Authors
Sabnam S Nambiara, Ajith Sa, Reshmi V Pa
a Department of Gynaecology, Government Medical College Kannur, Pariyaram, Kerala
Abstract
Background: Covid 19 is entering its third year now. Most studies have concentrated on third trimester. We have attempted to study outcome in pregnancies afflicted with covid in first and second trimester.
AIM: To study outcome of pregnancies with covid in first and second trimester
Methods: We reviewed pregnancy outcome retrospectively in 153 pregnant women with covid in first and second trimester admitted in our institution between March 2020 – January 2022.
Results: 39.86% were between 26-30 years, 32.02% between 20-25 years. 49.01% were < 14 weeks of gestation, 40.52% > 14 and < 26 weeks of gestation, 10.45% were 26 – 28 weeks. Intrauterine growth restriction [ IUGR] was seen in 13.07% patients, gestational diabetes mellitus [GDM] in 7.8%, hypertensive disorders of pregnancy [PIH] in 4.5% patients. 7.1% patients developed foetal distress. There were 42 miscarriages (27.45%), 42 normal deliveries (27.45%), 11 preterm deliveries [PTL (7.1%), 54 caesarean sections [CS]{30 emergency}. Asymptomatic patients had 80.95% of total abortions. Those with fever and upper respiratory tract infection (URT)] and severe acute respiratory illness [SARI] contributed 36.66% each of total emergency CS. 36.66% of total cases of PTL were contributed by SARI while 36.36% were in asymptomatic group. In asymptomatic patients 57.62 % had miscarriages,13.55% required emergency caesarean and 6.7% PTL.
In group with fever and URTI, 12% abortions, 22.91% emergency CS 6% PTL. There was one miscarriage in group with fever and diarrhoea. Those < 14 weeks, 38.66% miscarriages, contributing to 69.04% of total abortions. 10.66% emergency caesarean [two< 34 weeks]. 5.3% PTL [one < 34 weeks]. In patients > 14 – < 26 weeks, 20.96% miscarriages, 8% PTL (one< 34 weeks), 19.35% emergency CS [two< 32 weeks]; one maternal, 2 intrauterine and one neonatal death. In patients 26-28 weeks, 62.5% required emergency caesarean [three< 32 weeks]. There was one maternal death, 2 patients PTL <34 weeks. The maternal and neonatal death occurred in patients with SARI.
Conclusion: Our study shows increased abortions in early trimester irrespective of severity. The emergency caesarean and PTL rates increased in late second trimester and severe disease.
Keywords: Abortion, CS, COVID 19, PTL IUGR, PIH, GDM