TITLE:
Materno-Fetal Outcomes of COVID-19 Infected Pregnant Women Managed at the Douala Gyneco-Obstetric and Pediatric Hospital—Cameroon
AUTHORS:
Alphonse Nyong Ngalame, Humphry Tatah Neng, Rakya Inna, Dominique Tamchom Djomo, Diane Estelle Modjo Kamdem, Bilkissou Moustapha, Julie Ngo Batta, Diomede Njinkui Noukeu, Dominique Enyama, Rodrigue Tiokeng, Yannick Onana, Yves Moumbe, Martial Zanga, Jules Fils Ndongo, Armand Kamga, Robert Tchounzou, Ultrich Keumayou, Lemone Chingnabo, Toudjirob Djiallati, Emmanuel Passoret, Estella Toyoum Ramadji, Jean Blaise Ebimbe, Servais Albert F. Bagnaka Eloumou, Darolles Wekam Mwadjie, Guy Pascal Ngaba, Emile Telesphore Mboudou
KEYWORDS:
COVID-19, DGOPH, Pregnancy, Outcome, Mortality
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.10 No.9,
September
23,
2020
ABSTRACT: Introduction: The first case of the novel coronavirus (COVID-19) pandemic in Cameroon
was confirmed on March 6, 2020. Though widely considered that pregnant women
are more susceptible to respiratory tract infections, the available body of
literature on the effect of COVID-19 on pregnancy outcomes is shy from being conclusive.
In Cameroon, the Douala Gyneco-Obstetric and Pediatric Hospital (DGOPH) was one
of the main frontline tertiary health facilities for the management of severe
forms of the disease. After four months of managing COVID-19 cases in the
general population and especially in pregnant women at the DGOPH, we decided to
take a stop, analyze our findings from the patients managed in order to drive
future policies and clinical practices via informed decisions. Overall
objective: To describe and understand the clinical burden of patients
managed for COVID-19 in
pregnancy or post-partum at the DGOPH. Methodology: Cross-sectional and descriptive
study covering four months—March 24th to July 24th 2020
at DGOPH. Using a pretested questionnaire, we systematically enrolled all
patients who fulfilled the inclusion criteria, with analysis done using
proportions from an excel spreadsheet. Results: A total of 18 on the 301
pregnant women consulted at the DGOPH, tested positive for COVID-19 giving a
prevalence of 6%, and representing 2.3% of all the 800 COVID-19 cases. Of the 44 pregnant
women admitted at the DGOPH, 13 of them were due to COVID-19, giving a general
admission proportion of 29.5% and a COVID-19 case admission rate of 72.2%. Two-thirds
(66.7%) of the patients were aged 30 - 39 years
and over 61.1% (n = 11) of the total cases were referred from other health
facilities for better management. The most common presenting symptoms were: fever (27.4%), cough
(21.5%) and dyspnea (15.7%). Over 72.2% of cases were in their third trimester,
and only three had comorbidities. Nasal throat swab PCR was mainstay for
confirmatory diagnosis (83.3%). Chest CT scan was realized in 50% (n = 9) of
the patients and ground glass opacification (GGO) was observed in all of them.
All 18 patients received the standard national recommended regimen therapy for COVID-19.
While five of the cases are ongoing gestations, 8 of them were delivered by
cesarean section (61.5%), mostly indicated for maternal distress. The neonatal
mortality rate was 46%. Four of the 18 patients died giving a case fatality
rate of 22.2%. Conclusion: The profile of COVID-19 pregnant women in
Douala-Cameroon tends to be similar to what is observed around the world.
However, the high ICU admission rate and high case fatality rates recorded
differ from what is observed worldwide.