ABSTRACT
A review of the literature is devoted to the information on the effect of a new coronavirus infection (COVID-19) on the course of pregnancy, the possibility of vertical transmission of the virus from mother to fetus and the condition of the neonates. A review of the literature reveals similarities in the clinical manifestations of COVID-19 in pregnant and non-pregnant women. However, pregnant women are reported to have an increased risk of ICU admission and need for ventilatory support in various countries. Trans-placental transmission from the mother to the fetus has been widely reported. Preterm birth is now common among pregnancy outcomes, especially in women who have had moderate to severe COVID-19. In the assessment of newborns born to mothers with COVID-19, prematurity, hypoxic conditions and respiratory disorders predominated. Further study of the pathogenesis of a new coronavirus infection is necessary to determine factors of possible vertical transmission, the effect on fetal growth and development, the course of pregnancy and labor, and peculiarities of the early neonatal period in infants whose mothers had had this infection in the first and second trimesters of pregnancy. © 2023, Media Sphera Publishing Group. All rights reserved.
ABSTRACT
Objective. To improve perinatal outcomes in pregnant women with a new coronavirus infection COVID-19 by optimizing diagnostic, therapeutic, and prophylactic measures. Material and methods. The course of pregnancy, labor and perinatal outcomes were studied in 70 patients with COVID-19 during the present pregnancy who were delivered at the Moscow Regional Research Institute of Obstetrics and Gynecology (MORRIOG). The patients were divided into 2 groups depending on the timing of their visit to the outpatient department of MORRIOG: Group 1 comprised 45 pregnant women with new-onset coronavirus infection in the first to second trimesters of gestation, with subsequent presentation and follow-up at the MORRIOG outpatient department;Group 2 comprised 25 pregnant women who had new-on-set coronavirus (NCD) infection during gestation and presented to the outpatient department before delivery. In addition to a general clinical examination, all pregnant women underwent an extended haemostatic analysis, including a thrombodynamic test. Results. Analysis of the findings showed that hypercoagulable changes in the hemostatic system were observed in pregnant women with COVID-19 infection during gestation, but standard hemostatic tests did not reflect the characteristic postinfectional changes compared with the results of an extended coagulation potential study using the thrombodynamics test. Hypercoagulative changes were revealed irrespective of the severity of the COVID-19, which could be due to the combination of several risk factors and the presence of concomitant extragenital diseases. Conclusion. The most favorable gestational outcome in patients who have suffered a COVID-19 infection during pregnancy depends on the timely of the detection of hemostasis abnormalities after comprehensive examination and on the composition of available pathogenetic therapy. Rational anticoagulant and antiplatelet therapy under control of the coagulation parameters and achievement of normalization of coagulation tests result in a significant reduction in adverse obstetric and perinatal outcomes. © 2023, Media Sphera Publishing Group. All rights reserved.
ABSTRACT
Objective. To improve perinatal outcomes in pregnant women with a new coronavirus infection COVID-19 by optimizing diagnostic, therapeutic, and prophylactic measures. Material and methods. The course of pregnancy, labor and perinatal outcomes were studied in 70 patients with COVID-19 during the present pregnancy who were delivered at the Moscow Regional Research Institute of Obstetrics and Gynecology (MORRIOG). The patients were divided into 2 groups depending on the timing of their visit to the outpatient department of MORRIOG: Group 1 comprised 45 pregnant women with new-onset coronavirus infection in the first to second trimesters of gestation, with subsequent presentation and follow-up at the MORRIOG outpatient department;Group 2 comprised 25 pregnant women who had new-on-set coronavirus (NCD) infection during gestation and presented to the outpatient department before delivery. In addition to a general clinical examination, all pregnant women underwent an extended haemostatic analysis, including a thrombodynamic test. Results. Analysis of the findings showed that hypercoagulable changes in the hemostatic system were observed in pregnant women with COVID-19 infection during gestation, but standard hemostatic tests did not reflect the characteristic postinfectional changes compared with the results of an extended coagulation potential study using the thrombodynamics test. Hypercoagulative changes were revealed irrespective of the severity of the COVID-19, which could be due to the combination of several risk factors and the presence of concomitant extragenital diseases. Conclusion. The most favorable gestational outcome in patients who have suffered a COVID-19 infection during pregnancy depends on the timely of the detection of hemostasis abnormalities after comprehensive examination and on the composition of available pathogenetic therapy. Rational anticoagulant and antiplatelet therapy under control of the coagulation parameters and achievement of normalization of coagulation tests result in a significant reduction in adverse obstetric and perinatal outcomes. © 2023, Media Sphera Publishing Group. All rights reserved.