Vaginal delivery in COVID-19 pregnancies: experience from a referral
center in a high-prevalence area
Abstract
Objective: We aimed to describe mode of delivery and perinatal results
among COVID-19 confirmed infected women. Design: Prospective cohort of
consecutive pregnant women with confirmed SARS-CoV-2 infection, and
comparison of perinatal outcome with expected values on an historical
cohort. Setting: A tertiary referral center in Barcelona, Spain.
Population: Pregnant women with SARS-CoV-2 confirmed infection. Methods:
SARS-CoV-2 infected women managed under a standard protocol who
delivered during the period March 13th - April 25th, were evaluated.
Data on baseline maternal characteristics, COVID-19 disease parameters,
clinical management, mode of delivery, and perinatal outcome were
collected. Relevant perinatal data were compared with the expected
values observed in an historical control of our center. Main Outcome and
Measure: Rate of vaginal delivery among COVID-19 pregnancies. Secondary
outcomes were maternal or neonatal complications, and vertical
transmission of SARS-CoV-2. Results: A total of 21 women with COVID-19
delivered at our center during the study period: 42.9% had moderate or
severe respiratory infection. 14 out of 21 (66.7%) delivered vaginally.
Three out of 7 caesarean sections were maternal indicated because of
maternal worsening secondary to COVID infection. Preterm delivery
occurred in 4 cases (19%), half of them related to COVID-19. There were
no differences between the observed and the expected perinatal outcomes.
Conclusions: In the absence of severe maternal complications, vaginal
delivery among pregnant women with COVID-19 infection is a safe option,
both for the mother and the baby, with similar perinatal outcomes than
expected in a non-infected cohort and with no evidence of vertical
transmission.