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Sinaci S, Tanacan A, Besimoglu B, Menekse Beser D, Uyan Hendem D, Tugrul Ersak D, Atalay A, Kaya E, Ozden Tokalioglu E, Cankar Dal H, Ocal DF, Erdem D, Izdes S, Moraloglu Tekin O, Ates İ, Turan S, Sahin D. Adverse outcomes and maternal complications in pregnant women with severe-critical COVID-19: a tertiary center experience. J Perinat Med 2023; 51:874-885. [PMID: 37134274 DOI: 10.1515/jpm-2022-0564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 01/19/2023] [Indexed: 05/05/2023]
Abstract
OBJECTIVES This study aimed to present perinatal outcomes, clinical challenges, and basic ICU management in pregnant women with severe-critical COVID-19 at our tertiary referral center. METHODS In this prospective cohort study, patients were divided into two groups, whether they survived or not. Clinical characteristics, obstetric and neonatal outcomes, initial laboratory test results and radiologic imaging findings, arterial blood gas parameters at ICU admission, and ICU complications and interventions were compared between groups. RESULTS 157 of the patients survived, and 34 of the patients died. Asthma was the leading health problem among the non-survivors. Fifty-eight patients were intubated, and 24 of them were weaned off and discharged healthfully. Of the 10 patients who underwent ECMO, only 1 survived (p<0.001). Preterm labor was the most common pregnancy complication. Maternal deterioration was the most common indication for a cesarean section. Higher neutrophil-to-lymphocyte-ratio (NLR) values, the need for prone positioning, and the occurrence of an ICU complication were important parameters that influenced maternal mortality (p<0.05). CONCLUSIONS Overweight pregnant women and pregnant women with comorbidities, especially asthma, may have a higher risk of mortality related to COVID-19. A worsening maternal health condition can lead to increased rates of cesarean delivery and iatrogenic prematurity.
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Affiliation(s)
- Selcan Sinaci
- Clinic of Perinatology, Department of Obstetrics and Gynaecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - Atakan Tanacan
- Clinic of Perinatology, Department of Obstetrics and Gynaecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - Berhan Besimoglu
- Clinic of Perinatology, Department of Obstetrics and Gynaecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - Dilek Menekse Beser
- Clinic of Perinatology, Department of Obstetrics and Gynaecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - Derya Uyan Hendem
- Clinic of Perinatology, Department of Obstetrics and Gynaecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - Duygu Tugrul Ersak
- Clinic of Perinatology, Department of Obstetrics and Gynaecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - Aysegul Atalay
- Clinic of Perinatology, Department of Obstetrics and Gynaecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - Ecem Kaya
- Clinic of Perinatology, Department of Obstetrics and Gynaecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - Eda Ozden Tokalioglu
- Clinic of Perinatology, Department of Obstetrics and Gynaecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - Hayriye Cankar Dal
- Clinic of Anaesthesiology and Reanimation, Department of Intensive Care, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - Doga Fatma Ocal
- Clinic of Perinatology, Department of Obstetrics and Gynaecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - Deniz Erdem
- Clinic of Anaesthesiology and Reanimation, Department of Intensive Care, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
- University of Health Sciences, Ankara City Hospital, Istanbul, Türkiye
| | - Seval Izdes
- Clinic of Anaesthesiology and Reanimation, Department of Intensive Care, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
- University of Health Sciences, Ankara City Hospital, Istanbul, Türkiye
| | - Ozlem Moraloglu Tekin
- Clinic of Perinatology, Department of Obstetrics and Gynaecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
- General Internal Medicine, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - İhsan Ates
- General Internal Medicine, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
- University of Health Sciences, Ankara City Hospital, Istanbul, Türkiye
| | - Sema Turan
- Clinic of Anaesthesiology and Reanimation, Department of Intensive Care, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
- University of Health Sciences, Ankara City Hospital, Istanbul, Türkiye
| | - Dilek Sahin
- Clinic of Perinatology, Department of Obstetrics and Gynaecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
- University of Health Sciences, Ankara City Hospital, Istanbul, Türkiye
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