A review of 92 obstetric patients with COVID-19 in the Bronx, New York and their peripartum anaesthetic management

Abstract

Coronavirus disease 2019 , caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first reported in New York City (NYC) on 1 March 2020 [1]. NYC was one of the earliest and most profoundly impacted cities in the United States (US) by the COVID-19 pandemic, which continues to be a global crisis. As of 1 December 2020, NYC has recorded more than 290,000 confirmed cases and 19,000 deaths [2].The Bronx is a borough of NYC and has been the most devastated by COVID-19, with case rates considerably higher than its sister boroughs of Manhattan, Brooklyn, Queens, and Staten Island [3]. The borough is also home to the poorest congres-

Safety of spinal anesthesia in pregnant vaccinated with one or two doses of the BNT162b2 vaccine: A retrospective observational cohort study

“… 16 However, later studies found only a small fraction of thrombocytopenia in pregnant patients with mild or moderate acute Covid-19, which did not interfere with performing the spinal block. 17 , 18 This same concern has also been raised in patients vaccinated with vaccine mRNA-1273 due to reported cases of platelet abnormalities. Some suspected cases of primary or secondary thrombocytopenic purpura possibly related to the BNT162b2 vaccine have been reported.…”

Desfechos clínicos e perinatais de gestantes com e sem Covid-19 não vacinadas submetidas a parto cesariano: estudo de coorte retrospectivo

“…Outros estudos demonstraram um percentual diferente de internação na UTI em pacientes gestantes com Covid-19, variando de 4,7 a 6,5% (Breslin et al, 2020;Ababneh et al, 2021). O percentual de mortes nessas pacientes (2,2%) também variou em outros estudos, de 0,0% -3,2% (D´Antonio et al, 2021;Antolín et al, 2021;Bartolomé et al, 2022;Ioscovich et al, 2021;Chen et al, 2021).…”

“…O Apgar de 1° minuto foi significativamente menor nos recém-nascidos de gestantes com Covid-19 (23,3%), resultado esse diferente ao de outro estudo multicêntrico (Espanha, Israel, Portugal), que encontrou 5,46% de recém-nascidos com Apgar ≤ 7 (Ioscovich et al, 2021). A maior chance de necessidade de UTI Neonatal (18,3%) em recém-nascidos de gestantes com Covid-19 foi encontrada em outros estudos com variação de 8,7% a 36,4% (D´Antonio et al, 2021;Antolín et al, 2021;Ababneh et al, 2021;Chen et al, 2021;Gurol-Urganci et al 2021. Ao se calcular o risco relativo, encontrou-se que os recém-nascidos de gestantes com Covid-19 não vacinadas possuem 73% mais risco de internação na UTI Neonatal (RR = 1,73; 95% CI: 0,73 -4,14).…”

“…Quatro recém-nascidos (4,3%) evoluíram para óbito durante a internação, com taxa de mortalidade calculada derivada de Covid-19 materna de 2,15% (2/93). Em outros estudos, essa taxa variou de 0,9% -2,2% (Chen et al, 2021;D´Antonio et al, 2021;Antolín et al, 2021). Desse modo, ao se calcular o risco relativo, encontrou-se que os recémnascidos oriundos de gestantes com Covid-19 possuem 2,45 vezes mais risco de ir a óbito, em relação aos recém-nascidos de gestantes sem Covid-19.…”

Hemodynamic changes in patients with SARS-CoV-2 infection presenting for cesarean delivery under spinal anesthesia: a retrospective case-control study

“…Coronavirus disease 2019 (COVID-19) in pregnancy, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is associated with adverse maternal and neonatal outcomes, including increased risk for preterm delivery, cesarean delivery, and overall maternal morbidity and mortality. 1 , 2 , 3 , 4 , 5 , 6 The increased cesarean delivery rate has been attributed to critical maternal status, especially severe COVID-19 and preeclampsia. 4, 6 Increased COVID-19 severity is associated with higher odds of adverse peripartum outcomes.…”