With more than 1 million confirmed cases of coronavirus disease 2019 (COVID-19) worldwide and more than 50,000 deaths, the pandemic of Severe Acute Respiratory Syndrome CoV (SARS-CoV-2) is rapidly evolving. SARS-CoV-2 can also pose a higher risk to pregnant women, due to their immunosuppression during pregnancy. This study investigates the emerging and most UpToDate published scientific literature on the clinical feature and management recommendations for pregnant women with COVID-19.
A wide range of published scientific literature was systematically searched from PubMed, Embase, Scopus, Web of Science, and “Global research on coronavirus disease (COVID-19)” managed by the World Health Organization, published between 1 January 2019 to 27 March 2020. No limitations were used for geographical location, and articles published in English were included in the review. Results for the eligible studies were charted, analyzed, and presented in a narrative format.
Our study identified 52 unique articles, and 29 of those articles were included in this review after fulltext screening. Participants were mostly in their third trimester and presented with fever, dry cough, myalgia, shortness, and difficulty in breathing. Ground-glass opacity in the computerized tomography scan of the chest was the cardinal feature of COVID-19 pneumonia. Except for two participants, severe pneumonia did not occur among pregnant women. Pregnant women with COVID-19 were treated with a wide range of antiviral drugs. Higher episodes of preterm birth and cesarean delivery were observed; however, it cannot be explicitly attributed to the SARS-CoV-2. There is no published evidence on the vertical transmission of SARS-CoV-2. Pregnancy with COVID-19 infection must be managed by a collaborative team of healthcare professionals during antenatal, delivery, or postnatal stage. Detailed contact tracing, investigating travel history, radiological assessment, and laboratory tests with regular fetal health monitoring must be done.
The emerging evidence of higher perinatal complications puts pregnant women in a further vulnerable condition. Cautiousness is imperative during the clinical management of pregnant women with COVID-19, as there is no approved treatment regime available at this moment. More research is necessary to fill the gaps in the knowledge of the clinical spectrum of COVID-19 among pregnant women.