Adverse outcomes and maternal complications in pregnant women with severe-critical COVID-19: a tertiary center experience.

Sinaci, Selcan; Tanacan, Atakan; Besimoglu, Berhan; Menekse Beser, Dilek; Uyan Hendem, Derya; Tugrul Ersak, Duygu; Atalay, Aysegul; Kaya, Ecem; Ozden Tokalioglu, Eda; Cankar Dal, Hayriye; Ocal, Doga Fatma; Erdem, Deniz; Izdes, Seval; Moraloglu Tekin, Ozlem; Ates, İhsan; Turan, Sema; Sahin, Dilek

This study aimed to present perinatal outcomes, clinical challenges, and basic ICU management in pregnant women with severe-critical COVID-19 at our tertiary referral center. In this prospective cohort study, patients were divided into two groups, whether they survived or not. Clinical characteristics, obstetric and neonatal outcomes, initial laboratory test results and radiologic imaging findings, arterial blood gas parameters at ICU admission, and ICU complications and interventions were compared between groups. 157 of the patients survived, and 34 of the patients died. Asthma was the leading health problem among the non-survivors. Fifty-eight patients were intubated, and 24 of them were weaned off and discharged healthfully. Of the 10 patients who underwent ECMO, only 1 survived (p<0.001). Preterm labor was the most common pregnancy complication. Maternal deterioration was the most common indication for a cesarean section. Higher neutrophil-to-lymphocyte-ratio (NLR) values, the need for prone positioning, and the occurrence of an ICU complication were important parameters that influenced maternal mortality (p<0.05). Overweight pregnant women and pregnant women with comorbidities, especially asthma, may have a higher risk of mortality related to COVID-19. A worsening maternal health condition can lead to increased rates of cesarean delivery and iatrogenic prematurity.

EVALUATION of medical care; COVID-19; ASTHMA; PREMATURE infants; INTUBATION; TERTIARY care; EXTRACORPOREAL membrane oxygenation; PREGNANT women; IATROGENIC diseases; CATASTROPHIC illness; RISK assessment; COMPARATIVE studies; NEUTROPHIL lymphocyte ratio; PREGNANCY complications; SURVIVAL analysis (Biometry); MATERNAL mortality; CESAREAN section; OBESITY in women; LONGITUDINAL method; PREMATURE labor; LYING down position; COMORBIDITY; DISEASE risk factors; DISEASE complications; PREGNANCY

Journal of Perinatal Medicine, 2023, Vol 51, Issue 7, p874

0300-5577

Academic Journal

10.1515/jpm-2022-0564