Journal
ARCHIVES OF GYNECOLOGY AND OBSTETRICS
Volume 303, Issue 6, Pages 1401-1405Publisher
SPRINGER HEIDELBERG
DOI: 10.1007/s00404-020-05854-2
Keywords
Pregnancy; Delivery; COVID-19; Vaginal; Outcomes
Categories
Funding
- Israeli Ministry of Science and Technology
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Among SARS-CoV-2-infected mothers, high rates of vaginal delivery were associated with favorable outcomes and no cases of neonatal COVID-19. The study underscores the importance of obstetric indications in delivery management for infected mothers and may potentially reduce high rates of cesarean delivery in this setting.
Key Message Among SARS-CoV-2-infected mothers, vaginal delivery rates were high and associated with favorable outcomes with no cases of neonatal COVID-19. Purpose To investigate the mode of delivery and its impact on immediate neonatal outcome in SARS-CoV-2-infected women. Methods A prospective study following pregnant women diagnosed with COVID-19 who delivered between March 15th and July 4th in seven university affiliated hospitals in Israel. Results A total of 52 women with a confirmed diagnosis of COVID-19 delivered in the participating centers during the study period. The median gestational age at the time of delivery was 38 weeks, with 16 (30.8%) cases complicated by spontaneous preterm birth. Forty-three women (82.7%) underwent a trial of labor. The remaining 9 women underwent pre-labor cesarean delivery mostly due to obstetric indications, whereas one woman with a critical COVID-19 course underwent urgent cesarean delivery due to maternal deterioration. Among those who underwent a trial of labor (n = 43), 39 (90.7%) delivered vaginally, whereas 4 (9.3%) cases resulted in cesarean delivery. Neonatal RT-PCR nasopharyngeal swabs tested negative in all cases, and none of the infants developed pneumonia. No maternal and neonatal deaths were encountered. Conclusions In this prospective study among SARS-CoV-2-infected mothers, vaginal delivery rates were high and associated with favorable outcomes with no cases of neonatal COVID-19. Our findings underscore that delivery management among SARS-CoV-2-infected mothers should be based on obstetric indications and may potentially reduce the high rates of cesarean delivery previously reported in this setting.
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