Maternal Outcomes and Clinical Characteristics of COVID-19 in Korean Pregnant Women during the Early Period of the Pandemic.

The present study aimed to compare the clinical characteristics and outcomes between pregnant women and non-pregnant women of childbearing age (20-49 years old) diagnosed with coronavirus disease 2019 (COVID-19) during the initial stage of the COVID-19 pandemic in the Republic of Korea. This nationwide observational study included the information of COVID-19 patients collected by the Korea Disease Control and Prevention Agency from January 2020 to April 2021. Among 5,647 COVID-19 patients, 2,444 (43.3%) were women of childbearing age and 19 were pregnant. None of the pregnant women died. However, 4 deaths occurred among non-pregnant women aged 20-49 years. None of the 19 pregnant women with COVID-19 were admitted to the intensive care unit: they were admitted to the general ward, and none of them required supplemental oxygen. In conclusion, none of the pregnant women with COVID-19 experienced severe infection or death, unlike non-pregnant women of childbearing age.

A Postpartum Death Due to Coronavirus Disease 2019 (COVID-19) in the United States.

BACKGROUND: Limited U.S. reports of pregnant women with coronavirus disease 2019 (COVID-19) infection describe a few critical cases and no maternal mortality. CASE: A 36-year-old patient at 37 weeks of gestation presented with shortness of breath, fever, cough, and sore throat for 1 week. Within 3 hours of admission, she experienced respiratory distress, required intubation, and underwent cesarean delivery and transfer to the intensive care unit. She subsequently decompensated, with multiorgan failure, sepsis, and cardiopulmonary arrest within 36 hours, despite aggressive supportive care and investigational therapies. CONCLUSION: A pregnant patient with COVID-19 infection can experience a rapid onset of critical complications that may prove fatal, despite an indolent presentation. The pathogenesis leading to rapid deterioration is unknown.

Pregnancy outcomes following bipolar umbilical cord cauterization for selective termination in complicated monochorionic multiple gestations.

OBJECTIVE: To review pregnancy and childhood outcomes following selective termination by ultrasound guided bipolar umbilical cord cauterization (UCC) in complicated monochorionic multifetal pregnancies. STUDY DESIGN: Consenting patients (27 of 49, 55%) had review of pregnancy history and pediatric development in the surviving twin following selective UCC. RESULTS: UCC was performed at 21.2 +/- 2.8 weeks gestational age, followed by a liveborn delivery (n = 28) at 34.4 +/- 4.7 weeks. Mean birth weight was 2,218 +/- 926 g. Complications included preterm labor (25.0%), premature rupture of membranes (17.8%), placental abruption (10.7%) and chorioamnionitis (7.1%). Perinatal mortality was 10.3% in continuing fetuses. However, 96.2% of pregnancies achieved livebirths with 96% of neonates showing apparently normal development between ages 1.5 and 5 years. CONCLUSION: Bipolar UCC is a reasonably safe and effective treatment for selective termination in complicated monochorionic pregnancies.

Abnormal multiple marker screens are associated with adverse perinatal outcomes in cases of intrauterine growth restriction.

OBJECTIVE: The purpose of this study was to determine if abnormal multiple marker screens (MMS) are associated with adverse perinatal outcomes in intrauterine growth restriction (IUGR) pregnancies. STUDY DESIGN: This was a case control study of IUGR pregnancies (birth weight <10th percentile for gestational age [GA]) delivered in our unit over 6 years. Cases were compared with controls for the association between abnormal MMS and adverse perinatal outcomes (APO). RESULTS: Of the 261 IUGR pregnancies, 39 (16%) had at least 1 APO. An elevated HCG was significantly associated with an APO (OR 2.6, 95% CI 1.1-6.4). A low uE3 was also associated with an APO (OR 5.5, 95% CI 2.2-14). The association between an elevated AFP and APO was not statistically significant (OR 1.6, 95% CI, 0.6-4.6). CONCLUSION: An elevated HCG and low uE3 were associated with APO in cases of IUGR. This information could be useful in identifying a subset of IUGR cases deserving closer surveillance.