Second Wave of SARS-CoV-2: Impact on Pregnant Women and Newborns—A Tertiary Care Experience in North India

Abstract

Abstract Objectives The aim of this study was to evaluate the clinical presentation, course of disease, and management of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in pregnant women. We also aimed to evaluate the fetomaternal outcomes in these women. Material and Methodology This was a single-center, retrospective study performed in a tertiary care hospital for pregnant women with coronavirus disease 2019 (COVID-19) in India. The medical records of all antenatal or postnatal women who were admitted to COVID-19 facility from April 1 to June 30, 2021, were reviewed. The demographic characteristics, obstetric parameters, presence of comorbidities, disease severity, investigations, management, and fetal outcome were recorded. Statistical Analysis The data were entered in MS Excel spreadsheet and analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0. Result A total of 94 women were admitted to the COVID-19 facility; 54 (57.45%) were antenatal and 40 (42.55%) were postnatal, 75.53% of them were between 20 and 30 years of age, and 62.96% were multigravida. In addition, 42.55% were asymptomatic and 32.98, 9.58, and 14.89% had mild, moderate, and severe disease, respectively. Also, 42.59% of women had cesarean delivery. Among these, 14 (14.89%) required intensive care unit (ICU) admission, and 24.46% needed oxygen therapy. Comorbidities were present in 48.94%, with hypertensive disorder being the most common (14.89%). Common residual complaints were malaise, body ache, and cough. Among women admitted in the ICU, eight (57%) had comorbidities such as preeclampsia, diabetes, heart disease, and anemia. All these women required oxygen therapy, antibiotics, and thromboprophylaxis. Six among them received steroid (methylprednisolone) and four received antiviral drug (remdesivir). Three women succumbed to death. The mortality rate was 3.19%. Among the neonates, six babies were affected with SARS-CoV-2 and all recovered. On follow-up after discharge, one woman with rheumatic heart disease expired after 2 days of discharge and one woman had a spontaneous abortion. Conclusion During the second wave, caused by the Delta variant, maximum requirement was for oxygen therapy, antiviral drugs, and steroids. We conclude that women with comorbidities and advanced period of gestation had a severe course and required critical care. The optimum care and counselling regarding possible outcome in such a vulnerable population is needed.