Covid 19 in Pregnancy: Clinical Features and Outcome
Dr Sudhir Kumar MD DM
Covid 19, caused by SARS CoV2 virus is a global pandemic, which has infected more than 2.2 million people worldwide and resulted in death of about 1,50,000 people. Data regarding the effects of Covid 19 in pregnant women are lacking.
A recent case series of Covid 19 affecting pregnant women was reported from Wuhan, China. Following are the salient features:
- 118 pregnant women with SARS CoV 2 infection, with median age 31 years (range 28 to 34), were included,
- 52% were nulliparous,
- 64% got the infection in 3rd trimester,
- Most common symptoms were fever and cough,
- Lymphopenia was noted in 44%,
- CT chest showed infiltrates in both lungs in 79%,
- 92% had mild disease and 8% had severe disease with hypoxemia,
- One patient required noninvasive mechanical ventilation after delivery,
- 94% were discharged,
- There were no deaths,
- 68 women delivered 70 babies (2 sets of twins) during the study period,
- 93% underwent caesarian section.
- There were 3 spontaneous abortions and 2 ectopic pregnancies. 4 had induced abortion (due to concerns about Covid 19),
- No babies had neonatal asphyxia,
- Testing for SARS CoV2 was performed on neonatal throat swabs of 8 newborns and breast milk samples of 3 mothers- all were negative.
- Pregnant women tend to have lesser risk of severe Covid-19 disease as compared to general population (8% vs 16%).
- Pregnancy outcomes are generally good.
- Covid 19 does not seem to be transmitted from mothers to babies.
(Reference: NEJM, April 17, 2020)