AN INSIGHT ON THE MATERNAL & FETAL OUTCOME OF CRITICALLY ILL PREGNANT WOMEN DURING THE SECOND WAVE OF COVID-19 (preprint)

Objective: To assess and compare the Maternal and fetal outcomes of critically ill pregnant women infected with COVID – 19 cases of pneumonia who required admission to the intensive care unit. Design: A retrospective observational study Settings: Tertiary care hospital settings affiliated with an academic center in UAE. Patients and Methods: A total of 123 patients in their third trimester were included from 1 December 2020 to 31 March 2021 in the study with 30 cases of severe or critical COVID and 93 mild to moderate pregnant COVID patients. The maternal demographic, radiological, and biochemical profile of mothers was noted. Maternal and fetal outcomes were compared. Main outcomes Measured: Maternal and fetal outcomes were compared in severe and mild COVID cases. Result: A total of 30 (24.3%) patients were admitted in ICU and eight required invasive ventilation meaning, Severe COVID was significantly associated with higher mortality (20% vs 0% p-value <0.001), postpartum complications (50% vs 9.67% p-value<0.001) and increased overall hospital stay (p-value<0.001). Neonates born to severe COVID patients had significant higher chances of being born preterm (76.6% vs 35.7% p-value<0.001) and have low birth weight (46.6% vs 13.9% p-value=0.002). There were four cases of stillbirth, two cases of vertical transmission, and no neonatal deaths. Conclusion: Pregnant females with severe COVID have high mortality, peripartum complications; and increased hospital stay. The newborns born to such mothers may be premature, have low birth weights but have comparable mortality

Covid-19 Infection in Pregnant Women in Dubai: A Case-control Study (preprint)

Background: Whilst the impact of Covid-19 infection in pregnant women has been examined, there is a scarcity of data on pregnant women in the Middle East. Thus, the aim of this study was to examine the impact of Covid-19 infection on pregnant women in the United Arab Emirates population. Methods: A case-control study was carried out to compare the clinical course and outcome of pregnancy in 79 pregnant women with Covid-19 and 85 non-pregnant women with Covid-19 admitted to Latifa Hospital in Dubai between March and June 2020. Results: On admission, most pregnant women (69/79; 87%) were either asymptomatic or suffered mild respiratory symptoms, much like non-pregnant women. The main symptoms, observed in both groups, were fever, cough, headache, runny nose and myalgia. In early pregnancy four women had spontaneous miscarriages. However, severe Covid-19 illness, ICU admission, intubation and complications were observed in late pregnancy in 10/79 (13%) women with prior comorbidities. During the study period, 31/79 women delivered: 22 (70%) had a lower segment Caesarean section, 16 for obstetric reasons and 6 for severe Covid-19 pneumonia; and 12 had a preterm delivery. Postoperatively, none showed significant improvement on account of early delivery. Sepsis, acute renal failure and acute respiratory distress syndrome were the most common complications observed. The neonatal outcome was comparable to that of the general obstetric population, even though 12/31 (38%) were preterm and had to be admitted to the neonatal ICU. Two neonates, born by vaginal delivery, tested positive for Covid-19 after delivery. Both were asymptomatic and tests were negative within 72 hours. It was not possible to ascertain whether vertical transmission occurred in utero.Conclusions: Severe Covid-19 illness, ICU admission, intubation, complications and preterm deliveries were observed in late pregnancy in women with comorbidities. Pregnancy with Covid-19 infection, could, therefore, be categorised as high-risk pregnancy. It was not possible to confirm whether vertical transmission of Covid-19 had occurred during the third trimester of pregnancy.