Two major challenges for pregnancy: labor emergencies and SARS-CoV-2 infection - our experience in Saint John hospital, Bucharest, Romania

ABSTRACT

Introduction: Obstetric emergencies that occur during labor, often present as a major indication for prompt completion of labor by instrumental methods or emergency cesarean section. The purpose of this study was to present the clinical features of emergencies, the evolution of labor, maternal and fetal or neonatal complications at patients with SARS-COV-2 infection. Materials and methods: We performed a retrospective study that included 150 pregnant women who gave birth in Bucur Maternity, St John Hospital, Bucharest, between 2018-2020 that fulfilled the features of obstetrical emergency during labor and SARS-CoV-2 infection. The study group was divided in patients positive for SARS-CoV-2 and negative for SARS-CoV-2. Results: Following PCR testing for SARS-CoV-2 were 26.67% of patients positive and 73.33% had a negative result. Analyzing the data obtained from this group of patients, it resulted that the average hospitalization is higher in the positive group (7.05 days) versus the negative group (5.47 days). The average gestational age at birth of SARS-CoV-2 positive patients was 37.26 weeks, lower than the gestational age of neonates from uninfected mothers (38.41 weeks). The average of the APGAR scores in the COVID group is 8.41, and for the negative group is 8.90. Conclusions: The associated SARS-CoV-2 infection played a significant role in terms of the APGAR score and the early peripartum outcomes of new-borns, negatively influencing the value of the APGAR index. Gestational age was considerably lower in patients diagnosed with the infection. The SARS-CoV-2 virus infection has a significant influence in unsatisfactory neonatal outcomes compared to new-borns of healthy mothers.