Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 13 , ISSUE 2 ( March-April, 2021 ) > List of Articles


Study of Pregnancy with COVID-19 and its Clinical Outcomes in a Tertiary Care Teaching Hospital in Western India

Shital N Kapadia, Amiya Mehta, Charul R Mehta, Sumeeta T Soni, Neelam Joharwal, Monica Dixit, Jolly G Vaishnav

Keywords : Pregnancy with COVID-19, Vertical transmission

Citation Information : Kapadia SN, Mehta A, Mehta CR, Soni ST, Joharwal N, Dixit M, Vaishnav JG. Study of Pregnancy with COVID-19 and its Clinical Outcomes in a Tertiary Care Teaching Hospital in Western India. J South Asian Feder Obs Gynae 2021; 13 (2):125-130.

DOI: 10.5005/jp-journals-10006-1886

License: CC BY-NC 4.0

Published Online: 09-07-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Objectives: To study cases of pregnancy with coronavirus disease-2019 (COVID-19) and its clinical outcome. To study evidence of the vertical transmission in pregnant women infected with COVID-19. Materials and methods: A prospective study was performed in BJ Medical College and Civil Hospital, Ahmedabad, one of the biggest designated (1200 beds) COVID hospitals in India. It was carried out from June 2020 to mid-October 2020. A total of 50 pregnant patients who were COVID-19 positive and admitted to the labor room were studied. Results: The mean age of the mothers was 27.40 ± 4.76 years (range: 19–36 years) and mean gravidity was 1.67 ± 1.41 (range: 1–4). The mean gestational age was 38.31 ± 1.67 weeks. The main complaint was fever in 22 (44%), followed by dry cough in 9 (18%), sore throat in 4 (8%), headache in 2 (4%), malaise in 7 (14%), and diarrhea in 2 (4%) patients. Twenty-two (44%) patients showed an elevated C-reactive protein level, 17 (34%) had lymphopenia, 19 (38%) had mild elevation of the D-dimer level, and 16% of the patients had increased interleukin 6 levels. Most of the patients had normal renal function test (RFT) and liver function test (LFT) results. A majority of them (86%) had normal chest X-ray, whereas rest of them (14%) had haziness in bilateral lung fields. Twenty-six (52%) patients underwent C-section, and 23 (46%) delivered vaginally. Four (8%) babies required the admission in the newborn intensive care unit for mild birth asphyxia but were discharged well. Five babies developed physiological jaundice and required single surface phototherapy (SSPT). Forty-eight (96%) out of 50 had negative vaginal swab by reverse transcription polymerase chain reaction (RT-PCR), 48 (96%) did not show any evidence of the virus in the expressed breast milk by RT-PCR. We collected the cord blood sample of 35 patients after delivery which was found to be negative in all (100%). The nasopharyngeal swab of all the babies was negative on the very first day. Day 7 repeat swab was found positive only in one baby. This transmission was mostly via respiratory droplets during intermittent assisted breastfeeding. Most of the cases were having mild disease without acute respiratory distress syndrome (ARDS), which responded to the supportive treatment. Four patients (8%) had severe anemia and required blood transfusion. Conclusion: Most of the cases were having mild disease without ARDS, which responded to supportive treatment. Reassuringly, there was no evidence of poor fetal outcome, intrauterine fetal deaths, or premature deliveries. We did not find any evidence of the virus in the vaginal fluid, cord blood, or breast milk supporting vertical transmission of COVID-19 in the third trimester of pregnancy, even if patient delivered vaginally.

  1. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497–506. DOI: 10.1016/S0140-6736(20)30183-5.
  2. World Health Organization. Novel coronavirus–China. 2020. Available at: Accessed March 7, 2020.
  3. Center for Systems Science and Engineering (CSSE) at Johns Hopkins University. COVID19 dashboard. 2020. Available at: Accessed March 24, 2020.
  4. Cucinotta D, Vanelli M. WHO declares COVID-19 a pandemic. Acta Biomed 2020;91(1):157–160. DOI: 10.23750/abm.v91i1.9397.
  5. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 outbreak in China: summary of a report of 72314 cases from the Chinese center for disease control and prevention. JAMA 2020;323(13):1239–1242. DOI: 10.1001/jama.2020.2648.
  6. Qiancheng X, Jian S, Lingling P, et al. Coronavirus disease 2019 in pregnancy. Int J Infect Dis 2020;95:376–383. DOI: 10.1016/j.ijid.2020.04.065.
  7. Cao D, Yin H, Chen J, et al. Clinical analysis of ten pregnant women with COVID-19 in Wuhan, China: a retrospective study. Int J Infect Dis 2020;95:294–300. DOI: 10.1016/j.ijid.2020.04.047.
  8. Yan J, Guo J, Fan C, et al. Coronavirus disease 2019 in pregnant women: a report based on 116 cases. Am J Obstet Gynecol 2020;223(1):111.e1–111.e14. DOI: 10.1016/j.ajog.2020.04.014.
  9. Chen Y, Peng H, Wang L, et al. Infants born to mothers with a new coronavirus (COVID-19). Front Pediatr 2020;8:104. DOI: 10.3389/fped.2020.00104.
  10. Dawei W, Bo H, Chang H, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel corona virus infected pneumonia in Wuhan, China. JAMA 2020;323(11):1061–1069. DOI: 10.1001/jama.2020.1585.
  11. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020;395(10223):507–513. DOI: 10.1016/S0140-6736(20)30211-7.
  12. Brandon H, Viksejens M. Clinical characteristics of covid-19 in China. N Engl J Med 2020;382(19):1860–1861. DOI: 10.1056/NEJMc2005203.
  13. Chen H, Guo J, Wang C, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. J Lancet 2020;395(10226):809–815. DOI: 10.1016/S0140-6736(20)30360-3.
  14. Creanga AA, Johnson TF, Graitcer SB, et al. Severity of 2009 pandemic influenza A (H1N1) virus infection in pregnant women. Obstet Gynecol 2010;115(4):717–726. DOI: 10.1097/AOG.0b013e 3181d57947.
  15. Chen S, Huang B, Luo DJ, et al. [Pregnant women with new coronavirus infection: a clinical characteristics and placental pathological analysis of three cases]. Zhonghua Bing Li XueZaZhi. 2020;49:E005. DOI: 10.3760/cma.j.cn112151-20200225-00138.
  16. Zhang L, Jiang Y, Wei M, et al. [Analysis of the pregnancy outcomes in pregnant women with COVID-19 in Hubei Province]. Zhonghua Fu Chan KeZaZhi. 2020;55:E009. DOI: 10.3760/cma.j.cn112141- 20200218-00111.
  17. Nambiar SS, Ajith S, Reshmi VP, et al. Assessing disease outcome in COVID-19 pregnancies in a tertiary referral center in South India: a single-center retrospective cohort study. J S Asian Federat Obstet Gynaecol 2020;2020:1822. DOI: 10.5005/jp-journals-10006-1822.
  18. Juusela A, Nazir M, Gimovsky M. Two cases of coronavirus 2019-related cardiomyopathy in pregnancy. Am J Obstet Gynecol 2020;2(2):100113. DOI: 10.1016/j.ajogmf.2020.100113.
  19. Mascio DD, Khalil A, Saccone G, et al. Outcome of coronavirus spectrum infections (SARS, MERS, COVID-19) during pregnancy: a systematic review and meta-analysis. Am J Obstet Gynecol 2020;2(2):100107. DOI: 10.1016/j.ajogmf.2020.100107.
  20. Rashid F, Shahnaz S, Sharmin R, et al. Pregnancy with COVID-19: Weal and Woe. J S Asian Federat Obstet Gynaecol 2020;2020:1798. DOI: 10.5005/jp-journals-10006-1798.
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