open access

Vol 91, No 12 (2020)
Research paper
Published online: 2020-11-24
Get Citation

COVID-19 infection in symptomatic pregnant women at the midpoint of the pandemic in Spain: a retrospective analysis

Elias Ortiz Molina1, Rafael Hernandez Pailos1, Maria Pola Guillen1, Ana Pascual Pedreno1, Eduardo Rodriguez Rodriguez1, Antonio Hernandez Martinez2
DOI: 10.5603/GP.a2020.0130
·
Pubmed: 33447995
·
Ginekol Pol 2020;91(12):755-763.
Affiliations
  1. Hospital Mancha Centro, Av Constitucion sn, Alcazar de San Juan, Spain, Spain
  2. University Castilla La Mancha, Ciudad Real, Spain, Spain

open access

Vol 91, No 12 (2020)
ORIGINAL PAPERS Obstetrics
Published online: 2020-11-24

Abstract

Objectives: Determine the strengths and weakness of a symptomatic screening for COVID-19 in pregnant women. Analyze
the clinical presentation, management, and outcomes. Design: Descriptive retrospective observational study. Setting:
Mancha-Centro Hospital (Spain).
Material and methods: Population: Symptomatic pregnant women with confirmed diagnosis of COVID-19. Between the 12th
of March and 17th of April 2020, all the symptomatic pregnancies were screened with diagnostic test for SARS-CoV-2. Data
collection was done by reviewing the medical records and telephone interviews. Main outcome measures: Clinical characteristics,
management, treatment, and obstetric and neonatal outcomes.
Results: Twenty patients with positive COVID-19 diagnostic test out of thirty-four suspected. The most common symptoms
were fever (70%), cough (65%) and myalgia (35%). A unique symptom of presentation in 20% of cases. COVID-19 pneumonia
was diagnosed in 30% by chest X-ray and one case had pulmonary embolism associated diagnosed by CT-Scan. Thromboprophylaxis
was indicated in 16 out of 20 patients. Eight women finished their pregnancy during the observation period.
Type of birth: 25% natural birth, 12.5% assisted vaginal delivery and 62.5% caesarean section. We had three severe cases,
two of them with intensive care support. All neonates had negative test for COVID 19 infection.
Conclusions: We recommend universal screening of all pregnant woman for COVID-19 during the pandemic because of
the limits of the symptomatic screening seen in this studio and the ratio of asymptomatic pregnancies with positive test
for COVID-19 recently published.

Abstract

Objectives: Determine the strengths and weakness of a symptomatic screening for COVID-19 in pregnant women. Analyze
the clinical presentation, management, and outcomes. Design: Descriptive retrospective observational study. Setting:
Mancha-Centro Hospital (Spain).
Material and methods: Population: Symptomatic pregnant women with confirmed diagnosis of COVID-19. Between the 12th
of March and 17th of April 2020, all the symptomatic pregnancies were screened with diagnostic test for SARS-CoV-2. Data
collection was done by reviewing the medical records and telephone interviews. Main outcome measures: Clinical characteristics,
management, treatment, and obstetric and neonatal outcomes.
Results: Twenty patients with positive COVID-19 diagnostic test out of thirty-four suspected. The most common symptoms
were fever (70%), cough (65%) and myalgia (35%). A unique symptom of presentation in 20% of cases. COVID-19 pneumonia
was diagnosed in 30% by chest X-ray and one case had pulmonary embolism associated diagnosed by CT-Scan. Thromboprophylaxis
was indicated in 16 out of 20 patients. Eight women finished their pregnancy during the observation period.
Type of birth: 25% natural birth, 12.5% assisted vaginal delivery and 62.5% caesarean section. We had three severe cases,
two of them with intensive care support. All neonates had negative test for COVID 19 infection.
Conclusions: We recommend universal screening of all pregnant woman for COVID-19 during the pandemic because of
the limits of the symptomatic screening seen in this studio and the ratio of asymptomatic pregnancies with positive test
for COVID-19 recently published.

Get Citation

Keywords

COVID-19; pregnancy; screening; outcomes; symptoms; delivery

About this article
Title

COVID-19 infection in symptomatic pregnant women at the midpoint of the pandemic in Spain: a retrospective analysis

Journal

Ginekologia Polska

Issue

Vol 91, No 12 (2020)

Article type

Research paper

Pages

755-763

Published online

2020-11-24

DOI

10.5603/GP.a2020.0130

Pubmed

33447995

Bibliographic record

Ginekol Pol 2020;91(12):755-763.

Keywords

COVID-19
pregnancy
screening
outcomes
symptoms
delivery

Authors

Elias Ortiz Molina
Rafael Hernandez Pailos
Maria Pola Guillen
Ana Pascual Pedreno
Eduardo Rodriguez Rodriguez
Antonio Hernandez Martinez

References (33)
  1. WHO Director-General’s remarks at the media briefing on 2019-nCoV on 11 February 2020. https://www.who.int/dg/speeches/detail/who-director-general-s-remarks-at-the-media-briefing-on-2019-ncov-on-11-february-2020 (9.04.2020).
  2. WHO Timeline - COVID-19. https://www.who.int/news-room/detail/08-04-2020-who-timeline---covid-19 (9.04.2020).
  3. COVID-19 Map - Johns Hopkins Coronavirus Resource Center. https://coronavirus.jhu.edu/map.html (25.04.2020).
  4. Evolución de coronavirus COVID-19 en Castilla-La Mancha | Servicio de Salud de Castilla-La Mancha. https://sanidad.castillalamancha.es/ciudadanos/enfermedades-infecciosas/coronavirus/evolucion-de-coronavirus-covid-19-en-castilla-la-mancha (26.04.2020).
  5. Breslin N, Baptiste C, Miller R, et al. COVID-19 in pregnancy: early lessons. Am J Obstet Gynecol MFM. 2020: 100111.
  6. Zaigham M, Andersson O. Maternal and perinatal outcomes with COVID-19: A systematic review of 108 pregnancies. Acta Obstet Gynecol Scand. 2020; 99(7): 823–829.
  7. Ferrazzi EM, Frigerio L, Cetin I, et al. COVID-19 Obstetrics Task Force, Lombardy, Italy: Executive management summary and short report of outcome. Int J Gynaecol Obstet. 2020; 149(3): 377–378.
  8. Yan J, Guo J, Fan C, et al. Coronavirus disease 2019 in pregnant women: a report based on 116 cases. Am J Obstet Gynecol. 2020; 223(1): 111.e1–111.e14.
  9. Li Na, Han L, Peng M, et al. Maternal and neonatal outcomes of pregnant women with COVID-19 pneumonia: a case-control study. Clin Infect Dis. 2020.
  10. Poon LC, Yang H, Kapur A, et al. Global interim guidance on coronavirus disease 2019 (COVID-19) during pregnancy and puerperium from FIGO and allied partners: Information for healthcare professionals. Int J Gynaecol Obstet. 2020; 149(3): 273–286.
  11. Boelig RC, Manuck T, Oliver EA, et al. Labor and delivery guidance for COVID-19. Am J Obstet Gynecol MFM. 2020; 2(2): 100110.
  12. Saccone G, Carbone FI, Zullo F. The novel coronavirus (2019-nCoV) in pregnancy: What we need to know. Eur J Obstet Gynecol Reprod Biol. 2020; 249: 92–93.
  13. Qi H, Luo X, Zheng Y, et al. Safe delivery for pregnancies affected by COVID-19. BJOG. 2020; 127(8): 927–929.
  14. Favre G, Pomar L, Qi X, et al. Guidelines for pregnant women with suspected SARS-CoV-2 infection. Lancet Infect Dis. 2020; 20(6): 652–653.
  15. Di Renzo GC, Giardina I. COVID-19 in Pregnancy: Consider Thromboembolic Disorders and Thromboprophylaxis. Am J Obstet Gynecol. 2020: S0002-9378(20)30465-8.
  16. Thachil J, Tang N, Gando S, et al. ISTH interim guidance on recognition and management of coagulopathy in COVID-19. J Thromb Haemost. 2020; 18(5): 1023–1026.
  17. SEGO | Sociedad Española de Ginecología y Obstetricia. Posicionamiento SEGO sobre profilaxis de la enfermedad tromboembólica en el puerperio de pacientes COVID-19. https://sego.es/MasCovid-19 (15.04.2020).
  18. Shoushtari A, Nugent K. Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. The Southwest Respiratory and Critical Care Chronicles. 2020; 8(33): 1–6.
  19. Mortality Analyses - Johns Hopkins Coronavirus Resource Cente. https://coronavirus.jhu.edu/data/mortality (28.04.2020).
  20. Considerations for Inpatient Obstetric Healthcare Settings | CDC. https://www.cdc.gov/coronavirus/2019-ncov/hcp/inpatient-obstetric-healthcare-guidance.html (15.04.2020).
  21. Sutton D, Fuchs K, D'Alton M, et al. Universal Screening for SARS-CoV-2 in Women Admitted for Delivery. N Engl J Med. 2020; 382(22): 2163–2164.
  22. Vintzileos WS, Muscat J, Hoffmann E, et al. Screening all pregnant women admitted to Labor and Delivery for the virus responsible for 1 COVID-19 2. Am J Obstet Gynecol. 2020: S0002-9378(20)30472-5.
  23. Cheng MP, Papenburg J, Desjardins M, et al. Diagnostic Testing for Severe Acute Respiratory Syndrome-Related Coronavirus 2: A Narrative Review. Ann Intern Med. 2020; 172(11): 726–734.
  24. Guan WJ, Ni ZY, Hu Yu, et al. China Medical Treatment Expert Group for Covid-19. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020; 382(18): 1708–1720.
  25. Wang D, Hu Bo, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020; 323(11): 1061–1069.
  26. Hopkins C, Surda P, Kumar N. Presentation of new onset anosmia during the COVID-19 pandemic. Rhinology. 2020; 58(3): 295–298.
  27. Lechien JR, Chiesa-Estomba CM, De Siati DR, et al. Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study. Eur Arch Otorhinolaryngol. 2020; 277(8): 2251–2261.
  28. Vaira LA, Salzano G, Deiana G, et al. Anosmia and Ageusia: Common Findings in COVID-19 Patients. Laryngoscope. 2020; 130(7): 1787.
  29. Cui S, Chen S, Li X, et al. Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia. J Thromb Haemost. 2020; 18(6): 1421–1424.
  30. Tang N, Li D, Wang X, et al. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020; 18(4): 844–847.
  31. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020; 395(10229): 1054–1062.
  32. Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020; 323(13): 1239–1242.
  33. Ferrazzi E, Frigerio L, Savasi V, et al. Vaginal delivery in SARS-CoV-2-infected pregnant women in Northern Italy: a retrospective analysis. BJOG. 2020 [Epub ahead of print].

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk
tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl