Comparison of Obstetric Outcomes in First and Second COVID-19 Waves: Analysis from a COVID-19-dedicated Tertiary Care Hospital

Introduction: The physiological changes in the respiratory and cardiovascular systems in the immunosuppressed state of pregnancy may exacerbate clinical features and deteriorate outcomes due to COVID-19 infection. We aimed to compare the maternal and neonatal adverse effects in the first and second COVID-19 waves. Methodology: This study was a prospective cohort study conducted in a tertiary care COVID-19-dedicated hospital. In total, 104 (group A) and 96 (group B) COVID-19-positive pregnant women admitted during the first and second waves, respectively, were included in the study. Data on baseline variables, associated comorbidities, clinical presentations, management strategies, and neonatal and maternal outcomes were collected and compared using parametric and nonparametric tests and analyzed. Result(s): Around 2.08% in group A and 6.72% in group B of COVID-19-infected pregnant women, respectively, had moderate-to-severe disease and required intensive care unit stay. Almost 1.04% in group A and 3.84% in group B had maternal mortality, 13.4% and 19.8% babies of groups A and B required admission in neonatal intensive care units, and 8.6% and 7.3% of newborns in groups A and B had COVID-19-positive reports by reverse transcriptase polymerase chain reaction (RT-PCR) at birth, respectively. Of them, 2.1% newborns in group B had RT-PCR positive on day 7 of life and beyond, whereas none had positive RT-PCR reports on 7 days and beyond in group A. Conclusion(s): Dreadful maternal outcomes like requirement of ICU and mechanical ventilator and persistence of neonatal infections were higher during the second wave.Copyright © The Author(s). 2023.

Large Ovarian Dermoid, a Cause for Fetal Growth Restriction and Oligohydramnios: Rare Instance in Literature

Ovarian dermoids mostly remain asymptomatic during pregnancy. Large dermoids may present with torsion, hemorrhage, or rupture. However, a dermoid cyst causing fetal growth restriction (FGR) and oligohydramnios is a very rare entity. The authors report a case of a large ovarian dermoid (15 x 12 cm) hampering intrauterine fetal growth. Due to the coronavirus disease-2019 (COVID-19) lockdown, the patient was unable to get ultrasound examinations in early gestation, and thereby, surgical intervention was not possible during the second trimester. As a result, this growing teratoma finally led to FGR by either exerting a pressure effect upon the uterus or by dwindling its blood supply. Copyright © The Author(s). 2022.