Obstetric and perinatal outcomes in the first wave of COVID-19 infected pregnant women

Devi, Khwairakpam Selina; Devi, Aheibam Bidya; Singh, Moirangthem Rameswar; Singh, Lavleen; Bharati, S Dhivya

doi:10.33545/gynae.2021.v5.i5b.1024

Cited by 2 publications

(1 citation statement)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Maternal mortality rate in our study was 6.7%, while it was found to be 11% in a study by Kanhere et al, Kanwar et al reported this as 12%, Siddiq et al of 9.7%, while Devi et al reported no mortality in their studies. 4,[7][8][9] There were no significant differences noted between total and subtotal in terms of maternal or delivery characteristics. Subtotal hysterectomy was easy to perform but has a rare risk of development of cancer cervix and it has no role in cases of placenta previa or adherent placenta.…”

Section: Discussionmentioning

confidence: 99%

A retrospective analysis of obstetric hysterectomy in a tertiary center over one year

Khandkar,

Jain

2023

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

Background: Obstetric hysterectomy is a lifesaving procedure in a setting of life-threatening obstetrical hemorrhage. There is and increasing need of obstetric hysterectomy due to rising cases of caesarean sections and morbidly adherent placenta. We aimed to study the incidence, indications and fetomaternal outcome of obstetric hysterectomy. Various risk factors are discussed which may be helpful in reducing maternal and neonatal morbidity. Methods: A one year hospital based retrospective study involving detailed medical records of patients who underwent obstetric hysterectomy between 1st April 2022 and 31st march 2023. Results: The overall incidence of obstetric hysterectomy was 0.2% in this study with majority of patients in the 20-25-year age group, and patients who were 2nd and 3rd para comprised of the maximum number. The indication identified in this study were morbidly adherent placenta followed by atonic PPH and caesarean scar ectopic. The major risk factors noted were previous LSCS in 60% and morbidly adherent placenta in 53.3% patients. Of the 15 patients, 60% underwent total while 40% underwent subtotal hysterectomy. ICU admission, fever and coagulopathy were the leading post op complications. There was one case of maternal death noted and one case each of intrauterine death and perinatal mortality. Conclusions: Obstetric hysterectomy is the last resort to intractable bleeding and hence an important lifesaving procedure. The feto-maternal outcome depends on timely decision, surgical techniques and stringent post op monitoring of these patients.

show abstract

Section: Discussionmentioning

confidence: 99%

A retrospective analysis of obstetric hysterectomy in a tertiary center over one year

Khandkar,

Jain

2023

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

show abstract

COVID-19 in pregnant women: a systematic review and meta-analysis on the risk and prevalence of pregnancy loss

van Baar,

Kostova,

Allotey

et al. 2023

Human Reproduction Update

View full text Add to dashboard Cite

BACKGROUND Pregnant women infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are more likely to experience preterm birth and their neonates are more likely to be stillborn or admitted to a neonatal unit. The World Health Organization declared in May 2023 an end to the coronavirus disease 2019 (COVID-19) pandemic as a global health emergency. However, pregnant women are still becoming infected with SARS-CoV-2 and there is limited information available regarding the effect of SARS-CoV-2 infection in early pregnancy on pregnancy outcomes. OBJECTIVE AND RATIONALE We conducted this systematic review to determine the prevalence of early pregnancy loss in women with SARS-Cov-2 infection and compare the risk to pregnant women without SARS-CoV-2 infection. SEARCH METHODS Our systematic review is based on a prospectively registered protocol. The search of PregCov19 consortium was supplemented with an extra electronic search specifically on pregnancy loss in pregnant women infected with SARS-CoV-2 up to 10 March 2023 in PubMed, Google Scholar, and LitCovid. We included retrospective and prospective studies of pregnant women with SARS-CoV-2 infection, provided that they contained information on pregnancy losses in the first and/or second trimester. Primary outcome was miscarriage defined as a pregnancy loss before 20 weeks of gestation, however, studies that reported loss up to 22 or 24 weeks were also included. Additionally, we report on studies that defined the pregnancy loss to occur at the first and/or second trimester of pregnancy without specifying gestational age, and for second trimester miscarriage only when the study presented stillbirths and/or foetal losses separately from miscarriages. Data were stratified into first and second trimester. Secondary outcomes were ectopic pregnancy (any extra-uterine pregnancy), and termination of pregnancy. At least three researchers independently extracted the data and assessed study quality. We calculated odds ratios (OR) and risk differences (RDs) with corresponding 95% CI and pooled the data using random effects meta-analysis. To estimate risk prevalence, we performed meta-analysis on proportions. Heterogeneity was assessed by I2. OUTCOMES We included 120 studies comprising a total of 168 444 pregnant women with SARS-CoV-2 infection; of which 18 233 women were in their first or second trimester of pregnancy. Evidence level was considered to be of low to moderate certainty, mostly owing to selection bias. We did not find evidence of an association between SARS-CoV-2 infection and miscarriage (OR 1.10, 95% CI 0.81–1.48; I2 = 0.0%; RD 0.0012, 95% CI −0.0103 to 0.0127; I2 = 0%; 9 studies, 4439 women). Miscarriage occurred in 9.9% (95% CI 6.2–14.0%; I2 = 68%; 46 studies, 1797 women) of the women with SARS CoV-2 infection in their first trimester and in 1.2% (95% CI 0.3–2.4%; I2 = 34%; 33 studies; 3159 women) in the second trimester. The proportion of ectopic pregnancies in women with SARS-CoV-2 infection was 1.4% (95% CI 0.02–4.2%; I2 = 66%; 14 studies, 950 women). Termination of pregnancy occurred in 0.6% of the women (95% CI 0.01–1.6%; I2 = 79%; 39 studies; 1166 women). WIDER IMPLICATIONS Our study found no indication that SARS-CoV-2 infection in the first or second trimester increases the risk of miscarriages. To provide better risk estimates, well-designed studies are needed that include pregnant women with and without SARS-CoV-2 infection at conception and early pregnancy and consider the association of clinical manifestation and severity of SARS-CoV-2 infection with pregnancy loss, as well as potential confounding factors such as previous pregnancy loss. For clinical practice, pregnant women should still be advised to take precautions to avoid risk of SARS-CoV-2 exposure and receive SARS-CoV-2 vaccination.

show abstract

Obstetric and perinatal outcomes in the first wave of COVID-19 infected pregnant women

Cited by 2 publications

References 7 publications

A retrospective analysis of obstetric hysterectomy in a tertiary center over one year

A retrospective analysis of obstetric hysterectomy in a tertiary center over one year

COVID-19 in pregnant women: a systematic review and meta-analysis on the risk and prevalence of pregnancy loss

Contact Info

Product

Resources

About