TITLE:
Covid-19 in Pregnancy: Cases of Women Managed in the City of Douala-Cameroon
AUTHORS:
Bilkissou Moustapha, Alphonse Nyong Ngalame, Charlotte Nguefack Tchente, Frederic Victor Okala, Kingsley Ombaku, Humphry Tatah Neng, Diane Kamdem, Ngo Batta Julie, Nkendo Sandrine, Darolles Mwadjie, Emile Telesphore Mboudou
KEYWORDS:
COVID-19, Clinical, Para-Clinical, Materno-Foetal Outcomes, Pregnant Women
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.12 No.10,
October
12,
2022
ABSTRACT: Introduction: The SARS-COV-2 virus has been responsible for a health crisis in
pregnancy, causing severe acute respiratory distress syndrome. Materno-foetal
complications can be observed. Taking into account the materno-foetal risks
associated with COVID-19 infection in pregnant women and the low sample size of
the first publication in Cameroon, we considered it necessary to conduct an
in-depth study on the maternal and foetal prognosis of this condition in
pregnant women in three hospitals in Douala. Materials and Methods: We
conducted a cross-sectional survey with retrospective data collection in the
three state tertiary and reference hospitals in Douala (DGOPH, DGH and DLH)
from November 1, 2021 to April 30 2022 after obtaining ethical and
administrative clearances. All records of COVID-19 pregnant women confirmed by
reverse transcription polymerase chain reaction (RT PCR) or COVID-19 rapid
diagnostic test (COVID RDT) were included. The survey form contained
socio-demographic data, clinical and para-clinical characteristics, management
and materno-foetal outcome. SPSS.26 and Microsoft Excel 2016 software were used
to analyze the data, and a logistic regression model was used to look for
associations between the variables. Results: We found in total 96 files
that met our inclusion criteria. The most represented sector of activity was
the unemployed (44.46%). Patients with a secondary level of education
constituted the majority with 47% (45). The main comorbidity found was diabetes
(27.2%). The most frequent symptom was fever, found in 87 patients (90.1%). In
our series, a chest CT scan was performed in 50 patients. Caesarean section was
the most common mode of delivery (58.3%). We recorded 15.6% of maternal deaths,
mainly in patients admitted to intensive care. Factors
associated with maternal death were: Maternal diabetes, high LDH and D-dimer
levels, and 75% lung involvement on chest CT scan. Oxygen saturation > 94% on admission was a protective factor.
Regarding fetal and neonatal outcomes, we registered 30.2% cases of prematurity,
32.3% cases of respiratory distress at birth and 24% neonatal deaths. Factors
associated with neonatal death were temperature ≥ 38.5°C. Conclusion: At the end of the study, we can conclude that in pregnant women with
COVID-19, fever is the main symptom, 1/3 are admitted to intensive care and
caesarean section is the most common mode of delivery. The maternal death rate
remains high, especially in diabetic patients admitted to intensive care with
altered biological parameters. Fetal complications include prematurity and
death.