Document Type : Original Article
Authors
1 Resident of Obstetrics and Gynecology, Department of Obstetrics and Gynecology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
2 Associated Professor, Department of Obstetrics and Gynecology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
3 Master of Science Statistics, Clinical Research Development Centre, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
Abstract
Background: Pregnant women and their fetuses are likely to represent a high‐risk population during the coronavirus disease 2019 (COVID‐19) pandemic. The present study was designed aiming to evaluate the maternal and fetal outcomes in pregnant women diagnosed with COVID-19 with D-dimer levels.
Materials and Methods: In this descriptive analysis, blood samples were collected from patients with laboratory-confirmed COVID‐19 for evaluating D-dimer levels. The descriptive statistics are used to give more information using SPSS software.
Results: The flowing mean scores were obtained: age (30.99±5.66 y), gravidity (1.89±0.92 %), parity (1.38±0.63 %), and gestational age (24.39±10.6 w). Of 106 eligible pregnant women, 28.3% were receptive in the first trimester, 28.3% in the second trimester, and 43.39% in the third trimester. Our study showed RT-PCR test and HRCT chest scan to be positive in 91.5% and 63.2% of cases, receptively, with clinical suspicion and symptoms. The most common maternal and fetal outcomes included cesarean section, abortion, preterm labor, meconium, pulmonary embolism, prelabor rupture of membranes, and hypertension. The mean level of D-dimer in patients was 852.14±915.08 mg/L. Reference ranges for D-dimers level increased in the trimester order. In pregnant COVID-19 patients, about 79.25% of cases were out of the conventional normal threshold of D-dimer values.
Conclusion: The majority of complications were observed in the positive D-dimer levels. D-dimer level elevation continues to be a sign of poor prognosis in pregnant patients with COVID-19.
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- Porsoleiman L, Sadeghi M. A Survey on the Effect, of Covid19 on Pregnant Women and its Complications on their Fetuses and Newborn Childs (from February 2020 to January 2021). Paramed Sci Military Health. 2020; 15(3): 65-72.
- Alavian F, Alavian K. Pregnancy and COVID-19: Physiology, some Challenges, and Solutions. Iran J Obstet Gynecol Infertil. 2021; 24(1): 99-111.
- Holland C, Hammond C, Richmond MM. COVID-19 and Pregnancy: Risks and Outcomes. Nurs Women's Health. 2023; 27(1): 31-41.
- Esmailpour Estarkhi R, Borghei NS, Mehrbakhsh Z, Rahimian S. Clinical signs and maternal and neonatal outcomes of pregnant women with Covid-19 hospitalized in the first and second wave of coronavirus in Golestan province. Iran J Obstet Gynecol Infertil. 2022; 25(7): 59-69.
- Azh N, Pakniat H, Rajabi M, Ranjkesh F. Evaluation of Pregnancy Outcomes in Pregnant Women with COVID-19 in Qazvin 1399. IRJE. 2021; 16(5): 10-19.
- Ceriz T, Lagarteira J, Alves SR, Carrascal A, Terras Alexandre R. Disseminated Intravascular Coagulation in COVID-19 Setting: A Clinical Case Description. Cureus. 2023; 4;15(6): e39941.
- Doktorchik C, Premji S, Slater D, Williamson T, Tough S, Patten S. Patterns of change in anxiety and depression during pregnancy predict preterm birth. J Affect Disord. 2018; 227: 71-78.
- Khalili Fard MR, Salimi R, Amiri F. Evaluation of Correlation between D-dimer Levels with Disease Severity in Patients with Covid-19 Referred to Hamedan Besat Hospital in 2021-2022. Paramed Sci Military Health. 2022; 16(4): 10-17.
- Gallo Marin B, Aghagoli G, Lavine K, Yang L, Siff EJ, Chiang SS, et al. Predictors of COVID-19 severity: A literature review. Rev Med Virol. 2021; 31(1): 1-10.
- Cheng ZJ, Shan J. Novel coronavirus: where we are and what we know. Infection. 2020; 48(2): 155-163.
- Doulati MA, Doulati M. The value of D-Dimer as a biomarker in assessing disease severity and mortality in patients with Covid-19, a review study. J Lab Diagn. 2020; 12 (49): 41-45.
- Moaya M, Shahali S, Farhoudi B. Maternal and neonatal outcomes of pregnant women with COVID-19 in Amir-al-momenin hospital during March to May 2020. Iran J Obstet Gynecol Infertil. 2021; 23(9): 35-42.
- Kalantari Meybodi MS, Alizadeh S. The effects of COVID-19 on pregnancy: a review study. Nurs Midwifery J. 2021; 18(12): 933-941.
- Vouga M, Favre G, Martinez-Perez O, Pomar L, Acebal LF, Abascal-Saiz A, et al. Maternal outcomes and risk factors for COVID-19 severity among pregnant women. Sci Rep. 2021; 11(1): 1-11.
- Sahu KK, Lal A, Mishra AK. COVID‐2019 and Pregnancy: a plea for transparent reporting of all cases. Acta Obstet Gynecol Scand. 2020; 99(7): 951.
- Alserehi H, Wali G, Alshukairi A, Alraddadi B. Impact of Middle East Respiratory Syndrome coronavirus (MERS‐CoV) on pregnancy and perinatal outcome. BMC Infect Dis. 2016; 16(1): 1-4.
- Tapasvi I, Sethi A, Tapasvi C, Grover S, Rajora P. To Compare the Maternal and Fetal Outcomes of COVID-19-Affected Expectant Mothers During the First and Second COVID-19 Waves: Data From a Tertiary Care Referral Hospital in Punjab. Cureus. 2023; 17;15(3): e36319.
- Smith ER, Oakley E, Grandner GW., Ferguson K, Farooq F, Afshar Y, et al. Adverse maternal, fetal, and newborn outcomes among pregnant women with SARS-CoV-2 infection: an individual participant data meta- analysis. BMJ Glob Health. 2023; 8: e009495.
- Movahedi M, Siahafshari KM, Hajhashemi M, Khorvash F, Saeidi M, Allameh Z. Evaluation of Maternal and Fetal Outcomes in Pregnant Women with COVID-19 based on Different Trimesters. Adv Biomed Res, 2023; 30;12: 165.
- Vural T, Bayraktar B, Yildirim Karaca S, Odabas O, Yilmaz N, Samlioglu P, et al. Comparison of Maternal, Perinatal, and Neonatal Outcomes of Asymptomatic and Symptomatic Pregnant Women with Coronavirus Disease-2019. Medeni Med J. 2022; 37: 44-53.
- Berry M, Wang A, Clark SM, Harirah HM, Jain S, Olson GL, et al. Clinical Stratification of Pregnant COVID-19 Patients based on Severity: A Single Academic Center Experience. Am J Perinatol. 2021; 38: 515-22.
- Turan O, Hakim A, Dashraath P, Jeslyn WJL, Wright A, Abdul-Kadir R. Clinical characteristics, prognostic factors, and maternal and neonatal outcomes of SARS-CoV-2 infection among hospitalized pregnant women: A systematic review. Int J Gynecol Obstet. 2020; 151: 7-16.
- Yan J, Guo J, Fan C, Juan J, Yu X, Li J, et al. Coronavirus disease 2019 in pregnant women: a report based on 116 cases. Am J Obstet Gynecol. 2020; 223: 111.e1-111.e14.
- Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020; 395(10223): 507–13.
- Paixão JTR, Santos CdJSe, França APFdM, Lima SS, Laurentino RV, Fonseca RRdS, et al. Association of D-Dimer, C-Reactive Protein, and Ferritin with COVID-19 Severity in Pregnant Women: Important Findings of a Cross-Sectional Study in Northern Brazil. Int J Environ Res Public Health. 2023; 20: 6415.
- Olfati A, Soufivand P, Saadatfar A. Chemoimmunotherapy Drugs with Antiviral Activity to Treat Patients with Lung Cancer and COVID-19; a Narrative Review. Men's Health J. 2023; 7(1): Page e1.
- Guo L, Wei D, Zhang X, Wu Y, Li Q, Zhou M, et al. Clinical features predicting mortality risk in patients with viral pneumonia: the MuLBS tA score. Front Microb. 2019; 10: 2752.
- Zhang C, Chu H, Pei YV, Zhang J. Laboratory Effects of COVID-19 Infection in Pregnant Women and Their Newborns: A Systematic Review and Meta-Analysis. Front Global Women's Health. 2021; 2: 647072.
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