COVID-19 in the practice of maternity hospitals of various degrees in the Czech Republic.

IF 0.5 4区 医学 Q4 MICROBIOLOGY
Hynek Heřman, A Tefr Faridová, K Trojanová, B Jalůvková, A Šinská, Radovan Pilka, O Šimetka, B Čečetková, J Janák, P Steyerová
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引用次数: 0

Abstract

Objective: Pregnancy is not considered a condition that increases the body's susceptibility to SARS-CoV-2 (severe-acute-respiratory-syndrome-related coronavirus-2) infection, but in the case of infection in pregnancy, there is an increased risk of a more severe course of COVID-19 (coronavirus disease-19). However, the course of infection in pregnancy is mild or asymptomatic in most cases. The main objective of the study in pregnant women with COVID-19 was to prove that the delivery method is not changed, and serious complications do not occur more frequently due to this disease.

Methods: In a retrospective, observational, multicentric study, the pregnant women positively tested to COVID-19 were admitted and subsequently gave birth in the period from 15 March 2020 to 15 March 2021. Data from the delivery departments of five centers in the Czech Republic during COVID-19 pandemic were analyzed in relation to the delivery method and time, COVID-19 symptoms and potential complications with respect to demographics and comorbidities of pregnant women. COVID-19 positivity was confirmed with PCR (polymerase-chain reaction). The Excel program was used during statistical analysis.

Results: During the observed study period, 236 pregnant women with COVID-19 were detected at study centers. Most of the patients were asymptomatic (59.7%). In symptomatic patients, most common symptoms were cough (52.6 %), cold (43.2%) and fever (37.9%), and COVID-19 pneumonia was diagnosed in 8 patients. The delivery was performed vaginally in 52.5% patients, the pregnancy was terminated by C-section (cesarean section) in 44.5%, per VEX (vacuum extractor) in 2.1% and per forcipem in 0.8% cases. The average week of pregnancy at the time of delivery was 38 (29-41) and preterm delivery was performed in 19.1% patients. The study results in pregnant women with COVID-19 demonstrated that the method of delivery was not changed and major delivery and neonatological complications did not develop in most cases. However, two presented serious courses of COVID-19 in pregnant women led to premature terminations of pregnancies. The only associated risk factor was the patient's obesity.

Conclusions: Although COVID-19 is a disease that is mostly asymptomatic in pregnant women or with only mild flu-like symptoms, it is associated with increased morbidity and mortality compared to pregnant women without COVID-19. The challenge for the future is the possibility of segregating patients into lowand high-risk groups based on proven risk factors, and consistent vaccination of pregnant women or women planning conception. In critical cases, the correct timing of premature termination of pregnancy and early indication of the beginning of fetal lung maturation is necessary.

在捷克共和国不同程度的妇产医院开展COVID-19的实践。
目的:妊娠不被认为是增加机体对SARS-CoV-2(严重急性呼吸综合征相关冠状病毒-2)感染易感性的情况,但在妊娠感染的情况下,会增加发生更严重的COVID-19(冠状病毒病-19)病程的风险。然而,在大多数情况下,妊娠期感染的过程是轻微的或无症状的。对COVID-19孕妇进行研究的主要目的是证明分娩方式没有改变,严重并发症不会因该疾病而更频繁地发生。方法:在一项回顾性、观察性、多中心研究中,于2020年3月15日至2021年3月15日期间入院并随后分娩的COVID-19阳性孕妇。分析了捷克共和国五个中心的分娩部门在COVID-19大流行期间的分娩方式和时间、COVID-19症状和潜在并发症以及孕妇的人口统计学和合并症的数据。采用聚合酶链反应(PCR)检测COVID-19阳性。统计分析采用Excel程序。结果:在观察研究期间,在研究中心检测到236名感染COVID-19的孕妇。大多数患者无症状(59.7%)。在有症状的患者中,最常见的症状是咳嗽(52.6%)、感冒(43.2%)和发烧(37.9%),其中8例诊断为COVID-19肺炎。52.5%为顺产,44.5%为剖宫产,2.1%为真空抽吸器,0.8%为强行流产。分娩时平均妊娠周为38周(29-41周),早产率为19.1%。对COVID-19孕妇的研究结果表明,分娩方式没有改变,大多数病例没有发生重大分娩和新生儿并发症。然而,有两名孕妇出现严重的COVID-19病程,导致过早终止妊娠。唯一相关的危险因素是患者的肥胖。结论:尽管COVID-19是一种孕妇大多无症状或只有轻微流感样症状的疾病,但与未感染COVID-19的孕妇相比,其发病率和死亡率均有所增加。未来的挑战是根据已证实的危险因素将患者分为低风险组和高风险组的可能性,以及孕妇或计划怀孕的妇女持续接种疫苗的可能性。在危重病例中,正确的提前终止妊娠时机和胎儿肺成熟开始的早期指征是必要的。
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来源期刊
Epidemiologie Mikrobiologie Imunologie
Epidemiologie Mikrobiologie Imunologie Medicine-Immunology and Allergy
CiteScore
0.90
自引率
0.00%
发文量
20
期刊介绍: The journal publishes original papers, information from practice, reviews on epidemiological and microbiological subjects. Sufficient space is devoted to diagnostic methods from medical microbiology, parasitology, immunology, and to general aspects and discussions pertaining to preventive medicine. It also brings translations and book reviews useful for medical doctors and research workers and professionals in public health.
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