RESUMO
Aim To investigate clinical presentation of COVID-19 infection in pregnancy, its course during pregnancy, effects on pregnancy outcomes for both mothers and newborns as well as the potential for vertical transmission. Methods This retrospective observational study included all identifi ed COVID-19-positive pregnant women admitted to the Cantonal Hospital in Zenica at any stage of pregnancy or labour from 30 April 2020 to April 30 2021. Maternity and newborns were followed until discharge from the hospital. Results Twenty-four pregnant women were positive for COVID-19. There were 79.2% asymptomatic cases, 12.5% had mild symptoms, while 8.3% had more severe forms of the disease. The main follow-up morbidities were high BMI 33.3%, anaemia 16.7%, thrombocytopenia 12.5%, hypertensive disorders 4.2% and diabetes 4.2%. The rate of premature births was 33.3%, while 8.3% pregnant women had premature rupture of the amniotic sac. Caesarean section was done for 75% women while 25% delivered vaginally. Previous caesarean section (54.2%) was the most common indication for operative completion of labour. Twentythree (92%) live babies were born, of which 8 (33.3%) were admitted to the neonatal intensive care unit. Two (8%) intrauterine foetal deaths were recorded that occurred before admission to our hospital. Two infants (8.7%) had a positive PCR test for COVID-19. Conclusion COVID-19 viral disease in pregnancy is usually presented as an asymptomatic or mild disease. It is associated with high rates of preterm birth, admission of newborns to the intensive care unit and intrauterine foetal death. Vertical transmission is possible but the newborns were asymptomatic.
RESUMO
Aim To identify a rate of macrosomic births in a one-year review, associated maternal characteristics and pregnancy outcome. Methods This one-year retrospective review included all macrosomic deliveries at the Department of Obstetrics and Gynaecology at the Cantonal Hospital Zenica between 1 January 2018 and 31 December 2018. The data were collected from maternal and newborn medical records. A total of 361 singleton normal birth weight term newborns (birth weight <4000 g, but not small for gestational age) who were delivered in the same period, represented the control group. Results Among the total of 2758 women who gave birth, 360 (13.05%) macrosomic infants (birth weight more than 4000 g) were delivered. Mean birth weight was 4258.90 g (maximum 5460g); nine (0.33%) were >5000g. Male macrosomic infants were more frequently represented, 245 (68,1%) comparing to the control group (p<0.01); in the control group female infants were more frequently represented (p<0.01). The overall Cesarean section rate, including elective Cesarean delivery was 23.2%, and 76.1% underwent an attempt of labour delivered vaginally. Conclusion Macrosomia represents a risk for adverse outcome for the mother and neonate, with a higher risk for the operative mode of delivery.
