominally due to the intrauterine fetal demise of both twins using COVID-19 standard equipment.

Talasemia termasuk satu jenis hemoglobinopati, merupakan penyakit genetik yang paling umum di dunia. Kehamilan dengan talasemia mayor berisiko hipoksia janin, pembatasan pertumbuhan intrauterin, prematuritas dua kali kehamilan normal. Kami melaporkan kasus kehamilan pada pasien dengan talasaemia yang diobati dengan buruk, yaitu seorang wanita hamil berusia 28 tahun. Dia datang ke klinik rawat jalan obstetrik untuk perawatan antenatal pertama. Usia kehamilannya adalah 19-20 minggu. Dia didiagnosis dengan talasemia mayor sebelumnya, namun diobati dengan buruk. Dia pucat dan limpanya diperbesar dengan skor Schuffner berjumlah empat. Wajahnya menunjukkan wajah Cooley yang khas ditemukan pada pasien talasemia. Kadar hemoglobin awalnya adalah 2,2 g / dL dengan eritrosit mikrositik hipokromik. Setelah itu, ia menjalani 4 seri transfusi sel darah merah hingga melahirkan. Elektrokardiografi menunjukkan hipertrofi ventrikel kiri dengan iskemia global. Kehamilan dihentikan oleh operasi caesar elektif dengan indikasi disproporsi sefalopelvik. Tidak ada komplikasi intrapartum dan postpartum pada pasien ini. Bayinya 2,800 gram dan panjang 47 cm. Selanjutnya, tidak ada kelainan yang ditemukan pada pemeriksaan neonatal. Kesimpulan untuk presentasi kasus ini adalah menekankan pentingnya pembuatan diagnosis dan pengobatan yang optimal dari talasemia mayor selama kehamilan. Kolaborasi ahli obstetri, ahli jantung, hematologi, dan neonatologis diperlukan untuk mencapai hasil kehamilan yang menguntungkan pada pasien hamil besar thalassemia.