Maternal and neonatal outcomes in covid negative and covid probable obstetric women presenting with covid like symptoms

Objective: To study maternal and neonatal outcomes in covid negative and covid probable with covid like symptoms. Method: It was a retrospective study conducted in obstetrics and gynaecology department of Guru Teg Bahadur Hospital and University College of Medical Sciences, Delhi, India. Case records of 130 pregnant, postpartum or post-abortal women admitted with covid like symptoms were analyzed and categorized into covid negative (CN), positive(CP) or probable (CPro), based on RT-PCR report. The main outcome measures were disease categorization, pregnancy complications, maternal mortality and neonatal outcomes in the three groups. Results: Majority of the women were CN (76%), followed by CP (16.9%) and C Pro (6.9%). In all groups, mild disease was most common and severe disease was present in 18.1%, 13.6% and 33.3% in CN, CP and CPro groups respectively. The spectrum of maternal disease in the study groups ranged from isolated febrile illness to multi-organ dysfunction (MODS). The frequency of women requiring oxygen, mechanical ventilation and intensive care unit was more in CPro group. Overall, there were 21(16.1%) maternal deaths. Sepsis with MODS was the commonest cause of death in CN group, whereas, it was ARDS in CP and CPro groups. Stillbirths were more often seen in CPro group. Conclusion: Three-fourth of admitted women were covid negative. A small subset was labelled as covid probable due to inconclusive or no testing. This group had the highest morbidity and mortality. Prompt testing and initiation of treatment could have redefined the disease course in covid probable group