Maternal and neonatal outcome of vertical transmission in pregnant women during COVID-19 pandemic at Quetta, Balochistan; developing a regional consensus on existing evidence.

Abstract

Objectives: To evaluate deleterious impact of novel coronavirus infection 2019 (COVID-19), on both maternal and fetal well being during pregnancy. Study Design: Hospital-Based Cross-sectional Survey. Setting: Department of Gynecology & Obstetrics, Combined Military Hospital, Chiltan Road, Quetta (Balochistan); Department of Gynecology & Obstetrics, Frontier Corps Hospital, Quetta Cantonment (Balochistan), and the Department of Otorhinolaryngology (ENT), Combined Military Hospital, Chiltan Road, Quetta (Balochistan). Period: March 2020 till July 2020. Material & Methods: Careful history, clinical and obstetrical examination radiology and real time polymerase chain reaction of nasopharyngeal swab were carried out in pregnant patients presenting for childbirth. Deliveries were conducted through spontaneous vaginal birth and caesarean section as per indication. Neonatal evaluation and nasopharyngeal swab for COVID-19 real time polymerase chain reaction in all delivered fetuses were performed. Results: 516 pregnant women underwent spontaneous vaginal delivery and caesarean sections at these hospitals during the study duration. 4.06% (n=21) were confirmed as COVID-19 infected. All of the fetuses born to these infected mothers were delivered healthy and COVID-19 negative, except for one preterm fetus born at 22^nd week of gestation on account of maternal gestational hypertension. Conclusion: Trans-placental spread of COVID-19 infection to the fetus is unlikely. However, the infection places a pregnant mother at much higher risk to develop complications which may occasionally lead to adverse pregnancy outcome.