Effects Of COVID-19 Pandemic on the First and Second Trimester Pregnancies: Observations at a Secondary Care Setup
Objective: To observe the effect of COVID-19 on 1st and 2nd trimester miscarriage and whether infection of spouse before pregnancy has any link to pregnancy outcome.
Methodology: It was a comparative, retrospective, observational study conducted at Gynecology/Obstetrics Department of Advanced Engineering And Research Organization(AERO) Hospital. All patients attending Gynecology Department of AERO Hospital with diagnosis of spontaneous or missed miscarriage between March-August 2019 and between March-August 2020, aged between 20-38 years were included in study. Patients aged less than 19 years, and more than 38 years, with co-morbidities, history of recurrent pregnancy loss and those with induced miscarriages were excluded from the study. Data of the research was extracted from record of AERO Hospital. All patients who visited AERO Hospital with miscarriage between March to August 2020, had a through history including that related to COVID-19 and tests to confirm diagnosis along with routine baseline tests.
Results: Rate of miscarriage in anti-natal patients attending Gynecology Department of AERO Hospital between 1st and 2nd trimesters from March to August 2019 was found to be 6% and from March to August 2020 it was 9.2%. Out of 47 patients who had miscarriage 24 patients (51%) had positive history and/or tests of COVID-19, 15 (32%) patients had spouse who had positive history and/or tests of COVID-19, 1-2 months before current pregnancy. We observed a higher miscarriage rate from March-August 2020 as compared to March-August 2019. Ten patients (21%) had both, COVID-19 personal or/ and spouse history.
Conclusion: COVID-19 infection of mother during 1st or 2nd trimester increases the rate of pregnancy loss, which may be caused by vertical transmission or maternal viremia. Medicines used for treatment of these patients were generally considered safe during pregnancy. Paternal sperm quality may have an effect on pregnancy outcome.
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