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Preeclampsia in COVID-19: A Masquerading Errant-An Exploration of Foeto-Maternal Outcome from a Tertiary Care
Sheeba Marwah1, Anjali Dabral1, Neha Mohit Bhagwati1
1Department of Obstetrics & Gynecology, VMMC & Safdarjung Hospital, New Delhi, 110029 India.
Insights
Pregnant women with preeclampsia (a condition causing high blood pressure during pregnancy) who contract COVID-19 face more severe illness. This leads to increased intensive care needs and higher risks for both mothers and newborns.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Maternal-Fetal Medicine
Background:
- The COVID-19 pandemic highlighted multisystemic effects of SARS-CoV-2 infection, extending beyond typical respiratory viral illness symptoms.
- Preeclampsia, a significant pregnancy complication, presents unique challenges when co-occurring with COVID-19.
Purpose of the Study:
- To evaluate the impact of COVID-19 on pregnant women diagnosed with preeclampsia.
- To assess the incidence, maternal characteristics, and feto-maternal outcomes in SARS-CoV-2 positive women with preeclampsia.
Main Methods:
- A descriptive, retrospective study was conducted from May to November 2020.
- Medical records of laboratory-confirmed SARS-CoV-2 positive pregnant women with preeclampsia were reviewed.
- Data collected included socio-demographic factors, COVID-19 severity, and feto-maternal outcomes.
Main Results:
- 12.58% of SARS-CoV-2 positive pregnant women presented with preeclampsia.
- Severe preeclampsia occurred in 65.71% of cases, with 20% experiencing severe COVID-19.
- Maternal outcomes included ICU admissions and mortality, while neonatal outcomes showed high rates of prematurity and low birth weight.
Conclusions:
- Pregnant women with preeclampsia infected with SARS-CoV-2 experience more severe illness.
- These patients exhibit increased requirements for intensive care.
- High maternal and neonatal morbidity are associated with this co-infection.
Background:
COVID-19 pandemic has shown that the multisystem involvement in COVID-infected patients is beyond the usual clinical manifestations of other respiratory viral illnesses. This study aims to evaluate the upshots of COVID-19 in women with preeclampsia.
Methodology:
This descriptive study was conducted in department of Obstetrics & Gynaecology at VMMC & Safdarjung Hospital (May-November 2020), wherein a retrospective review of the medical records of laboratory confirmed SARS CoV2-positive pregnant women (as per ICMR), with preeclampsia (as defined by ACOG guidelines), was done in the dedicated COVID labour ward. Primary outcome was incidence of preeclampsia in SARS CoV2 positive gravid females. Secondary outcomes were socio-demographic and maternal characteristics, severity of COVID-19 and foeto-maternal outcome.
Results:
During these 7 months, 38/302 (12.58%) SARS COV2-positive women presented with pre-eclampsia, either before or at the time of admission; amongst them 47.37% were primigravida. Severe preeclampsia was chronicled in 65.71% women. Around 20% women had severe COVID-19. All women with severe COVID19 required ICU stay, 5 requiring intubation. Three of these patients succumbed to their illness. Out of the 40 babies born to these women (including 2 twin pregnancies), 36.84% were premature deliveries. Seventeen (42.50%) babies had low birth weight. Although 82.50% were live births, five (12.50%) were intrauterine demise and 2 were early neonatal deaths.
Conclusion:
Gravid women with preeclampsia infected with SARS CoV2 have comparative more severe illness, requiring more intensive care requirement and high maternal and neonatal morbidity.
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