Clinical Profile of Pregnant Women with COVID-19 Hospitalized in Regional Referral Hospital

Abstract

Objective: To determine the clinical profile of pregnant women with COVID-19 who hospitalized in a referral hospital.Methods: This was a descriptive study conducted on pregnant women with COVID-19 who were hospitalized at Regional Hospital of Bau-Bau and Bahteramas Hospital in Southeast Sulawesi from May to July 2020. The confirmation of COVID-19 was based on RT-PCR. Data including characteristics, clinical profile, laboratory test, imaging, management, and outcomes.Results: There were 41 pregnant women with COVID-19 and no maternal death cases. Maternal age was approximately 19 to 39 years, had middle education levels, and was a housewife. Most of them did not know their closed contacts, had no comorbidities, and referrals from other hospitals. They were 3rd-trimester and hospitalized with complaints related to pregnancy. Only 3 cases had complaints related to COVID-19, namely fever and cough. The majority of laboratory tests were leucocytosis. Chest X-ray shows bronchopneumonia, pneumonia, and normal imaging. Obstetrics management was performed according to the condition of the mother and fetus, including vaginal delivery, cesarean section, and curettage. The treatment was using broad-spectrum antibiotics and antiviral. Complications in the fetus/infant were abortion, fetal distress, LBW, and asphyxia.Conclusion: Pregnant women with COVID-19 have mild or asymptomatic symptoms, hospitalized with complaints related to their pregnancy, and treatment according to the condition of the mother and fetus. There are no complications in the mother, while complications in the baby are not clear.Keywords: COVID-19, pregnant women, referral hospital.
 
 Abstrak 
 Tujuan: Mengetahui gambaran klinis ibu hamil dengan COVID-19 yang masuk di rumah sakit rujukan COVID-19.Metode: Penelitian ini bersifat deskriptif yang dilakukan pada ibu hamil dengan COVID-19 yang dirawat di rumah sakit rujukan di Sulawesi Tenggara, yaitu RSUD Bau-Bau dan RSU Bahteramas di Kendari, pada bulan Mei sampai Juli 2020. Konfirmasi positif COVID-19 berdasarkan hasil pemeriksaan RT-PCR. Data berupa karakteristik, gambaran klinis, pemeriksaan penunjang, penatalaksanaan, dan luaran. Hasil: Terdapat 41 ibu hamil dengan COVID-19 dan tidak ada kasus kematian ibu. Usia ibu berkisar 19-39 tahun, tingkat pendidikan menengah, dan sebagai ibu rumah tangga. Sebagian besar kasus pada trimester-3, tidak tahu memiliki kontak erat, tidak memiliki komorbid, dan rujukan dari RS lain. Sebagian besar dirawat dengan keluhan terkait kehamilannya dan hanya 3 kasus dengan keluhan terkait COVID-19, yaitu demam dan batuk. Pemeriksaan laboratorium menunjukkan lekositosis. Gambaran foto toraks menunjukkan bronkopneumonia, pneumonia, dan normal. Tindakan obstetri dilakukan atas indikasi ibu dan janin, yaitu persalinan normal, seksio sesarea, dan kuretase. Terapi yang digunakan adalah antibiotic spectrum luas dan antivirus. Komplikasi pada janin/bayi berupa abortus, gawat janin, BBLR, dan asfiksia. Kesimpulan: Ibu hamil dengan COVID-19 memiliki gejala ringan atau asimtomatik, dirawat dengan keluhan terkait kehamilannya, dan dilakukan tindakan obstetri sesuai dengan indikasi ibu dan janin. Tidak ada komplikasi pada ibu, sedangkan komplikasi pada bayi belum jelas.Kata kunci: COVID-19, ibu hamil, rumah sakit rujukan

Pregnancy and COVID-19

“…In this study, we found the majority of the pregnant women suffers from Covid-19 in 3 rd trimester of pregnancy (85.39%). This result study is similar to other study from Saimin et al, they identified most of pregnant women suffers from Covid-19 at 3 rd trimester (87.8%) [10]. Most of pregnant women who come to hospital because of obstetric complaints, example giving birth or with complications in her pregnancy.…”

“…Some potential answers might be explained. During pregnancy, immunologic changes of pregnancy may suppress virus virulence, interfere virus pathophysiology by modulating expression of ACE-2 receptor, and produce extra steroid hormone for interfering the fat content of virus envelope to prevent severe lung injury [10].…”

Clinical Overview in Pregnancy with COVID-19 at prof. Dr. I.G.N.G. Ngoerah Hospital Period of April 2020-March 2021

“…In NLR, there is a significant difference between number of participants than this study. This might be affected by the level of local spread of the disease, the protocol for treating COVID-19, and the place where the study was conducted (hospital types: Primary, secondary, or tertiary hospitals) [9], [10]. The participants age distribution in this study (mostly 26-30 years old) correlates with other studies with median age 29 years old [9] and 31 years old [11].…”

Impact of COVID-19 Pandemic on Postpartum Contraceptives Method Choice (IUD vs Tubectomy) and Characteristic Aspects: A Retrospective Descriptive Study

“…3 The clinical signs and symptoms of COVID-19 in most cases were fever, and some cases have dyspneu. 4 The COVID-19 pandemic has the potential to significantly disrupt the achievement of family planning programs by 2030. Lockdown measures imposed on communities and the risk of infection among healthcare workers make it imperative to anticipate barriers to reproductive health services during the COVID-19 pandemic.…”