E-ISSN: 2619-9467

Contents    Cover    Publication Date: 20 Sep 2023
Year 2023 - Volume 33 - Issue 3

Open Access

Peer Reviewed

1170 Viewed947 Downloaded

Impact of Mode of Birth and Type of Anesthesia on Clinical Outcomes of Pregnant Women with COVID-19 in a Referral Pandemic Hospital: An Analytical Study

Full Text PDF  
JCOG. 2023;33(3):133-42
DOI: 10.5336/jcog.2023-96995
Article Language: EN
Copyright Ⓒ 2020 by Türkiye Klinikleri. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
Objective: During the pandemic, pregnant women were more likely to develop severe illness, necessitating critical care, and require mechanical ventilation. Birth of the pregnant women can be necessary for the rapid decline in mother's clinical situation or for obstetric indication. This study aimed to investigate the clinical outcomes of pregnant women who gave birth during coronavirus disease-2019 (COVID-19) isolation period with regard to mode of birth and type of anesthesia in cesarean delivery. Material and Methods: The clinical outcomes of pregnant women who were admitted to the hospital, confirmed to be infected with severe acute respiratory syndrome-coronavirus-2, and gave birth during the hospitalization for COVID-19 treatment or isolation period between March, 2020 and November, 2021were analyzed according to mode of birth and type of anesthesia, retrospectively. Results: Among all pregnant women, 106 (%35.45) gave birth vaginally while 193 (64.55%) underwent cesarean section. Out of all cesarean births, 55 (28.5%) and out of all vaginal births, 2 (1.9%) had indication of birth as deterioration of maternal clinical status. Intensive care unit admission rate was 23.3%, maternal mortality rate was 11.9%, and preterm birth rate (
  1. Tug N, Yassa M, Köle E, Sakin Ö, Çakır Köle M, Karateke A, et al. Pregnancy worsens the morbidity of COVID-19 and this effect becomes more prominent as pregnancy advances. Turk J Obstet Gynecol. 2020;17(3):149-54. [Crossref]  [PubMed]  [PMC] 
  2. Tekin AB, Yassa M, Birol İlter P, Yavuz E, Önden B, Usta C, et al. COVID-19 related maternal mortality cases in associated with Delta and Omicron waves and the role of lung ultrasound. Turk J Obstet Gynecol. 2022;19(2):88-97. [Crossref]  [PubMed]  [PMC] 
  3. Lokken EM, Walker CL, Delaney S, Kachikis A, Kretzer NM, Erickson A, et al. Clinical characteristics of 46 pregnant women with a severe acute respiratory syndrome coronavirus 2 infection in Washington State. Am J Obstet Gynecol. 2020;223(6):911.e14. [Crossref]  [PubMed]  [PMC] 
  4. Gajbhiye RK, Sawant MS, Kuppusamy P, Surve S, Pasi A, Prusty RK, et al. Differential impact of COVID-19 in pregnant women from high-income countries and low- to middle-income countries: a systematic review and meta-analysis. Int J Gynaecol Obstet. 2021;155(1):48-56. [Crossref]  [PubMed]  [PMC] 
  5. Rasmussen SA, Smulian JC, Lednicky JA, Wen TS, Jamieson DJ. Coronavirus disease 2019 (COVID-19) and pregnancy: what obstetricians need to know. Am J Obstet Gynecol. 2020;222(5):415-26. [Crossref]  [PubMed]  [PMC] 
  6. Chinn J, Sedighim S, Kirby KA, Hohmann S, Hameed AB, Jolley J, et al. Characteristics and outcomes of women with COVID-19 giving birth at US academic centers during the COVID-19 pandemic. JAMA Netw Open. 2021;4(8):e2120456. [Crossref]  [PubMed]  [PMC] 
  7. Kalafat E, Prasad S, Birol P, Tekin AB, Kunt A, Di Fabrizio C, et al. An internally validated prediction model for critical COVID-19 infection and intensive care unit admission in symptomatic pregnant women. Am J Obstet Gynecol. 2022;226(3):403.e13. [Crossref]  [PubMed]  [PMC] 
  8. Pineles BL, Stephens A, Narendran LM, Tigner MA, Leidlein C, Pedroza C, et al. The relationship between delivery and the PaO2 /FiO2 ratio in COVID-19: a cohort study. BJOG. 2022;129(3):493-9. [Crossref]  [PubMed]  [PMC] 
  9. Gupta P, Kumar S, Sharma SS. SARS-CoV-2 prevalence and maternal-perinatal outcomes among pregnant women admitted for delivery: experience from COVID-19-dedicated maternity hospital in Jammu, Jammu and Kashmir (India). J Med Virol. 2021;93(9):5505-14. [Crossref]  [PubMed]  [PMC] 
  10. Wong SF, Chow KM, Leung TN, Ng WF, Ng TK, Shek CC, et al. Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome. Am J Obstet Gynecol. 2004;191(1):292-7. [Crossref]  [PubMed]  [PMC] 
  11. Lapinsky SE. Acute respiratory failure in pregnancy. Obstet Med. 2015;8(3):126-32. [Crossref]  [PubMed]  [PMC] 
  12. Cai J, Tang M, Gao Y, Zhang H, Yang Y, Zhang D, et al. Cesarean section or vaginal delivery to prevent possible vertical transmission from a pregnant mother confirmed with COVID-19 to a neonate: a systematic review. Front Med (Lausanne). 2021;8:634949. [Crossref]  [PubMed]  [PMC] 
  13. Ghosh K, Sarma N, Saji PN, Dey KR. Association of mode of delivery with maternal and perinatal outcome in SARS CoV-2 pregnancies: a retrospective observational study. [Crossref] 
  14. Debrabandere ML, Farabaugh DC, Giordano C. A review on mode of delivery during COVID-19 between December 2019 and April 2020. Am J Perinatol. 2021;38(4):332-41. [Crossref]  [PubMed] 
  15. Lumbiganon P, Moe H, Kamsa-Ard S, Rattanakanokchai S, Laopaiboon M, Kietpeerakool C, et al. Outcomes associated with anaesthetic techniques for caesarean section in low- and middle-income countries: a secondary analysis of WHO surveys. Sci Rep. 2020;10(1):10176. [Crossref]  [PubMed]  [PMC] 
  16. Martínez-Perez O, Vouga M, Cruz Melguizo S, Forcen Acebal L, Panchaud A, Mu-oz-Chápuli M, et al. Association between mode of delivery among pregnant women with COVID-19 and maternal and neonatal outcomes in Spain. JAMA. 2020;324(3):296-9. Erratum in: JAMA. 2020;324(3):305. [Crossref]  [PubMed]  [PMC] 
  17. Binte Masud S, Zebeen F, Alam DW, Hossian M, Zaman S, Begum RA, et al. Adverse birth outcomes among pregnant women with and without COVID-19: a comparative study from Bangladesh. J Prev Med Public Health. 2021;54(6):422-30. [Crossref]  [PubMed]  [PMC] 
  18. 16 ilde Delta varyantı görüldü: Yoğunluk İstanbul'da. TRT Haber. 24.06.2021. [Link] 
  19. Plaçais L, Richier Q, Noël N, Lacombe K, Mariette X, Hermine O. Immune interventions in COVID-19: a matter of time? Mucosal Immunol. 2022;15(2):198-210. [Crossref]  [PubMed]  [PMC] 
  20. Clinical management of COVID-19: living guideline, 15 September 2022. Geneva: World Health Organization; 2022 (WHO/2019-nCoV/Clinical/2022.2). Licence: CC BY-NC-SA 3.0 IGO. [Link] 
  21. Tekin AB, Yassa M. Implementation of lung ultrasound in the triage of pregnant women during the SARS-CoV-2 pandemics. Artif Intell Med Imaging. 2021;2(3):56-63. [Crossref] 
  22. Vimercati A, De Nola R, Trerotoli P, Metta ME, Cazzato G, Resta L, et al. COVID-19 infection in pregnancy: obstetrical risk factors and neonatal outcomes-a monocentric, single-cohort study. Vaccines (Basel). 2022;10(2):166. [Crossref]  [PubMed]  [PMC] 
  23. Lapinsky SE, Rojas-Suarez JA, Crozier TM, Vasquez DN, Barrett N, Austin K, et al. Mechanical ventilation in critically-ill pregnant women: a case series. Int J Obstet Anesth. 2015;24(4):323-8. [Crossref]  [PubMed] 
  24. Resende MHF, Yarnell CJ, D'Souza R, Lapinsky SE, Nam A, Shah V, et al. Clinical decision analysis of elective delivery vs expectant management for pregnant individuals with COVID-19-related acute respiratory distress syndrome. Am J Obstet Gynecol MFM. 2022;4(6):100697. [Crossref]  [PubMed]  [PMC] 
  25. Smith LH, Dollinger CY, VanderWeele TJ, Wyszynski DF, Hernández-Díaz S. Timing and severity of COVID-19 during pregnancy and risk of preterm birth in the International Registry of Coronavirus Exposure in Pregnancy. BMC Pregnancy Childbirth. 2022;22(1):775. [Crossref]  [PubMed]  [PMC] 
  26. Bezhenar VF, Nesterov IM, Dobrovolskaya IA. Perinatal outcomes of pregnancy and childbirth in moderate to severe COVID-19 patients. J Obstet Women Dis. 2022;71(4):5-12. [Crossref] 
  27. Working Party:; Association of Anaesthetists of Great Britain & Ireland; Obstetric Anaesthetists' Association; Regional Anaesthesia UK. Regional anaesthesia and patients with abnormalities of coagulation: the Association of Anaesthetists of Great Britain & Ireland The Obstetric Anaesthetists' Association Regional Anaesthesia UK. Anaesthesia. 2013;68(9):966-72. Erratum in: Anaesthesia. 2016;71(3):352. [Crossref]  [PubMed] 
  28. Katz D, Bateman BT, Kjaer K, Turner DP, Spence NZ, Habib AS, et al. The Society for Obstetric Anesthesia and Perinatology Coronavirus Disease 2019 Registry: An Analysis of Outcomes Among Pregnant Women Delivering During the Initial Severe Acute Respiratory Syndrome Coronavirus-2 Outbreak in the United States. Anesth Analg. 2021;133(2):462-73. [PubMed]