Presentation and Outcomes in Pregnant Women

107 views 0 04/05/2020 05/02/2020 and

Clinical manifestations :

  1. Clinical manifestations in pregnant women were comparable to those seen in infected non-pregnant adults. 
  2. Initial normal body temperature was seen more commonly in pregnant women, thus rendering early detection of the virus more difficult in this population. 
  3. It has not been shown that pregnancy is a risk factor for more severe infection.

 

CT and lab findings :

  1. Low-dose CT scan is preferred to regular CT scan if possible.
  2. Pulmonary consolidation lesions on CT imaging were frequent in pregnant women. 
  3. Typical ground-glass opacities were a recurring early manifestation on chest CT. 
  4. Lab work-up may show lymphopenia and elevated C-reactive protein. Atypical findings of leukocytosis and elevated neutrophil ratio were noted in pregnant women. However, the physiological changes seen in pregnancy may act as a confounding factor in this setting.  

 

Outcomes :

  1. Infections in late pregnancy had good maternal, fetal and neonatal outcomes with active management in full-term pregnancies. Data on long-term outcomes is unavailable. 
  2. Outcomes are unknown for early pregnancy infections.
  3. Incidence of preterm labour is inconsistent from one study to another; it is unclear if COVID-19 is associated with greater risk of preterm labour at this time.

 

This data comes from multiple records. Breslin and al. described the symptoms and outcomes of 43 pregnant women positive for COVID-19. Di Mascio and al. conducted a systematic review about maternal and perinatal outcomes of different coronaviruses. 79 women were included in the study, from which 41 suffer of COVID-19. Li and al  conducted a case-control study to compare outcomes in pregnant women with and without COVID-19 pneumonia. Liu D. and al conducted an analysis of clinical signs and symptoms as well of CT scan results for 15 COVID-19 infected pregnant women with pneumonia in China. Liu H. and al. conducted a preliminary analysis of 59 patients with COVID-19 (14 non-pregnant adults, 41 pregnant women, 4 children) from January 27, 2020 to February 14, 2020. Among the pregnant women, 16 diagnoses were laboratory-confirmed and 25 were clinically-diagnosed. The characteristics seen both clinically and on CT imaging were studied and compared across the different groups of patients. Mimouni and al. analyzed the current literature about the transmission and perinatal outcomes of COVID-19 infection. Wu and al. conducted a study to determine clinical presentation, lab results, symptoms and CT findings in 23 pregnant women. Yu and al. carried out a retrospective analysis of 7 pregnant women in the Tongji Hospital in Wuhan, China between January 1, 2020 and February 8, 2020. All cases were full-term and underwent Caesarean section. Data on clinical, laboratory and CT findings in addition to demographics, treatments and outcomes were collected. Yang and al. conducted a study including 55 pregnant women and analyzed their symptoms and their different labs and imaging results. Zaigham and Andersson conducted a systematic review about maternal and perinatal outcomes. 108 pregnant women from 18 different studies were included in the review.

Sources:

  1. Breslin N., Baptiste C. and al. (April 9 2020) COVID-19 infection among asymptomatic and symptomatic pregnant women: Two weeks of confirmed presentations to an affiliated pair of New York City hospitals. American Journal of Obstetrics & Gynecology MFM. https://doi.org/10.1016/j.ajogmf.2020.100118 
  2. Di Mascio D., Khalil A. and al. (March 25 2020) Outcome of Coronavirus spectrum infections (SARS, MERS, COVID-19) during pregnancy: a systematic review and meta-analysis. American Journal of Obstetrics & Gynecology MFM. https://doi.org/10.1016/j.ajogmf.2020.100107 
  3. Li N., Han L. et al. (March 13 2020). Maternal and neonatal outcomes of pregnant women with COVID-19 pneumonia: a case-control study. https://doi.org/10.1101/2020.03.10.20033605
  4. Liu D., Li L. et al. (March 7, 2020) Pregnancy and Perinatal Outcomes of Women With Coronavirus Disease (COVID-19) Pneumonia: A Preliminary Analysis. American journal of Roentgenology. https://doi.org/10.2214/AJR.20.23072
  5. Liu H., Liu F., Li J. et al (March 2, 2020). Clinical and CT imaging features of the COVID-19 pneumonia: Focus on pregnant women and children. J Infect.  https://doi.org/10.1016/j.jinf.2020.03.007
  6. Mimouni F., Lakshminrusimha S. and al. (April 10 2020) Perinatal aspects on the covid-19 pandemic: a practical resource for perinatal–neonatal specialists. Journal of Perinatalogy. Retrieved from : https://www.nature.com/articles/s41372-020-0665-6
  7. Wu X., Sun R. and al. (April 8 2020) Radiological findings and clinical characteristics of pregnant women with COVID‐19 pneumonia. International Journal of Gynecology and Obstetrics. https://doi.org/10.1002/ijgo.13165   
  8. Yang H., Sun G. and al. (April 12 2020) Clinical Features and Outcomes of Pregnant Women Suspected of Coronavirus Disease 2019. Journal of Infection. https://doi.org/10.1016/j.jinf.2020.04.003
  9. Yu N., Li W., Kang Q., et al. (March 24, 2020). Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single centre, descriptive study. The Lancet Infectious Diseases. https://doi.org/10.1016/S1473-3099(20)30176-6
  10. Zaigham M. and Andersson O. (April 7 2020) Maternal and Perinatal Outcomes with COVID‐19: a systematic review of 108 pregnancies. Acta Obstetricia et Gynecologica Scandinavica. https://doi.org/10.1111/aogs.13867
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