Patient Characteristics, Clinical Presentation and Maternal- Fetal Outcomes of Women with COVID-19 Admitted At a Tertiary Hospital, South-Western Uganda

Authors: Byamukama O*, Tibaijuka L, Kalyebara PK, Garcia KRM, Saturday P, Kayondo M and Ngonzi J

DOI: 10.23880/whsj-16000192

Volume 7, Issue 2

Abstract

Background: The coronavirus disease (COVID-19) outbreak declared a pandemic by the World Health Organization (WHO) in 2019 significantly affected pregnant women. Pregnancy causes immunological and physiological changes making a pregnant woman susceptible to a higher risk of infection with SARS-CoV-2 and death. We described the maternal socio-demographic and obstetric characteristics, clinical presentation, as well as maternal-fetal outcomes among pregnant women with COVID-19 disease at Mbarara Regional Referral Hospital. Methods: We conducted a retrospective cohort study at the COVID-19 treatment unit (CTU) of Mbarara Regional Referral Hospital (MRRH) from May 13, 2020 to July 22, 2021. We reviewed files of pregnant women with a confirmed diagnosis of COVID-19 disease by either Polymerase Chain Reaction or rapid diagnostic test (RDT). We used a chart abstraction tool in Red Cap to capture the information. We described the maternal sociodemographic and obstetric characteristics, clinical presentation, and maternal-fetal outcomes as frequencies and percentages. Results: A total of 30 participants were included in this study. The mean age was 28.6 (±5.8) years, majority were multigravida (66.7%), rural residents (53.3%), with gestational age <37 weeks (58.62%) and had severe or critical disease (43.3%) on admission. The most common symptoms at admission were cough (33%) and fever (25%). Majority of the participants had their pregnancy terminated (60.0%, 18/30). Cesarean delivery was conducted in 12/17 (70.6).13/17 (76.5%) were live births, while (4/17) 23.5% were still births and 13/17 (76.5%) had birth weight of ≥2.5 kilograms. 9/30 (30.0%) of the women died, mainly from respiratory failure (33.3%, n=3) and pulmonary embolism (33.3%, n=3). Conclusion: The maternal mortality among pregnant women admitted with COVID-19 disease was high. The main causes of death were respiratory failure and pulmonary embolism. were delivered by cesarean section with most having live births and a normal birth weight. Health systems need to strengthen measures to handle pregnant women with COVID-19 disease, ensuring well designed effective treatment protocols and intensive care facilities including the critical human resources and equipment that may be required to provide advanced care for pregnant women with COVID-19.

Keywords: COVID-19; COVID-19 in pregnancy; Maternal-fetal outcomes; Mbarara Regional Referral Hospital; Uganda

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