Pregnancy Outcome in First and Second Trimester Covid Infection
Abstract
Background: Covid 19 is entering its third year now. Most studies have concentrated on third trimester. We have attempted to study outcome in pregnancies afflicted with covid in first and second trimester.
AIM: To study outcome of pregnancies with covid in first and second trimester
Methods: We reviewed pregnancy outcome retrospectively in 153 pregnant women with covid in first and second trimester admitted in our institution between March 2020 - January 2022.
Results: 39.86% were between 26-30 years, 32.02% between 20-25 years. 49.01% were < 14 weeks of gestation, 40.52% > 14 and < 26 weeks of gestation, 10.45% were 26 - 28 weeks. Intrauterine growth restriction [ IUGR] was seen in 13.07% patients, gestational diabetes mellitus [GDM] in 7.8%, hypertensive disorders of pregnancy [PIH] in 4.5% patients. 7.1% patients developed foetal distress. There were 42 miscarriages (27.45%), 42 normal deliveries (27.45%), 11 preterm deliveries [PTL (7.1%), 54 caesarean sections [CS]{30 emergency}. Asymptomatic patients had 80.95% of total abortions. Those with fever and upper respiratory tract infection (URT)] and severe acute respiratory illness [SARI] contributed 36.66% each of total emergency CS. 36.66% of total cases of PTL were contributed by SARI while 36.36% were in asymptomatic group. In asymptomatic patients 57.62 % had miscarriages,13.55% required emergency caesarean and 6.7% PTL.
In group with fever and URTI, 12% abortions, 22.91% emergency CS 6% PTL. There was one miscarriage in group with fever and diarrhoea. Those < 14 weeks, 38.66% miscarriages, contributing to 69.04% of total abortions. 10.66% emergency caesarean [two< 34 weeks]. 5.3% PTL [one < 34 weeks]. In patients > 14 -< 26 weeks,20.96% miscarriages, 8% PTL (one< 34 weeks), 19.35% emergency CS [two< 32 weeks]; one maternal, 2 intrauterine and one neonatal death. In patients 26-28 weeks, 62.5% required emergency caesarean [three< 32 weeks]. There was one maternal death, 2 patients PTL <34 weeks.
The maternal and neonatal death occurred in patients with SARI.
Conclusion: Our study shows increased abortions in early trimester irrespective of severity. The emergency caesarean and PTL rates increased in late second trimester and severe disease.
When publishing with Kerala Medicial Journal (KMJ), authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal. Work includes the material submitted for publication and any other related material submitted to KMJ. In the event that KMJ does not publish said work, the author(s) will be so notified and all rights assigned hereunder will revert to the author(s).
The assignment of rights to KMJ includes but is not expressly limited to rights to edit, publish, reproduce, distribute copies, include in indexes or search databases in print, electronic, or other media, whether or not in use at the time of execution of this agreement.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
The author(s) hereby represents and warrants that they are sole author(s) of the work, that all authors have participated in and agree with the content and conclusions of the work, that the work is original, and does not infringe upon any copyright, propriety, or personal right of any third party, and that no part of it nor any work based on substantially similar data has been submitted to another publication.
