Covid-19 in Gravid Uterus – The Challenge in Antenatal Care and Its Outcome – A Tertiary Level Cross Sectional Analysis from Chennai, India

• Published in: Journal of evolution of medical and dental sciences Vol. 10; no. 37; pp. 3202 - 3206
• Main Authors: Maran, Varsha, Vishwanath, Usha, Pillai, Sheila K, Nadar, Alka
• Format: Journal Article
• Language: English
• Published: Akshantala Enterprises Private Limited 13.09.2021
• Subjects: Analysis; Cesarean section; Diabetes; Disease transmission; Epidemics; Hypertension; India; Infants (Newborn); Medical colleges; Medical research; Medical screening; Medicine, Experimental; Obstetrics; Pregnant women; Severe acute respiratory syndrome; Virus diseases; India
• ISSN: 2278-4748; 2278-4802
• DOI: 10.14260/jemds/2021/651

BACKGROUND With the emerging pandemic of corona virus disease 19 (Covid-19) infection around the world, the need to identify the course of this disease in pregnant women becomes the need of the hour. Its effect on pregnancy and the neonatal outcome is not well known because of lack of any reliable data. We wanted to evaluate the clinical features, laboratory manifestations and obstetric outcome of Covid-19 in the term of antenatal mothers who were either admitted in labour, induction of labour or elective caesarean section and rule out vertical transmission by doing a routine neonatal screening for Covid-19. METHODS A descriptive cross-sectional study conducted at Sri Ramachandra Medical College & Research Institute, Chennai from March 2020 to September 2020 includes all antenatal women who were tested positive for severe acute respiratory syndrome (SARS- Cov2) reverse transcription - polymerase chain reaction (RT-PCR). 43 Covid positive patients were included in the study. RESULTS Incidence of Covid positive antenatal women was found to be 1.7 %. Only 3 % were symptomatic with mild disease. Gestational diabetes mellitus accounted for (27 %), Class II obesity (7 %), hypertensive disorders of pregnancy (13 %) of the screen positive mothers. 20 % of the labouring women had meconium-stained liquor. Lymphopenia was seen in 73 % of cases. Elevated d-dimer in 13 %, requiring thromboprophylaxis. Negative RT-PCR for SARS-CoV-2 in the neonates ruled out vertical transmission. CONCLUSIONS Covid-19 in pregnancy is more common in those with gestational diabetes, obesity, with development of complications like hypertension and meconium-stained liquor. The impact of Covid-19 is not as disabling as it is in the non-pregnant population. KEY WORDS Universal Screening, In/Near Labour, Lymphopenia, Thromboprophylaxis, Meconium- Stained Amniotic Fluid.