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

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.