The effect of SARS-CoV-2 infection on maternal, fetal and neonatal outcomes: A single-centre case series in Western India

Abstract

To study the effect of SARS-CoV-2 Infection on maternal, fetal and neonatal outcomes.
A retrospective cohort study was undertaken in a tertiary Covid Care Centre (CCC), Ahmedabad, Gujarat, India. The study was conducted from 1st April 2021 to 30th June 2021. A total of 22 symptomatic antenatal patients diagnosed with SARS-CoV-2 by RT-PCR method were included.
The mean age of the mothers was 30.2 ± 4.0 years and the mean gestational age was 29.7 ± 9.1 weeks. Six (27.3%) patients required intensive care unit (ICU) admission. 63.7% of the subjects required respiratory support i.e. 40.9% with nasal oxygen therapy and 22.7% with invasive ventilation. Six Intrauterine fetal death were also recorded. Only two neonates (born at 37 and 38 weeks of gestation, respectively) both with low Apgar scores at 1st minute & 5th minute experienced respiratory distress and required neonatal ICU (NICU) admission. Among them, only one neonatal death was recorded because of the diffuse exudative lesions & lung whiteout. The current study had the maternal mortality rate of 13.6% (3/22) owing to various medical complications with two of them succumbing to multiple organ failure with Disseminated intravascular coagulation (DIC) & one patient to sepsis with DIC.
The clinical course of COVID‐19 during pregnancy appears to be unique to each patient, with a higher incidence of DIC and multiorgan failure. Hence, a multidisciplinary team approach is vital in individualising the timing, mode for delivery, and course of management in these patients.

Full text

Indian Journal of Obstetrics and Gynecology Research 2022;9(1):103–110
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Indian Journal of Obstetrics and Gynecology Research
Journal homepage: www.ijogr.org
Original Research Article
The effect of SARS-CoV-2 infection on maternal, fetal and neonatal outcomes: A
single-centre case series in Western India
Ankita Jain1,*, Erika Patel2, Dipesh Sorathiya2, Snehal Patel3, Wasimahmed Sachora4,
Jigar Mehta5, Neeraj Bharti4, Hetal Patoliya1, Vivek Ambaliya6
1Dept. of Obstetrics and Gynaecology, K. D. Hospital, Ahmedabad, Gujarat, India
2IVF, K. D. Hospital, Ahmedabad, Gujarat, India
3Dept. of Paediatrics, K. D. Hospital, Ahmedabad, Gujarat, India
4Dept. of General Medicine, K. D. Hospital, Ahmedabad, Gujarat, India
5Dept. of Critical Care, K. D. Hospital, Ahmedabad, Gujarat, India
6Dept. of Emergency Medicine, K. D Hospital, Ahmedabad, Gujarat, India
ARTICLE INFO
Article history:
Received 23-11-2021
Accepted 16-12-2021
Available online 14-02-2022
Keywords:
COVID- 19 infection in pregnancy
Maternal and perinatal outcome
Obstetric complications
ABSTRACT
Objectives: To study the effect of SARS-CoV-2 Infection on maternal, fetal and neonatal outcomes.
Materials and Methods: A retrospective cohort study was undertaken in a tertiary Covid Care Centre
(CCC), Ahmedabad, Gujarat, India. The study was conducted from 1st April 2021 to 30th June 2021. A
total of 22 symptomatic antenatal patients diagnosed with SARS-CoV-2 by RT-PCR method were included.
Results: The mean age of the mothers was 30.2 ±4.0 years and the mean gestational age was 29.7
±9.1 weeks. Six (27.3%) patients required intensive care unit (ICU) admission. 63.7% of the subjects
required respiratory support i.e. 40.9% with nasal oxygen therapy and 22.7% with invasive ventilation.
Six Intrauterine fetal death were also recorded. Only two neonates (born at 37 and 38 weeks of gestation,
respectively) both with low Apgar scores at 1st minute & 5th minute experienced respiratory distress and
required neonatal ICU (NICU) admission. Among them, only one neonatal death was recorded because of
the diffuse exudative lesions & lung whiteout. The current study had the maternal mortality rate of 13.6%
(3/22) owing to various medical complications with two of them succumbing to multiple organ failure with
Disseminated intravascular coagulation (DIC) & one patient to sepsis with DIC.
Conclusion: The clinical course of COVID-19 during pregnancy appears to be unique to each patient,
with a higher incidence of DIC and multiorgan failure. Hence, a multidisciplinary team approach is vital in
individualising the timing, mode for delivery, and course of management in these patients.
This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons
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1. Introduction
It is not the first time that Zoonotic virus have led to
worrisome situations all over the world. At two separate
occasions, the Severe Acute Respiratory Syndrome (SARS)
in 2003 followed by Middle East respiratory syndrome
(MERS) in 2012 resulted in case fatality rate (CFR) of
* Corresponding author.
E-mail address:academics.kdh@gmail.com (A. Jain).
10.5% and 34.4% respectively.1,2 At the time of writing,
COVID-19 with the global cumulative incidence of 185,
786, 411 reported cases and 4, 019, 859 associated deaths
with a CFR of 2.2% has already caused more deaths than
MERS and SARS combined.3An insight from the past
has taught us to evolve continuously on every front to
prevent mortality in highly vulnerable community from
these infections. This brings us to the cohort scrutinized
thoroughly in this study i.e. pregnant women who are
https://doi.org/10.18231/j.ijogr.2022.020
2394-2746/© 2022 Innovative Publication, All rights reserved. 103

104 Jain et al. / Indian Journal of Obstetrics and Gynecology Research 2022;9(1):103–110
regarded as one of the highly vulnerable groups to this
respiratory syndrome. As the physiological changes in
pregnant subjects go hand-in-hand over different trimesters,
it makes them more prone to respiratory infections that
ultimately progress to respiratory failure.
Since the beginning of this pandemic, several studies
have shed light on the genetic, virologic, epidemiologic and
clinical aspects of this emerging infection. Leaving aside the
significant heterogeneity in reported studies, contradictory
observations have been reported in terms of adverse effects
on mother as well as on newborns, causing fetal distress,
premature labor, respiratory distress, thrombocytopenia
accompanied by abnormal liver function, and even death.4–7
Moreover, lack of clarity on the route of infection in SARS-
Cov-2-positive neonates as well as conflicting evidence
from nucleic acid-based testing and antibody testing,8,9
in neonates born to mothers with COVID-19 has raised
further eyebrows among treating obstetricians. But, due to
variation in demographics, treatment protocol and logistical
resources, realization on neonatal outcomes following
maternal COVID-19 in pregnancy is still based on case
series and centre experiences. Hence, we too as a part
of medical fraternity felt the need to study the effect of
SARS-CoV-2 infection on maternal, fetal and neonatal
outcomes in order to formulate better management plans
for the future. Our study is not a typical case control
analysis as it studies the retrospectively collected data of
antenatal patients diagnosed with SARS-CoV-2. Ultimately,
every individual must co-ordinate, co-operate, collaborate
and innovate to reduce the morbidity and mortality in this
pandemic.
2. Materials and Methods
2.1. Study design
A retrospective cohort study was undertaken among the
pregnant women with confirmed or suspected SARS-CoV-
2 infection who were admitted/referred to a tertiary Covid
Care Centre (CCC), Ahmedabad, Gujarat over a span of
three months starting from 1st April 2021 to 30th June 2021.
Patients with following inclusion criteria were enrolled
in the study:
1. All symptomatic antenatal patients diagnosed with
SARS-CoV-2 by RT-PCR method.
2. Patient with written informed consent signed by
patient/guardian.
Following mothers were excluded from study:
1. Any pregnant patient diagnosed with SARS-CoV-2
and delivered outside the study centre.
2. Any asymptomatic pregnant patient diagnosed with
SARS-CoV-2.
RT-PCR test being highly specific is the current gold
standard diagnostic method for the diagnosis of COVID-19.
Only Indian Council of Medical Research (ICMR) approved
kits were used for the detection of the SARS-CoV2.
On admission, the nasopharyngeal and oropharyngeal
swabs of patients were taken and sent for RT-PCR.
Detection was based on RT-PCR method targeting the RNA-
dependent RNA polymerase (RdRp) gene. HRCT thorax
scan examination was carried out in selective patients (only
mothers). Chest X-ray of selective neonates (case specific)
were take. Clinical manifestations such as fever, coughing,
myalgia, fatigue, headache, diarrhoea or dyspnea were
recorded.
2.2. Data collection & analysis
The data was collected using a predesigned template which
was filled by the concerned physician involved in the
immediate treatment of the patient. During clinical course,
personal interview was held with each subject. Interview
method has been considered to be more appropriate as
it provides an opportunity to the interviewer to be able
to extract the appropriate information by coming in face
to face contact with the subject. Follow up data were
retrieved from digital and written patient records. In a
few cases where follow-up data were not available from
hospital records, the patient or their general practitioner
was called to obtain information on their condition, hospital
admissions and discharge summary. All care and caution
were exercised while utilizing the patient data for current
research as outlined in the hospital guidelines pertaining to
the usage of patient’s data for this study and confidentiality
was maintained throughout. The collected data variables
obtained was compiled by using an excel spreadsheet.
The outcome data was descriptively analysed. The baseline
patient characteristics are presented as frequencies &
percentage for the categorical variables and as the means
and standard deviations for continuous variables. After
appropriate data filtration, the data sheet was transferred
and analyzed using Statistical Package for Social Sciences
(SPSS vs. 22.0).
2.3. Subject confidentiality & consent
Confidentiality was maintained regarding patient specific
data and it was kept in strict confidence. Ethical committee
approval was sought.
3. Results
We studied 22 COVID-positive (RT-PCR) mothers over
a span of 3 months who were admitted in the
dedicated COVID ward/ICU in accordance with the
inclusion−exclusion criteria.
Table 1 depicts the demographic details as well
as baseline characteristics of the pregnant patients at

Jain et al. / Indian Journal of Obstetrics and Gynecology Research 2022;9(1):103–110 105
Diagram 1: Flowchart of the study
presentation. The mean age of the mothers was 30.2 ±
4.0 years (range 23–37 years) and the mean gestational
age was 29.7 ±9.1 weeks. 15 (68.2%) patients had
none of the comorbidities while 3 (13.6%) had obesity,
2 (9.1%) patients each with hypothyroidism and diabetes
mellitus were also recorded. One patient each with Juvenile
Myoclonic Jerks, Epilepsy, pregnancy induced DM and
Pregnancy induced HTN respectively. On admission, the
main complaint was malaise in 17 (77.3%), followed by
fever in 16 (72.7%), dry cough in 5 (22.7%), headache
in 4 (18.2%), diarrhoea in 3 (13.6%) and sore throat in 2
(9.1%) patients. 77.3% of the women enrolled were in the
third trimester followed by first (13.6%) & second trimester
(9.1%). 8 (36.4%) patients had mild while 9 (40.9%) and
5 (22.7%) had moderate and severe severity of the disease
respectively.
Table 2 demonstrates the radiological investigation.
Pulmonary CT scan on admission was carried out for all 22
cases. Following CT signs were evaluated for each patient:
Location: a) Peripheral, b) Intermediate, c) Subpleural;
Density: a) Ground-glass opacity; Lung Lobe involvement:
a) Single lobe, b) Bilateral / Multiple lobes. Among them 14
(63.6%) patients were normal, while remaining 36.4% cases
were found abnormal in different degrees including ground-
glass opacity (GGO), patch-like shadows mostly affecting
the multiple lobes.
Table 3 demonstrates the need of respiratory support.
63.6% of the subjects required respiratory support in

106 Jain et al. / Indian Journal of Obstetrics and Gynecology Research 2022;9(1):103–110
Table 1: Baseline characteristics of the pregnant patients at
presentation.(n=22)
Maternal Age group (Years)
20 – 25 Years 2 (9.1%)
26 – 29 Years 7 (31.8%)
30 – 35 Years 11 (50%)
36 – 39 Years 2 (9.1%)
Comorbidities
Obesity 3 (13.6%)
Hypothyroidism 2 (9.1%)
Diabetes Mellitus 2 (9.1%)
Pregnancy induced DM 1 (4.6%)
Pregnancy induced HTN 1 (4.6%)
Juvenile Myoclonic Jerks 1 (4.6%)
Epilepsy 1 (4.6%)
None 15 (68.2%)
Pregnancy trimester at diagnosis
First 3 (13.6%)
Second 2 (9.1%)
Third 17 (77.3%)
Symptoms on presentation
Fever 16 (72.7%)
Dry Cough 5 (22.7%)
Sore throat 2 (9.1%)
Malaise 17 (77.3%)
Headache 4 (18.2%)
Diarrhoea 3 (13.6%)
COVID-19 severity
Mild 8 (36.4%)
Moderate 9 (40.9%)
Severe 5 (22.7%)
Table 2: Chest-CT manifestations (n=22)
Location
Peripheral 6 (27.3%)
Intermediate 3 (13.6%)
Subpleural 5 (22.7%)
Density
Ground-glass opacity 6 (27.3%)
Normal 16 (72.7%)
Lung Lobe involvement
Single lobe 2 (9.1%)
Bilateral / Multiple lobe 6 (27.3%)
Normal characteristics 15 (68.2%)
one way or other i.e. 40.9% with nasal oxygen therapy
and remaining 22.7% with invasive ventilation. 8 (36.4%)
patients required no respiratory support.
Table 3: Respiratory support (n=22)
Nasal oxygen therapy 9 (40.9%)
Invasive mechanical ventilation 5 (22.7%)
Not required 8 (36.4%)
Tables 4 and 5 depicts the mode of delivery in pregnant
patients presenting in third trimester and the indications of
delivery respectively. More than half of the patients (64%)
required a cesarean section (CS) for obstetrics indications
(seven for maternal distress, one each for obstructed labor
and severe oligohydramnios respectively), and the rest of the
patients (36%) delivered vaginally. Out of five patients who
delivered normally, none required instrumental delivery.
Table 4: Route of delivery
Vaginal delivery 5 (22.7%)
Cesarean sectiona9 (40.9%)
a -includes one twin pregnancy.
Table 5: Indications for delivery (n=14)
Maternal Distress 7 (50%)
Obstructed labor 1 (7.1%)
Oligohydramnios 3 (21.5%)
Early onset of labor 1 (7.1%)
Intrauterine fetal death 2 (14.3%)
Table 6 shows the incidence of anaesthesia used in C-
section. All the nine patients who got delivered through CS
were administered spinal anaesthesia.
Table 6: Anaesthesia used for CS (n=9)
General 0
Spinal 9 (100%)
Tables 7 and 8 demonstrates the type of intervention
and details about the medical management used during the
course of the treatment respectively. 12 (54.5%) patients
required only medical intervention while remaining 10
(45.5%) required both medical & surgical intervention.
Table 7: Intervention (n=22)
Medical intervention 12 (54.5%)
Medical & Surgical
intervention
10 (45.5%)
Table 8: Medical management
Remdesivir 13 (59.1%)
Fabiflu 3 (13.6%)
Zinc 21 (95.4%)
Antibiotic 22 (100%)
Steroids 19 (86.4%)
Tables 9 and 10 depicts the obstetric & medical
complications and final maternal outcome respectively.
The current study had the maternal mortality rate of
13.6% (3/22) owing to various medical complications
with two of them succumbing to multiple organ failure
with Disseminated intravascular coagulation (DIC) & one
patient to sepsis with DIC. The patient with Postpartum

Jain et al. / Indian Journal of Obstetrics and Gynecology Research 2022;9(1):103–110 107
Haemorrhage (PPH) responded to the treatment and got
discharged.
Table 9: Obstetric & medical complications
Disseminated intravascular coagulation
(DIC)
3 (13.6%)
Postpartum haemorrhage (PPH) 1 (4.6%)
Multiple organ failure (MOF) 2 (9.1%)
Sepsis 1 (4.6%)
None 19 (86.4%)
Table 10: Final outcome (Maternal; n=22)
Discharged 19 (86.4%)
Death 3 (13.6%)
Table 11 depicts the neonatal outcome. The Apgar score
(measured at two separate time intervals i.e., at 1st minute
and at 5t h minute) was normal in 8 (80%) babies. The mean
Apgar score at 1s t minute and at 5th minute was 7.1 ±
1.9 and 8.6 ±2.1 respectively. Both the babies bearing low
Apgar scores required NICU admission. Among them, one
neonate was discharged well with a good outcome. Only
one neonatal death was recorded because of the diffuse
exudative lesions & lung whiteout. Six Intrauterine fetal
death were also recorded in this study.
Table 11: Neonatal outcome
NICU admission required (n=16) 2 (12.5%)
Discharged (n=16) 9 (56.3%)
Premature delivery (n=16) 0
Neonatal death (n=16) 1 (6.3%)
Intrauterine fetal death (n=22) 6 (27.3%)
Apgar 1st minute (n=10) 7.1 ±1.9
Apgar 5th minute (n=10) 8.6 ±2.1
Fetal Respiration rate (n=10) 21.9 ±7.9
Fetal Heart rate (n=10) 135.8 ±7.7
Birth Weight (n=10) 2.638 ±0.4 kg
Table 12 shows the other characteristics of the patients
which were recorded during the course of the treatment. The
baseline patient characteristics are presented as mean and
standard deviation for continuous variables.
4. Discussion
Evaluating the implications of COVID-19 on maternal and
neonatal outcome becomes more relevant when we look
back in the time of the outbreak caused by coronaviruses
at two separate instances. In the year 2003, high maternal
mortality during the first trimester and intrauterine growth
restriction in the second and third trimesters was recorded at
the time of SARS-CoV-1 outbreak. 17 This was followed by
an another similar viral outbreak in the year 2012, termed as
MERS-CoV infection in which a case series of 11 patients
Table 12: Other characteristics
Mean gestational age at diagnosis (weeks) 29.7 ±9.1
Mean gestational age of delivered
mothers (weeks)
34.8 ±3.6
Length of hospital stay (days) 6.8 ±5.6
Body Mass Index (BMI) 25.8 ±2.6
Pulse 92.4 ±19.5
Systolic Blood Pressure (SBP) 119.3 ±9.2
Diastolic Blood Pressure (DBP) 78.29 ±8.6
Glasgow Coma Score (GCS) 15 ±0
Ferritin 245.9 ±179.9
C-reactive protein 64.6 ±56.8
D-dimer 2830.9 ±3929.4
reported the CFR of 35% for pregnant women and 27%
for infants.18 A study by WHO comprising of 25 national
and international experts travelled to the affected parts of
China in 2020 and investigated 147 pregnant women (64
confirmed, 82 suspected, and 1 asymptomatic with COVID-
19) concluded that pregnant women were not at higher
risk for developing severe disease due to COVID-19. 19
However, preliminary data of several studies from different
countries had demonstrated fluctuating course of the disease
from asymptomatic or mild symptoms to maternal death.
Moreover, insights from the past pertaining to human
coronavirus outbreaks suggests that pregnant women and
their fetuses are particularly susceptible to poor outcomes.
Hence, our study on 22 pregnant women with confirmed
COVID-19 diagnosis was undertaken in order to draw
conclusion about any maternal and neonatal consequences
that needs our immediate attention and we tried to compare
our results with the similar kind of published studies
on national as well as on international front. The mean
age of the mothers was 30.2 ±4.0 years and the mean
gestational age was 29.7 ±9.1 weeks. Average body mass
index (BMI) was 25.8 ±2.6 kg/m2. Fever, dry cough,
sore throat, malaise, sore throat, and occasional diarrhoea
were the common presenting symptoms. Studies by Yang
et al and Guan et al in 2020 reported that individuals
with co-morbid diseases are more susceptible to COVID-
19.20,21 Approximately one- third of confirmed cases in
the present study had co-morbid diseases (31.8%) and
is consistent with the literature. Comparison of maternal
baseline characteristics between several published studies
has been depicted in Table 13. 10–14
COVID-19 pneumonia in pregnant patients warrants
special consideration as CT radiation is a factor in fetal
teratogenicity. Chest CT was performed in approximately
one-quarter (27.3%) of the confirmed cases in the present
study and more than half of them had findings consistent
with COVID-19 infection indicating radiologic imaging
might be useful in appropriately selected cases. Also,
lymphocytopenia and neutrophilia were the other findings in
the present study. The timing and choice of delivery is also

108 Jain et al. / Indian Journal of Obstetrics and Gynecology Research 2022;9(1):103–110
Table 13: Comparison of maternal baseline characteristics
Study N Country Type Maternal Age
(years)
Gestational Age on
admission (weeks)
Wu et al (2020)10 23 China Case series 21–37 6–40
Chen et al(2020) 11 4 China Case report 23-34 37-39
Liu et al (2020)12 15 China Case series 23–40 12–38
Kapadia SN et al. (2021)13 50 India Prospective 19-36 38.3
Iqbal (2020)14 1 USA Case report 34 39
Present study (2021) 22 India Case series 23-37 29.7
Table 14: Compares the pregnancy outcomes of women with COVID-19 in different studies
Study N Country Type Total
number of
deliveries
Antenatal
patients
Delivery by
cesarean
section
Vaginal
delivery
Maternal
mortality
Neonatal
mortality
Intrauterine
fetal
death
Liu et al
(2020)15 15 China Case
series
11 4 10 1 0 0 0
Kapadia SN et al
(2021)13 50 India Prospective 50 0 26 24 0 1 0
Liu et al
(2020)15 16 China Case
series
6 10 6 0 0 0 0
Zhang et al
(2020)16 16 China Case
series
16 0 16 0 0 0 0
Present study
(2021)
22 India Case
series
14 8 9a5 3 1 6
the dilemma among pregnant women with COVID infection
but the real onus is on the health professionals to formulate
an individualised delivery plan depending on the weeks
of gestation and maternal and fetal conditions. Generally,
vaginal delivery is the first choice to avoid any risks of
major surgery. Septic shock or fetal distress should prompt
emergency cesarean delivery. In the present study, 64%
required a cesarean section (CS) under spinal anesthesia
for obstetrics indications while the rest of the five patients
(36%) delivered vaginally. We found a higher operative
delivery rate in this study group owing to obstetrics
indications (seven for maternal distress, one each for
obstructed labor and severe oligohydramnios respectively)
and not because of COVID-19. A poorer neonatal outcome
in pregnancy and higher rate of the CS with COVID-19 was
reported in a systematic review and meta-analysis published
by Mascio et al.22
A total of 10 neonates (including one set of twins) were
born with median gestational age at birth being 37 weeks.
As COVID-19 presents as an acute infection, if developed
close to delivery it is unlikely to have an impact on birth
weight and mean birth weight in the current study was
2,638 grams. Most of the neonates were asymptomatic
and had no signs of SARS-CoV-2 infection confirmed by
nasopharyngeal swab testing on day 1 and repeated on day
3. Isolation is the key to prevent infection transmission to
neonates and thus majority of neonates are isolated in NICU
to closely monitor their condition. Only two neonates (born
at 37 and 38 weeks of gestation, respectively) both with
low Apgar scores at 1st minute & 5th minute experienced
respiratory distress and required neonatal ICU (NICU)
admission. One neonate from NICU was discharged with
a good outcome. Only one neonatal death was recorded
throughout the study because of the diffuse exudative
lesions & lung whiteout (Figure 1). Six intrauterine fetal
deaths were also recorded owing to obstetrics reasons.
In terms of maternal mortality; hypertensive disorders
of pregnancy, obstructed labor, complications of induced
abortion, haemorrhage and sepsis are the leading severe
obstetric complications in developing countries. The current
study had the maternal mortality rate of 13.6% (3/22)
owing to various medical complications with two of them
succumbing to multiple organ failure & one woman to
sepsis. In lieu of these findings, maternal mortality cannot
be ruled out with COVID-19 infection during pregnancy.
Table 14 compares the pregnancy outcomes of women with
COVID-19 in different studies.15,16
As with the majority of case series, the design of the
current study is also subject to limitations, and findings of
this study have to be seen in light of some of the factors.
The nature of the study is retrospective, single-institution
study with limited time frame and with small sample size.
So caution must be employed while extrapolating this data
to cohorts of other countries. However, single-centre studies
with homogeneous populations and standard care processes,
offers the advantage over multicentre studies that differs
in the availability of their logistical resources and lack of
uniformity in patient management. The another limitation
of the study was the lack of statistics pertaining to the final
outcome data of the pregnant women who had not delivered

Jain et al. / Indian Journal of Obstetrics and Gynecology Research 2022;9(1):103–110 109
by the end of the study period.
Fig. 1: 26-year-old pregnant woman with gestational age of 38
weeks presented with fever, dry cough and malaise underwent
CT scan examination. (a) Coronal chest CT image of mother
obtained just before delivery shows bilateral extensive ground-
glass opacities (GGOs) with crazy wave pattern in both lungs. (b)
Chest X-ray image at birth of the vaginally delivered baby girl
(APGAR score of 3 & 4 at 1st min and 5th min respectively.) shows
white-out lung, a complication due to maternal respiratory distress
during labor
5. Conclusion
The world is battling with SARS Cov-2 infection for the
past 1.5 years only. This relatively new virus with its ever-
emerging mutations has baffled the medical fraternity. Even
though multiple studies have been published on COVID-
19 in pregnancy, there are still many unanswered questions.
The clinical course of COVID-19 during pregnancy appears
to be unique to each patient, with a higher incidence of
DIC and multiorgan failure leading to maternal mortality.
Hence, it isn’t easy to generalize a treatment algorithm
as coronavirus affects almost all the body organs. A
multidisciplinary team approach is vital in individualizing
the timing, mode for delivery, and course of management in
these patients.
6. Source of Funding
None.
7. Conflict of Interest
None.
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110 Jain et al. / Indian Journal of Obstetrics and Gynecology Research 2022;9(1):103–110
Author biography
Ankita Jain, Consultant
Erika Patel, Consultant
Dipesh Sorathiya, Consultant
Snehal Patel, Consultant
Wasimahmed Sachora, Consultant
Jigar Mehta, Consultant
Neeraj Bharti, Consultant
Hetal Patoliya, Consultant
Vivek Ambaliya, Consultant
Cite this article: Jain A, Patel E, Sorathiya D, Patel S, Sachora W,
Mehta J, Bharti N, Patoliya H, Ambaliya V. The effect of SARS-CoV-2
infection on maternal, fetal and neonatal outcomes: A single-centre case
series in Western India. Indian J Obstet Gynecol Res
2022;9(1):103-110.