Caesarean delivery of first prediagnosed COVID-19 pregnancy in Nigeria

Makwe, Christian Chigozie; Okunade, Kehinde Sharafadeen; Rotimi, Muyiwa; Ekor, Oluwayemisi Esther; Oyeleke, Olalekan Gabriel; Bello, Qazeem Oladele; Oluwole, Ayodeji A.; Akase, Iorhen E.; Ezenwa, Beatrice; Fajolu, Iretiola; Dada, Rotimi; Oshodi, Yewande; Olatosi, John Olutola; Opanuga, Olabisi; Omilabu, Sunday; Ezeaka, Chinyere; Afolabi, Bosede Bukola

doi:10.11604/pamj.2020.36.100.23892

Cited by 4 publications

(6 citation statements)

References 7 publications

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“…The characteristics of included trials were presented in Table 1 . A total of 269 patients from 47 studies [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] were included in our meta-analysis. The mean age of operative patients with COVID-19 was 50.91 [95% CI, 42.49; 59.34], and 49% [95% CI, 0.33, 0.65] patients were female.…”

Section: Resultsmentioning

confidence: 99%

“…Of the 47 studies included in the analysis, only 20 studies [ 16 , [18] , [19] , [20] , 24 , 25 , 29 , 32 , 39 , 42 , 45 , 46 , 50 , 53 , [55] , [56] , [57] , [58] , [59] , 61 ] reported the information of medical staff infection which identified that a total of 38 medical staff were infected, and medical staff who used biosafety level 3 (BSL-3) protective equipment during the perioperative period did not get infected.…”

Section: Resultsmentioning

confidence: 99%

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Factors affecting the mortality of patients with COVID-19 undergoing surgery and the safety of medical staff: A systematic review and meta-analysis

Wang¹,

Wu²,

Xu³

et al. 2020

EClinicalMedicine

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Background The 2019 novel coronavirus disease (COVID-19) can complicate the perioperative course to increase postoperative mortality in operative patients, and also is a serious threat to medical staff. However, studies summarizing the impact of COVID-19 on the perioperative mortality of patients and on the safety of medical staff are lacking. Methods We searched PubMed, Cochrane Library, Embase and Chinese database National Knowledge Infrastructure (CNKI) with the search terms “COVID-19″ or “SARS-CoV-2″ and “Surgery” or “Operation” for all published articles on COVID-19 from December 1, 2019 to October 5, 2020. Findings A total of 269 patients from 47 studies were included in our meta-analysis. The mean age of operative patients with COVID-19 was 50.91 years, and 49% were female. A total of 28 patients were deceased, with the overall mortality of 6%. All deceased patients had postoperative complications associated with operation or COVID-19, including respiratory failure, acute respiratory distress syndrome (ARDS), short of breath, dyspnea, fever, cough, fatigue or myalgia, cardiopulmonary system, shock/infection, acute kidney injury and severe lymphopenia. Patients who presented any or more of the symptoms of respiratory failure, ARDS, short of breath and dyspnea after operation were associated with significantly higher mortality ( r = 0.891, p < 0.001), while patients whose symptoms were presented as fever, cough, fatigue or myalgia only demonstrated marginally significant association with postoperative mortality ( r = 0.675, p = 0.023). Twenty studies reported the information of medical staff infection, and a total of 38 medical staff were infected, and medical staff who used biosafety level 3 (BSL-3) protective equipment did not get infected. Interpretation COVID-19 patients, in particular those with severe respiratory complications, may have high postoperative mortality. Medical staff in close contact with infected patients is suggested to take high level personal protective equipment (PPE). Funding Heilongjiang postdoctoral scientific research developmental fund and the National Natural Science Foundation of China.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Factors affecting the mortality of patients with COVID-19 undergoing surgery and the safety of medical staff: A systematic review and meta-analysis

Wang¹,

Wu²,

Xu³

et al. 2020

EClinicalMedicine

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“…LUTH managed the first pregnant woman with confirmed COVID-19 in Nigeria. The hospital subsequently put together a multidisciplinary team of obstetricians, anaesthetists, neonatologists, nurses, psychiatrists and infectious disease control experts to provide care for these women (Ishola, 2020; Makwe et al ., 2020).…”

Section: Methodsmentioning

confidence: 99%

A Cost Analysis of Childbirth for Pregnant Women with COVID-19 in Nigeria’s Epicentre

Banke-Thomas

Makwe

Balogun

et al. 2020

Preprint

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The Coronavirus disease 2019 (COVID-19) has been a major disruptor of health systems globally. Its emergence has warranted the need to reorganize maternity services for childbirth. However, it is not known if this comes at an additional cost to women. We conducted a hospital-based cost analysis to estimate the out-of-pocket cost of spontaneous vaginal delivery (SVD) and caesarean delivery (CD). Specifically, we collected facility-based and household costs of all nine pregnant women with COVID-19 who were managed between 1st April and 30th August 2020 at the largest teaching hospital in Lagos, the epicentre of COVID-19 in Nigeria. We compared the mean facility-based costs for the cohort with costs paid by pregnant women pre-COVID-19, identifying major cost drivers. We also estimated what would have been paid without subsidies, testing assumptions with a sensitivity analysis. Findings showed that total utilization cost ranged from US$494 (N190,150) for SVD with mild COVID-19 to US$4,553 (N1,751,165) for emergency CD with severe COVID-19. Though 32-66% of facility-based cost has been subsidized, cost of SVD and CD have doubled and tripled respectively during the pandemic compared to those paid pre-COVID. Out of the facility-based costs paid, cost of personal protective equipment (PPE) was the major cost driver (50%) for SVD and CD. Supplemental oxygen was a major cost driver when women had severe COVID-19 symptoms and required long admission (48%). Excluding treatment costs specifically for COVID-19, mean facility-based costs for SVD and CD are US$228 (N87,750) and US$948 (N364,551) respectively. Our study demonstrates that despite cost exemptions and donations, utilization costs remain prohibitive. Regulation of the PPE and medical oxygen supply chain can help drive down utilization cost and reduce mark-ups being passed to users. The pandemic offers an opportunity to expand advocacy for subscription to health insurance schemes in order to avoid any catastrophic health expenditure.

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“…[5][6][7] However, although pregnant women are not necessarily more susceptible to infection by the virus, changes to their immune system in pregnancy may be associated with more severe symptoms. 8 Adverse maternal and perinatal outcomes have been reported among pregnant women with COVID-19infection, including maternal pneumonia and maternal death, intrauterine fetal death/stillbirth, preterm birth, neonatal pneumonia/sepsis, disseminated intravascular coagulopathy and neonatal death. [9][10][11] Though congenital infection with COVID-19 infection has not been documented, and the virus has not been detected in expelled products of conception, the possibility of vertical transmission exists.…”

Section: Introductionmentioning

confidence: 99%

“…6,9,10 Literature on the antenatal and perinatal management and outcomes of COVID-19infection in pregnancy in Nigeria and sub-Saharan Africa is gradually emerging, but sparse. 8 Clinical characterisation of COVID-19 infection in pregnancy is important for prognostication, health care guidelines and policy formulation. The few studies done in Nigeria, though did not document significant association between COVID-19 infection in pregnancy and adverse maternal and perinatal outcomes, did not compare these outcomes with that of the general pregnant population.…”

Section: Introductionmentioning

confidence: 99%

Clinical characterisation and management outcomes of COVID-19 infection in pregnancy in a Nigerian tertiary hospital

Ijarotimi

Ubom

Awowole

et al. 2021

Int J Reprod Contracept Obstet Gynecol

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Background: Literature on the antenatal and perinatal management and outcomes of COVID-19 infection in pregnancy in Nigeria and sub-Saharan Africa is gradually emerging but sparse. There is an urgent need to build up the knowledge base of COVID-19 infection in Nigerian pregnant women. The objective of the current study was to determine the clinical characteristics and management outcomes of COVID-19 infection in pregnancy at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Nigeria.Methods: A one-year retrospective review of all cases of COVID-19 infection in pregnancy managed at the OAUTHC. Relevant data were extracted from the case records of all cases managed using a purpose-designed proforma. Data collected was analysed using IBM-SPSS, version 24. Associations between categorical variables were assessed using chi square, with level of significance set at <0.05.Results: A total of 22 cases were managed. Majority (15, 68.2%) of the women were either asymptomatic or had mild symptoms. The commonest symptom was cough (8, 36.4%). The mean duration of admission was 6.6±4.2 days. The most common maternal and perinatal complication was preterm delivery/birth (3, 13.6%). There was no maternal mortality. The mean birth weight of the babies was 3226g±597g, with mean 1- and 5- minutes Apgar scores of 8.0±1.3 and 9.5±0.6 respectively.Conclusions: Although COVID-19 infection in pregnancy is an asymptomatic or mild infection in the majority of cases in Ile-Ife, Nigeria, it is associated with adverse maternal and perinatal outcomes. Further studies are recommended to determine transplacental transmission of COVID-19 infection and antibodies.

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Caesarean delivery of first prediagnosed COVID-19 pregnancy in Nigeria

Cited by 4 publications

References 7 publications

Factors affecting the mortality of patients with COVID-19 undergoing surgery and the safety of medical staff: A systematic review and meta-analysis

Factors affecting the mortality of patients with COVID-19 undergoing surgery and the safety of medical staff: A systematic review and meta-analysis

A Cost Analysis of Childbirth for Pregnant Women with COVID-19 in Nigeria’s Epicentre

Clinical characterisation and management outcomes of COVID-19 infection in pregnancy in a Nigerian tertiary hospital

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