Mihajlovic Sladjana, Trifunovic Kubat Jelena, Nikolic Dejan, Santric-Milicevic Milena, Milicic Biljana, Dimic Nemanja, Lackovic Milan
Department of Obstetrics and Gynecology, University Hospital "Dragisa Misovic", 11000 Belgrade, Serbia.
Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
J Clin Med. 2023 Jun 7;12(12):3902. doi: 10.3390/jcm12123902.
During the COVID-19 pandemic, Serbia has faced devastating losses related to increased mortality rates among men and women of all ages. With 14 registered cases of maternal death in 2021, it became obvious that pregnant women are faced with a serious threat that jeopardises their life as well as the life of their unborn child. Studying the consequences of the COVID-19 pandemic on maternal outcomes is vivifying and stimulating for many professionals and decision-makers, and knowing the contextual characteristics can facilitate the application of literature findings in practice. Therefore, the aim of this study was to present findings of maternal mortality in Serbia associated with SARS-CoV-2 infected and critically ill pregnant women.
Clinical status and pregnancy-related features were analysed for a series of 192 critically ill pregnant women with confirmed SARS-CoV-2 infection. According to the treatment outcome, pregnant women were divided in two study groups: a group of survivors and a group of deceased patients.
A lethal outcome was recorded in seven cases. Pregnant women in the deceased group were presenting at admission more commonly with X-ray-confirmed pneumonia, a body temperature of >38 °C, cough, dyspnea, and fatigue. They were more likely to have a progression of the disease, to be admitted to intensive care unit, and be dependent from mechanical ventilation, as well as to have nosocomial infection, pulmonary embolism, and postpartum haemorrhage. On average, they were in their early third trimester of pregnancy, presenting more commonly with gestational hypertension and preeclampsia.
Initial clinical manifestations of SARS-CoV-2 infection, such as dyspnea, cough, fatigue, and fever, could be a potent factors in risk stratification and outcome prediction. Prolonged hospitalization, ICU admission, and associated risk of hospital-acquired infections require strict microbiological surveillance and should be a constant reminder of rational antibiotics use. Understanding and identification of risk factors associated with poor maternal outcomes among pregnant women infected with SARS-CoV-2 should warn medical professionals of potentially unwanted outcomes and can be used for organising an individualised treatment for a pregnant patient's specific needs, including a guide to necessary consultations with medical specialists in various fields.
在新冠疫情期间，塞尔维亚面临着与各年龄段男性和女性死亡率上升相关的毁灭性损失。2021年有14例孕产妇死亡登记病例，很明显孕妇面临着严重威胁，这危及她们自己以及未出生孩子的生命。研究新冠疫情对孕产妇结局的影响，对许多专业人员和决策者来说既生动又有启发性，了解背景特征有助于将文献研究结果应用于实践。因此，本研究的目的是呈现塞尔维亚与感染新冠病毒且病情危重的孕妇相关的孕产妇死亡率研究结果。
对192例确诊感染新冠病毒的危重孕妇的临床状况和妊娠相关特征进行了分析。根据治疗结果，将孕妇分为两个研究组：存活组和死亡组。
记录到7例死亡病例。死亡组孕妇入院时更常见的表现为经X线证实的肺炎、体温>38°C、咳嗽、呼吸困难和疲劳。她们更有可能病情进展、入住重症监护病房、依赖机械通气，以及发生医院感染、肺栓塞和产后出血。平均而言，她们处于妊娠晚期早期，更常见的情况是妊娠期高血压和子痫前期。
新冠病毒感染的初始临床表现，如呼吸困难、咳嗽、疲劳和发热，可能是风险分层和结局预测的重要因素。长时间住院、入住重症监护病房以及医院获得性感染的相关风险需要严格的微生物监测，并且应时刻提醒合理使用抗生素。了解和识别感染新冠病毒的孕妇中与不良孕产妇结局相关的风险因素，应提醒医疗专业人员注意潜在的不良后果，并可用于根据孕妇的特定需求组织个体化治疗，包括指导与各领域医学专家进行必要的会诊。
