Irregular Antenatal Care Attendance among Pregnant Women during COVID-19 Pandemic in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

INTRODUCTION: The coronavirus disease 2019 pandemic has made access to antenatal care services difficult, which could lead to serious implications for the health of mothers and fetus. There is limited study regarding its impact on pregnant women. This study aimed to find out the prevalence of irregular antenatal care attendance among pregnant women during the COVID-19 pandemic in a tertiary care centre. METHODS: A descriptive cross-sectional study was carried out among pregnant women attending antenatal care visits at the Department of Gynaecology and Obstetrics in a tertiary care centre from 23 July 2021 to 5 September 2021. Ethical approval was granted by the Institutional Review Committee (Reference number: 077/078/67). Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. RESULTS: Among 196 pregnant women, 49 (25%) (18.96-31.06, 95% Confidence Interval) had irregular antenatal care attendance during the COVID-19 pandemic. CONCLUSIONS: The prevalence of irregular antenatal care attendance during the COVID-19 pandemic was lower than other studies done in similar settings. Antenatal care is crucial to prevent maternal, fetal morbidity and mortality, hence uninterrupted antenatal care services should be provided even during crisis situation like COVID-19 pandemics.

Effects of COVID-19 on Pregnant Women and Newborns: A Review.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus originated in Wuhan, China, and spread all over the world, causing the worst pandemic of the century. The disease has a broad continuum of clinical presentations, from mild to life-threatening. The virus is highly contagious and transmittable to humans. Emerging evidence of its effects on pregnant women and newborns is inconsistent and ever-evolving. Therefore, the objective of this review is to compile the scientific literature on the effects of SARS-CoV-2 coronavirus on pregnancy, pregnant women, and newborns. Data were obtained by several authors using PubMed, MEDLINE, Google Scholar, and Web of Science. "COVID-19", "pregnancy", "vertical transmission", and "newborn" were the search words used to find relevant articles. Most studies suggested pregnant women and newborns are not at additional risk for unfavorable outcomes. Besides, very few studies found newborns who tested positive for SARS-CoV-2 upon delivery from a COVID-positive mother. However, several studies showed no evidence of intrauterine or transplacental transmission of COVID-19 infection. Studies had mixed findings with a few showing the presence of the virus in breastmilk. In conclusion, there is no concrete evidence of additional adverse effects of SARS-CoV-2 on pregnant women and newborns.

'How COVID 19 imposed a new normal outlook in reproductive health care of patients, research, teaching and assessment'- Perspective of a Gynecologist.

With the frequently changing guidelines on Pregnancy care, management of obstetric patients remains a major challenge during COVID-19 Pandemic. The department of Obstetrics and Gynecology had a huge responsibility to provide respectable maternity care to all women irrespective of their virologic status and at the same time protect the frontline warriors dealing with patient care during the COVID-19 pandemic. We would like to share our perspective regarding the challenges faced and the solutions sought for, in both patient care and teaching and research.

Maternal and Neonatal Clinico-Demographic profile and outcomes during the COVID-19 Pandemic at the Chinese General Hospital and Medical Center

Background@#COVID-19 is an ongoing health concern that hospitals have struggled to keep up with, given its increasing burden with the passage of time. Considerations for the management of COVID-19 should be made especially for pregnant patients and their neonates.@*Objectives@#To determine COVID-19 prevalence and the clinical profile of mothers admitted for childbirth at Chinese General Hospital and Medical Center from May 2020 to July 2020. The profile and outcomes of neonates born to these mothers were likewise studied. @*Materials and Method@#A descriptive cross-sectional study was done that included mothers admitted for childbirth who had SARS-CoV-2 RT PCR swab test and their neonates. A total of 408 medical records of mother and neonate dyads were reviewed. Relevant variables such as the patients’ demographic profile, clinical characteristics, co-morbidities and the maternal and neonatal outcomes were obtained. Frequency distributions were made to assess the prevalence of COVID-19 among the patients, as well as maternal and neonatal outcomes. @*Results@#Twenty-two (5.39%) mothers tested positive for COVID-19, while all neonates (n = 22) that underwent RT-PCR swab at the 24th hour of life had negative results. Of the 22 COVID-19 positive mothers, 2 (9.09%) were symptomatic upon admission while 20 (90.09%) were asymptomatic. The following were the key trends among those mothers who tested positive for COVID-19: (1) 81.82% were from ages 20-39 years old, (2) 72.73% were multigravida mothers, (3) 54.55% had normal spontaneous delivery, (4) diabetes mellitus was the only noted comorbidity. Key findings on the neonatal outcomes observed in the study population of both COVID-19 positive and negative cases, include: (1) majority of neonates had an APGAR score of greater than 7 at 1st and 5th minute of life; (2) higher frequency of neonates with Ballard’s score of more than 37 weeks AOG; (3) more male neonates as compared to female neonates; (4) a normal birth weight for majority of cases; (5) 45.45% of neonates born to COVID positive mothers had a length of stay of <48 hours as compared to 72.8% of neonates born to COVID negative mothers; and (6) neonatal pneumonia as the most common comorbid condition in both cases. @*Conclusion@#This study noted a prevalence of 5.39% COVID-19 positive mothers. SARS-CoV-2 virus was not detected in all of the neonates born to COVID-19 affected mothers. Neonates delivered to COVID-19 positive mothers had similar trends in the neonatal outcomes when compared to neonates delivered to mother who were COVID-19 negative.

Epidemiología de la COVID-19 y la embarazada en el mundo y Venezuela

El binomio madre-hijo es una población muy especial y recibe toda la atención social para asegurar su protección y asistencia. La pandemia de la COVID-19 con más de 1 año de duración es un riesgo para muchos grupos vulnerables ya identificados con los estudios epidemiológicos donde resaltan las personas mayores de 65 años, personas con comorbilidades tipo obesidad, hipertensión diabetes, enfermedades cardiovasculares e inmunosupresoras. Se revisan las estadísticas de la COVID-19 en la población general y en las gestantes, con especial revisión de la región de las Américas y Venezuela. Las embarazadas han sido estudiadas durante la pandemia y se concluye que es una población de riesgo más vulnerable a complicaciones durante la gestación, en parto el puerperio y su producto durante la vida neonatal mayor riesgo de enfermar grave y requerir cuidados intensivos. Se insta a los grupos de investigación incorporarse en los protocolos de monitoreo internacionales, y seguir estudiando la COVID-19 en la embarazada y el feto.

The mother-child binomial is a very special population and receives all the social care to ensure its protection and assistance. The COVID-19 pandemic lasting more than 1 year is a risk for many vulnerable groups already identified with epidemiological studies highlighting people over the age of 65, people with obesity-like comorbidities, diabetes hypertension, cardiovascular disease and immunosuppressants. Statistics of the COVID-19 pandemic in the general population and pregnant women are reviewed, with special revision of the Americas and Venezuela region. Pregnant women have been studied during the pandemic and it is concluded that it is a population at risk more vulnerable to complications during pregnancy, childbirth, postpartum and its product during neonatal life increased risk of serious illness and intensive care. Research groups are encouraged to join international monitoring protocols, and further study COVID-19 in pregnant women and fetuses.