COVID-19, COVID-19 Pneumonia, Fetal Growth Retardation
Conditions
Keywords
COVID19 Pneumonia, Feto-maternal infection, COVID 19 placental infection, Maternal mortality, Intrauterine fetal death
Brief summary
The novel coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was discovered for the first time in December 2019 in Wuhan (China) and the disease it causes is called coronavirus disease 2019 (COVID-19). Now, this pandemic is rapidly spreading all over the world. Pregnant have higher rates of COVID-19, associated with hospitalizations, and severe in-hospital outcomes. Immune responses may have a potential role in the diagnosis, treatment, and prognosis of patients with COVID-19. So we need of identifying biomarkers for disease severity and progression.
Detailed description
It is important to define whether a novel virus is transmissible from a mother to her infant, vertical infection, and there are three possible mechanisms for vertical infection - intrauterine infection (including transplacental and ascending infections), intrapartum transmission (during delivery), and postpartum infection. These mechanisms have important implications that can influence obstetrical management decisions, best practice delivery options, and neonatal care (3). Aim of work To detect the effect of time of infection by COVID 19 on the fetomaternal outcome including vertical transmission, and the immunological and genetic changes during the disease course. Patients and Methods: * All pregnant women eligible for the study will undergo detailed medical history. * Each patient will have the following data: • Patient name. • Age. • Past medical and surgical history. • Menstrual history and contraceptive history: especially emphasis on Last Menstrual Period to determine the exact gestational age. * Clinical examination of the patients: - General examination of vital data (blood pressure, pulse, temperature, respiratory rate). CBC, PT, PTT, RBS, ALT, AST, serum creatinine), and ultrasound will be done. * Abdominal examination: to detect any abnormality as intrauterine growth restriction, with serial ultrasound estimation.
Interventions
None listed
Sponsors
Fayoum University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
Pregnant pt with covid 19 infection (at any gestational age) diagnosis of infection based on any one of the following criteria: 1. Positive RT-PCR nasopharyngeal swab is taken (even if the result became available after labor); 2. Positive rapid antigen test performed before labor 3. Chest computed tomography (CT) scan performed before labor showing changes consistent with pneumonitis secondary to SARS-CoV-2 infection; 4. Positive pre-labor immunoglobulin G or immunoglobulin M antibody test; or 5. Clinical diagnosis made before labor (in the absence of negative RT-PCR swab results).
Exclusion criteria
1. Healthy individuals: 2. Acute or chronic infectious disease, 3. And any medication with known influence on immunological factors.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| First, second and third trimester fetomaternal complications. | 3 months | Abdominal examination: to detect any abnormality as intra uterine growth restriction, with serial ultrasound estimation. |
| fetal distress | 3 months | Intrapartum fetal heart rate (FHR) to detect viability and any abnormalities. Pregnant women diagnosed to have intrapartum fetal distress (Non reassuring or pathological changes according to NICE guidelines 2017) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| fetal outcome | 3 months | After birth: Apgar score will be used to identify distress newborns that need resuscitation and nicu admissionsigns of fetal pulmonary complication, acute respiratory distress syndrome. The Apgar score comprises five components: 1) color, 2) heart rate, 3) reflexes, 4) muscle tone, and 5) respiration, each of which is given a score of 0, 1, or 2. A score of 7 to 10 after five minutes is reassuring. A score of 4 to 6 is moderately abnormal. A score of 0 to 3 is concerning. It indicates a need for increased intervention, usually in assistance for breathing. |
| Time of infection and fetal complications | 3 months | Time from the diagnosis of SARS-CoV-2 infection to day of labour will be collected as a categorical factor and pre-determined to be analysed. |
Countries
Egypt
Outcome results
None listed