OC04.05: The interwoven effect of maternal age and co‐morbidities in COVID‐19 fatality among pregnant women: the Mexican national cohort

Abstract

Oral communication abstracts obstetrical ultrasound for patients in underserved rural and remote communities where this service is not available. The objective of this study is to assess the feasibility of providing obstetrical ultrasound services remotely using a telerobotic ultrasound system in a remote community isolated due to COVID-19. Methods: A telerobotic ultrasound system was used to remotely perform obstetrical ultrasound exams in La Loche, Canada, a remote community without regular access to obstetrical ultrasound. Using a telerobotic ultrasound system, a sonographer 605km away remotely controlled an ultrasound probe and ultrasound settings. 21 exams were performed in a 5-week period during a COVID-19 outbreak, including limited first, second and third trimester exams (n = 11) and complete second trimester exams (n = 10). Radiologists interpreted all exams and determined adequacy of images for diagnosis. Results: Of 11 limited obstetrical exams, radiologists indicated images were adequate in 9 (81%) cases, adequate with some reservations in 1 (9%) case and inadequate in 1 (9%) case. Of 10 second trimester complete obstetrical exams, radiologists indicated images were adequate in 2 (20%) cases, adequate with some reservations in 3 (30%) cases and inadequate in 5 (50%) cases. Second trimester complete obstetrical exams were limited due to a combination of body habitus, fetal lie and telerobotic technology. Conclusions: A telerobotic ultrasound system may be used to answer focused clinical questions such as fetal viability and fetal presentation in a timely manner while minimising patient travel to larger centres and potential exposure to SARS-CoV-2 during the COVID-19 pandemic. The COVID-19 pandemic may catalyse the implementation of telerobotic sonography to bring greater accessibility and equity in the delivery of obstetrical ultrasound to patients in rural and remote communities.

Maternal and Neonatal Characteristics and its Contact Tracing of Covid-19 in Pregnancy in Cipto Mangunkusumo General Hospital

“…The average age of respondents is 28.33+4.82 years with a tendency towards young adults (21-30 years). Different from the previous study by Martinez et al 9 which showed that advanced age with an increased risk of complications and maternal death. This may be influenced by the health protocols and contact tracing which comes from asymptomatic relatives or spouses.…”

“…The majority of subjects had no comorbidities (73.5%), however Martinez et al 9 study showed that subjects with comorbidities were more common and associated with increased mortality. 9 The presence of comorbidities in a patient does not determine the risk for COVID-19, however it can increase the patient's poor outcome. Most of the pregnant women with COVID-19 had mild to moderate eJKI Vol.…”

Increased levels of soluble fms‐like tyrosine kinase‐1 are associated with adverse outcome in pregnant women with COVID‐19

“…(1) a CURB-65 score for pneumonia > 1 point; (2) persistent fever > 39 • C; (3) comorbidity such as chronic hypertension, chronic pulmonary obstructive syndrome, pregestational diabetes or treatment with immunosuppressant drugs; and (4) chest X-ray showing signs of pneumonia 16 . Asymptomatic patients and patients with negative RT-qPCR for SARS-CoV-2 were excluded, as they did not require hospital admission or additional biochemical evaluation according to our protocol.…”

A Literature Review of Advanced Maternal Age in Pregnant Women with COVID-19

“…The ACE2 receptor, which is upregulated during a typical pregnancy, is where SARS-CoV-2 enters human cells and binds. Additionally, increased expression of ACE2 receptors is linked to advancing age, which may contribute to the disease's worsening severity (Martinez Portilla et al, 2020).…”