COVID-19 and Anxiety in Perinatal Women.

Introduction: With a global pandemic like coronavirus disease 2019 (COVID-19) spreading across borders, creating an extensive fear amongst all groups alike due to the increased morbidity and mortality, there is uncertainty in all patients affected. The government policy of quarantine of pregnant and postnatal women with COVID-19 in hospitals leads to ironic isolation and loneliness, mounting anxiety and fear of unknown outcomes. This study was undertaken to assess maternal anxiety in relation to COVID-19 and to observe factors influencing anxiety, drawing on anxiety scoring scales and a comparison of the levels of anxiety between antenatal and postnatal mothers. Methods: This cross-sectional descriptive study was conducted on 123 perinatal women with COVID-19 and their levels of anxiety were assessed on the basis of a pre-formed questionnaire, using the Coronavirus Anxiety Scale (CAS) and Generalized Anxiety Disorder-7 Questionnaire (GAD-7). The levels of anxiety between antenatal and postnatal mothers were compared based on these 2 scoring systems, using IBM.SPSS statistics software Version23.0. Results: Although both groups were having high scores of anxiety, antenatal women were found to possess statistically significant higher level of anxiety, compared to postnatal women, as determined by CAS. Conclusion: Better assessment on antenatal and postnatal women will lead to need-based counselling from healthcare workers during their hospital stay and better use of resources for the identification of the vulnerable group and their management.

COVID-19 and obstetricians and gynecologist: The Indian perspective

Introduction: Since its emergence, COVID 19 caused by severe acute respiratory syndrome coronavirus 2, turned out to be a health threat throughout the world. The degree of risk for the health-care workers who are dealing with the COVID-19 patients is uncertain. Questionnaire-based prospective cross-sectional study was done to assess the extent to which the Indian obstetrics and gynecology practice has been affected by the pandemic. Materials and Methods: From August to October 2020, 309 obstetricians (OBs) and gynecologists took part in the survey via Google forms. Impact on the present working scenario during the pandemic compared to the Pre-COVID era was evaluated. The categorical variables got illustrated through frequency (%). The association among the variables Chi-square test was utilized. Statistical significance was contemplated by the P < 0.05. Graphs were prepared using Google Sheets and Microsoft Excel 365. Results: There was drastic fall in parameters of obstetric practice. Over half of the OBs witnessed fall in outpatients over 90%. Significant association seen reduction in earnings with the sector, type of set-up, and duration of practice (P < 0.001) was found. Apprehension among the study group was present still majority 54.8% said that they were working voluntarily in this time of national crisis. Conclusions: This research indicates that the pandemic has entailed practice of obstetrics and gynecology in India. However, the smooth functioning was maintained due to the high degree of knowledge and preparedness among the doctors and the well-laid guidelines by the authorities.

Pregnancy Outcomes With COVID-19 Lessons Learned From the Pandemic.

Background Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) that causes Coronavirus disease has caused one of the most damaging pandemics in the recorded human history. Objective To assess pregnancy outcomes with COVID-19 lessons learned from the pandemic. Study design This retrospective observational study was conducted at Teerthanker Mahaveer Medical College and Research Centre, Moradabad, a level 3 COVID hospital in Northern India, with a patient pool of all the antenatal females diagnosed COVID 19 positive via a positive quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR) test of maternal pharyngeal and nasal swab samples in the given time period of three months and ten days, i.e., May 25, 2020 to September 3, 2020. In conjunction with maternal outcomes, neonatal outcomes including evidence of perinatal transmission of SARS-CoV-2 was assessed by testing neonatal pharyngeal swab samples. Results Out of 100 COVID-19 positive patients, the average age of women was 26.2 years, 73 women (73%) were asymptomatic, and 50 patients (50%) women had associated co-morbidities such as anaemia in 38 (38%) women, gestational diabetes mellitus (GDM) and pregnancy-induced hypertension (PIH) in four patients (4%) each, respectively. No case of spontaneous abortion in early gestation was reported. Out of 100 patients, 32 (32%) patients delivered during their stay, out of which 17 women (53.1%) delivered via cesarean section which was performed mainly due to obstetric indications. One maternal death was reported due to antepartum eclampsia which was unrelated to COVID-19 complications. Five neonates were born prematurely, out of which three were delivered followed by spontaneous premature preterm rupture of membranes (PPROM). The Appearance Pulse Grimace Activity Respiration (APGAR) score was recorded to be ≥9 at the five minutes mark in 28 out of 30 live babies (93.3%) and the birth weight of the babies ranged from 1.8 to 3.5 kg) with an average birth weight of 2.71 kg. Two neonatal deaths were reported due to respiratory distress. There were two documented intrauterine demise (IUD) cases both due to PIH. Furthermore, all 30 live neonates tested for SARS CoV-2 had negative results. Conclusion The spectrum of Coronavirus infection leans more towards asymptomatic and mild symptomatic clinical presentation. Favourably, the likelihood of spontaneous preterm birth was not escalated in our current study and remained low. The rate of intrauterine fetal demise and neonatal death were less. As none of the neonates tested positive for COVID-19, there is no corroborative proof of vertical perinatal transmission.