COVID-19 and Pregnancy: A Prospective Descriptive Study from a Tertiary Hospital in Nigeria

BACKGROUND

It is known that pregnant women are more susceptible to viral infectious diseases, with an attendant risk of adverse foetal and maternal outcomes. The objective of this descriptive study is to evaluate the epidemiologic and clinical pattern, as well as the obstetric and COVID-19 outcome among pregnant women seen at a tertiary hospital in Southern, Nigeria.

METHODS

This was a descriptive prospective study of all pregnant women seen and diagnosed with COVID-19 based on positive RT-PCR for SARS-COV-2, at the University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria from March 2020 to August 2020.

RESULTS

Seven (5.2%) pregnant patients were diagnosed with COVID-19 out of 134 patients. The common presenting symptoms were fever 4(57.1%), Productive cough 3 (42.9%), shortness of breath 3 (42.9%), myalgia 3 (42.9%), rhinorrhoea 3 (42.9%), and anosmia 3 (42.9%). The majority (85.7%) of patients were in the second and third trimesters at diagnosis. All deliveries occurred at term, with a mean gestational age of 38±0.82 weeks. Four patients (57.1%) had caesarean section (CS) deliveries for obstetric indications. No adverse outcomes were recorded for mothers and babies with birth weight ranging from 2.5 to 3.5 Kg. No case fatality was recorded.

CONCLUSION

In this study, pregnant women with COVID-19 did not have adverse maternal and foetal outcome. The pattern of symptoms and the presence of severe disease also did not differ from what is observed in the general non-pregnant population. The impact of COVID-19 on pregnancy is less severe when compared to other high consequence viral infectious diseases.

AN APPRAISAL OF RETAINED PLACENTA AT THE UNIVERSITY OF PORT HARCOURT TEACHING HOSPITAL: A FIVE-YEAR REVIEW

BACKGROUND

Retained placenta is associated with an increased risk of maternal morbidity and mortality especially in developing countries.

OBJECTIVE

To determine the incidence and evaluate the mode of presentation, risk factors and method of treatment of patients with retained placenta.

METHODOLOGY

A retrospective review of retained placenta managed at the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt over a 5 year period (January 2009 to December 2013). Data obtained were analyzed using statistical software SPSS 17.0.

RESULTS

There were 93 cases of retained placenta out of 15,789 deliveries, giving an incidence of 0.59%.85 patients' case records were available for analysis. Majority of the patients 69 (81.2%) were unbooked (had no antenatal care) with 60 (70.6%) having home deliveries. Previous history of dilatation and curettage and preterm deliveries, accounted for the major identifiable risk factors at 55 (64.7%) and 22 (25.9%) respectively. At presentation, 22(25.9%) were in hypovolemic shock. Manual removal of the placenta was the commonest treatment modality (87.1%).There was one maternal death giving rise to a case fatality rate of 1.18%.

CONCLUSION

Retained placenta is a major cause of maternal morbidity and mortality from postpartum haemorrhage and other complications related to its removal. The incidence can be reduced by antenatal care, skilled birth attendance and provision of emergency obstetrics care services.