Women entered the delivery rooms with clear respiratory symptoms following infection with the SARS-CoV-2 corona virus. The researchers' research hypothesis was that women with respiratory symptoms (RS) would experience a more complicated birth than women without these symptoms
A large and extensive observational study carried out on the initiative Prof. Alexander Yuskovitz, Director of the Obstetrics and Ambulatory Anesthesia Department of the Shaare Zedek Medical Center and the Faculty of Medicine at the Hebrew University, Tried to examine the administration of obstetric anesthesia and the use of painkillers during the corona period, among women giving birth in several medical centers in Israel and around the world. During their work, the researchers were exposed to alarming data received regarding women who entered the delivery rooms with clear respiratory symptoms following infection with the SARS-CoV-2 corona virus. The researchers' research hypothesis was that women with respiratory symptoms (RS) would experience a more complicated birth than women without these symptoms.
The study was carried out in a total of eight medical centers in Israel, Spain and Portugal between April 1 and July 31, 2020. The data was collected in real time during the observations of corona patients during childbirth as well as from the computerized medical records collected in the hospitals. In addition, maternal demographic variables, vital signs of corona, laboratory values during the birth, the course of the birth, pain relievers given during the birth and/or during the caesarean section, anesthesia after surgery including treatment with an oxygen mask, length of hospitalization, initial medical details regarding the newborns (such as the Apgar test) were examined , birth weight and any complication such as intrauterine fetal death, intrauterine growth restriction and premature birth - before 37 full weeks of pregnancy), and more.
According to the results of the study, 165 women with corona infection gave birth in the eight centers during the study period - 0.9% of the total of 18,250 women who gave birth in all medical centers during this period. 12% suffered from a respiratory syndrome following the infection of the virus and 88% (the rest) were without symptoms. Among women with respiratory symptoms, 7% of the births also suffered from pneumonia and 4% of the births suffered from the development and worsening of the respiratory syndrome caused by the corona virus. It is worth noting that most of the women who suffered from problematic breathing symptoms did not end up needing oxygen support - only 4.25% breathed through a nasal cannula, about 2% were helped by a face mask, and only about 1% needed a high dose of oxygen in the nose.
The most significant data is related to the increase in the number of newborns in caesarean sections - A 5-fold increase over normal time! 30% of the women who were infected with Corona and suffered from respiratory symptoms had to undergo a cesarean delivery under general anesthesia. About 16% of them underwent cesarean delivery due to lack of progress in labor, about 27% due to fetal distress and about 3% due to respiratory distress on the part of the mother and the rest (57%) due to other fetal reasons. A higher than expected rate of intrauterine fetal death, IUFD - Intrauterine Fetal Demise - 3% was also recorded (according to the medical-research literature, only about 0.2-0.3% of births in advanced countries are silent births).
Moreover, among women who suffered from severe respiratory symptoms, the researchers noticed an increase in the rate of early gestational age (about 50% of births before the 37th week) and in the rate of cesarean births - up to 65% (compared to 22.1% in the group without respiratory symptoms). Fortunately, there was no complication from the anesthesia following the surgeries or any other significant health change. Also, during the study period, the death of a woman in labor occurred as a result of a massive pulmonary embolism - five days after the cesarean delivery in a woman with a normal health history, who had respiratory symptoms due to corona infection. Following all the findings, the researchers stated in the article that "Women suffering from corona with severe symptoms are a special population that requires individual considerations and careful management."
Researchers, doctors, took part in the study, among them Prof. Amelia Guash, head of obstetric anesthesia at La Paz University Hospital in Madrid, in close cooperation with Prof. Yehuda Ginoser from Hadassah Ein Kerem Hospital, Dr. Daniel Shtlin from Shaare Zedek Medical Center, Prof. Carolyn Weiniger, Director of the Obstetric Anesthesia Unit, Department of Anesthesia, Pain and Intensive Care at the Souraski Tel Aviv Medical Center, Prof. Haim Breckenstadt, Director of the Department of Anesthesia at the Sheba Medical Center, and another group of other research men and women from Israel, Spain, and Portugal (SA) about 17).
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