Birthing in Covid-A Study in a tertiary care Hospital, GGH, Kadapa

Abstract

Background: COVID 19, caused by SARS-COV-2 is a global health emergency. Corona viruses are enveloped, RNA viruses and is spread by respiratory droplets. Pregnancy is a physiological state that predisposes to viral infections and making them more susceptible to COVID-19 than the general population.Aims and Objectives: 1) To evaluate the effects of COVID-19 infection on maternal morbidity and maortaloty,course of labour and perinatal outcome. 2) To study the effective implementation of COVID management protocol in antenatal mothers attending labour room, counseling and isolation. Materials and Methods: A Retrospective Observational Analytical study is done in the Department of OBG from 1st April to 30th October,2010 at a Tertiary care hospital, GGH, Kadapa. A total of 197 pregnant women who were COVID positive were included in the study.Results: Among 197 COVID positive antenatal women, 137 cases delivered. Out of 137 deliveries, 75 (54.7%) patients were delivered by LSCS and 62 (45.2% ) patients delivered vaginally. Most common indication for LSCS is Prior LSCS (40% ) followed by CPD (16%) and fetal distress(6%). One Maternal Death was reported due to Severe Preeclampsia with pulmonary edema in COVID positive mother. Out of the remaining 60 patients, 21 were admitted with symptoms(fever, cold and cough) and given symptomatic treatment , 39 were in quarantine for 14days and discharged. Out of 137 deliveries, only 5 babies had APGAR <6 and needed SNCU admission and 2 babies required ventilatory support. All the babies were tested for COVID, only one baby was tested Positive and remaining all the babies were healthy.Discussion: All the symptomatic antenatal mothers should be admitted and treated as COVID positive unless otherwise tested negative by RT-PCR. Deliveries should be conducted by wearing PPE kits , Donning and Doffing should be done with precautions. Breastfeeding should be encouraged to all the babies.Conclusion: There is no significant effect of COVID 19 infection on maternal outcome in pregnancy and most of the complications were due to associated comorbidities like preeclampsia. The perinatal transmission of COVID19 infection is very minimal. Timely isolation, Isolation, Counselling, Breastfeeding methods and following strict COVID management protocol at our hospital resulted in better maternal and perinatal outcome.