COVID-19 infection in symptomatic pregnant women at the midpoint of the pandemic in Spain: a retrospective analysis

Abstract

Objectives: Determine the strengths and weakness of a symptomatic screening for COVID-19 in pregnant women. Analyze the clinical presentation, management, and outcomes.

Design: Descriptive retrospective observational study.

Setting: Mancha-Centro Hospital (Spain).

Material and methods: Population: Symptomatic pregnant women with confirmed diagnosis of COVID-19. Between the 12th of March and 17th of April 2020, all the symptomatic pregnancies were screened with diagnostic test for SARS-CoV-2. Data collection was done by reviewing the medical records and telephone interviews.

Main outcome measures: Clinical characteristics, management, treatment, and obstetric and neonatal outcomes.

Results: Twenty patients with positive COVID-19 diagnostic test out of thirty-four suspected. The most common symptoms were fever (70%), cough (65%) and myalgia (35%). A unique symptom of presentation in 20% of cases. COVID-19 pneumonia was diagnosed in 30% by chest X-ray and one case had pulmonary embolism associated diagnosed by CT-Scan. Thromboprophylaxis was indicated in 16 out of 20 patients. Eight women finished their pregnancy during the observation period. Type of birth: 25% natural birth, 12.5% assisted vaginal delivery and 62.5% caesarean section. We had three severe cases, two of them with intensive care support. All neonates had negative test for COVID 19 infection.

Conclusions: We recommend universal screening of all pregnant woman for COVID-19 during the pandemic because of the limits of the symptomatic screening seen in this studio and the ratio of asymptomatic pregnancies with positive test for COVID-19 recently published.

Keywords: COVID-19; delivery; outcomes; pregnancy; screening; symptoms.