COVID-19 Infection in Pregnancy: A Case Series from Derna, Libya

Introduction: Pregnant women are potentially a high-risk population during infectious disease outbreaks such as COVID-19, because of physiologic immune suppression in pregnancy. However, data on the morbidity and mortality of COVID-19 among pregnant women, compared to nonpregnant women, are lacking. We sought to describe the management of twenty-one pregnant women with COVID-19 infection. Methods: A prospective chart review was conducted to identify pregnant women who presented with symptom and sign of COVID- 19 and tested positive or highly suspected even if test was negative, from 15 June 2020 to 04 October 2021. Results: Four women required non-invasive supplemental oxygen therapy and one required mechanical ventilation. One woman had a pulmonary embolism and expired after delivery. Conclusion: Management of pregnant women with severe COVID-19 is complex and should involve multidisciplinary expertise. Avoiding early delivery may be a safe option. We recommend an individualized approach to care, including careful consideration of the expected risks and benefits of expectant obstetric management versus delivery.