| Autor: |
Morán Antolín E; Department of Gynecology and Obstetrics, Son Espases University Hospital, 07120 Palma de Mallorca, Spain., Broullón Molanes JR; Department of Gynecology and Obstetrics, Puerta del Mar University Hospital, 1109 Cádiz, Spain., de la Cruz Conty ML; Fundación de Investigación Biomédica, Puerta de Hierro University Hospital of Majadahonda, 28222 Madrid, Spain., Encinas Pardilla MB; Department of Gynecology and Obstetrics, Puerta de Hierro University Hospital of Majadahonda, 28222 Madrid, Spain., Guadix Martín MDP; Department of Gynecology and Obstetrics, Virgen de la Macarena University Hospital, 41009 Sevilla, Spain., Sainz Bueno JA; Department of Gynecology and Obstetrics, G. Chacon (Viamed Santa Angela de la Cruz Hospital), 41014 Sevilla, Spain., Forcén Acebal L; Department of Gynecology and Obstetrics, 12 de Octubre University Hospital, 28041 Madrid, Spain., Pintado Recarte P; Department of Gynecology and Obstetrics, Gregorio Marañon University Hospital, 28007 Madrid, Spain., Álvarez Bartolomé A; Department of Anesthesia and Resuscitation, Puerta de Hierro University Hospital of Majadahonda, 28222 Madrid, Spain., Martínez Cendán JP; Department of Gynecology and Obstetrics, Santa Lucia University Hospital, 30202 Cartagena, Spain., Martínez-Pérez Ó; Department of Gynecology and Obstetrics, Puerta de Hierro University Hospital of Majadahonda, 28222 Madrid, Spain.; Medical Simulation Department, Universidad Católica de Murcia, 30107 Murcia, Spain.; Obstetric and Gynecology Department, Universidad Autónoma de Madrid, 28029 Madrid, Spain., On Behalf Of The Spanish Obstetric Emergency Group |
| Abstrakt: |
Pregnant women are particularly vulnerable to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. In addition to unfavorable perinatal outcomes, there has been an increase in obstetric interventions. With this study, we aimed to clarify the reasons, using Robson's classification model, and risk factors for cesarean section (C-section) in SARS-CoV-2-infected mothers and their perinatal results. This was a prospective observational study that was carried out in 79 hospitals (Spanish Obstetric Emergency Group) with a cohort of 1704 SARS-CoV-2 PCR-positive pregnant women that were registered consecutively between 26 February and 5 November 2020. The data from 1248 pregnant women who delivered vaginally (vaginal + operative vaginal) was compared with those from 456 (26.8%) who underwent a C-section. C-section patients were older with higher rates of comorbidities, in vitro fertilization and multiple pregnancies ( p < 0.05) compared with women who delivered vaginally. Moreover, C-section risk was associated with the presence of pneumonia ( p < 0.001) and 41.1% of C-sections in patients with pneumonia were preterm (Robson's 10th category). However, delivery care was similar between asymptomatic and mild-moderate symptomatic patients ( p = 0.228) and their predisposing factors to C-section were the presence of uterine scarring (due to a previous C-section) and the induction of labor or programmed C-section for unspecified obstetric reasons. On the other hand, higher rates of hemorrhagic events, hypertensive disorders and thrombotic events were observed in the C-section group ( p < 0.001 for all three outcomes), as well as for ICU admission. These findings suggest that this type of delivery was associated with the mother's clinical conditions that required a rapid and early termination of pregnancy. |
