ABSTRACT
Intro: COVID-19 pandemic era makes quality of obstetric triage care including caesarean section in obstetric true emergency cases delayed. Maternal fetal triage index (MFTI) score is an instrument used to define true emergency in obstetric cases. Decision to delivery interval (DDI) is time interval from caesarean section decision to delivery within <30 minutes standard in emergency cases.This study was designed to evaluate the decision to delivery time interval and its effect on perinatal outcomes and the associated factors during category-1 emergency caesarean section deliveries. Method(s): A prospective observational descriptive study was conducted from 2020-2022 at Kariadi tertiary Hospital. A total of 40 clients who were undergone category-1 emergency caesarean section were included in this study. This is a indepht analysis pregnant women confirmed with COVID-19 infection and had true emergency cases based on MFTI score (stat-priority 1). Finding(s): Among 346 pregnant women with COVID-19, total 160 C-section cases with 40 eligible data were included in this study. Gestational age mostly in their second and third trimester. Maternal comorbidities were diabetes in pregnancy, HIV, pre eclampsia, SLE and thyroid disease. This study showed that DDI <30 minutes were found in 34 cases (85%), DDI 30-60 minutes as many as 6 (15%), and no (0%) DDI >60 minutes. Emergency cases with the shortest DDI were umbilical cord prolapse 3 (100%), fetal distress 14 (93%), placental abruption 5 (83%), impending uterine rupture 5 (83%), and antepartum hemorrhage 7 (70%). Perinatal outcome were Apgar score lower than 7 at 1 minutes (25%) and stillbirth (5%). Conclusion(s): Most of DDI in this study met the recommendation of <30 minutes, but some cases did not meet the standard. This can be caused by multifactorial factors such as advice from the doctor in charge, patient transfer distance, operating room preparation, and anesthetic preparation due to COVID-19.Copyright © 2023
ABSTRACT
Background: The COVID-19 pandemic has led to global health crisis. Most studies have focused on evaluating the effects of COVID-19 on the general population, and there is still insufficient data on its impact on vulnerable populations, such as pregnant women. The study evaluates maternal and perinatal outcomes on pregnant women with COVID-19 in Kariadi as tertiary hospital in Central Java. Methods: We prospectively collected and analyzed data for a cohort of 45 pregnant patients with COVID-19 between March 31st and September 23th 2020 in Kariadi hospital. Results: Atotalof45pregnantwomenwith COVID-19 delivered 46 babies including one twin pregnancy. The symptoms ranged from asymptomatic (54.3%), mild (26.6%), moderate (8.8%), severe (2.2%), and critical (6.6%). Gestational age was 22 to 41 weeks. Cesarean section was the most mode of delivery (86.7 %). Diabetes in pregnancy and HIV were the most common comorbidities found in this study, there were also seven patients came with preeclampsia. There were three maternal mortalities, we reported one maternal death (2.2 %) caused by severe respiratory disease COVID-19 in second trimester. The other two death cases were pregnancy complicated with severe preeclampsia with hyperthyroid and preeclampsia with diabetes in pregnancy. Perinatal outcomes were intrauterine fetal death (8.7%), stillbirth (2.2%), and severe asphyxia (2.2%). Conclusion: Although we obtain mostly maternal and perinatal outcomes in good outcomes, it is urgent to analyze potential high-risk maternal death with COVID 19. © 2021, Sanglah General Hospital. All rights reserved.