Experience of a tertiary pandemic centre on the labour and delivery of 337 pregnant women with COVID-19: a prospective cohort study from Turkey.

The aim of the present study is to share the experience of a tertiary reference pandemic centre on the labour and delivery of pregnant women with coronavirus disease 2019 (COVID-19). This prospective cohort study was conducted on pregnant women with COVID-19 ( = 337). Patients were divided into two groups based on their severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) positivity ( = 103 positive and  = 234 negative) during the delivery. Thereafter, clinical characteristics and perinatal outcomes were compared between the groups. Moreover, delivery characteristics and clinical features were compared between primary caesarean section ( = 117) and normal spontaneous vaginal delivery cases ( = 100). Labour induction was performed in 16% of cases with a failure rate of 35%. Caesarean rate was 70% and the most common indication was worsening in maternal condition. Significant, positive and moderate correlations were observed between COVID-19 severity at admission ( = 0.422, <.001), radiologic findings consistent with COVID-19 ( = 0.400, <.001), the necessity for oxygen support during the delivery ( = 0.406, <.001) and postpartum worsening in maternal condition. A significant, positive weak correlation was found between caesarean delivery and postpartum worsening in maternal condition ( = 0.176, <.001). COVID-19 seems to be associated with increased rates of obstetric complications and caesarean delivery.Impact Statement Increased rates of foetal distress and caesarean section were reported in pregnant women with COVID-19. Appropriate management of labour and delivery in infected pregnant women is crucial to obtain favourable perinatal outcomes. COVID-19 seems to be associated with increased rates of obstetric complications and caesarean delivery. PCR positive group had significantly higher primary and prelabor caesarean delivery rates. Severe/critic COVID-19 infection rate was significantly higher in the primary caesarean group. Significant, positive and moderate correlations were observed between COVID-19 severity at admission, radiologic findings consistent with COVID-19, the necessity for oxygen support during the delivery and postpartum worsening in maternal condition. A significant, positive weak correlation was found between caesarean delivery and postpartum worsening in maternal condition. Management and delivery of pregnant women with COVID-19 should be individualised. The findings of the present study may lead to the establishment of future obstetric protocols in this special population.