International Journal of Research in Medical Sciences | December 2021 | Vol 9 | Issue 12 Page 3495
International Journal of Research in Medical Sciences
Singh R et al. Int J Res Med Sci. 2021 Dec;9(12):3495-3500
www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012
Original Research Article
Anaesthetic management in COVID-19 parturients scheduled for
caesarean delivery - a comparison with non-COVID-19 parturients
Ranju Singh
1
, Pooja Singh
1
*, Eashwar Neelakandan
1
, Maitree Pandey
1
,
Manju Puri
2
, Sushma Nangia
3
INTRODUCTION
Coronavirus disease 2019 (COVID-19) is caused due to
infection by severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2). The disease was first
reported from Wuhan in China and was subsequently
declared as a pandemic by World Health Organization
(WHO).
1
The SARS-CoV-2 belongs to the same family as
the severe acute respiratory syndrome corona virus
(SARS-CoV) and the Middle East respiratory syndrome
coronavirus (MERS-CoV). Prior experience with these
two viruses has shown that they may be associated with
preterm delivery and still births in pregnant women.
2
Increased respiratory disorders and maternal mortality has
also been associated with these infections. This
predisposition to respiratory complications may be
explained by physiological changes in pregnancy such as
increased oxygen consumption, increased minute
1
Department of Anaesthesiology,
2
Department of Obstetrics and Gynaecology,
3
Department of Neonatology, Lady
Hardinge Medical College and Associated Shrimati Sucheta Kriplani Hospital, New Delhi, India
Received: 16 October 2021
Revised: 09 November 2021
Accepted: 11 November 2021
*Correspondence:
Dr. Pooja Singh,
E-mail: dr.pooja260887@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Background: Data regarding outcomes after anaesthesia in COVID-19 parturients is scanty. There is hardly any
information about the length of hospital stay in COVID-19 parturients who undergo caesarean delivery (CD) as
compared to non-COVID-19 parturients.
Methods: An observational study of COVID-19 parturients undergoing CD was conducted. Age and CD indication
matched non COVID-19 parturients were taken as controls. The length of hospital stay along with maternal and neonatal
outcomes were studied.
Results: A total of 45 COVID-19 parturients and an equal number of non-COVID-19 parturients were studied. The
length of hospital stay was significantly longer in COVID-19 parturients as compared to non-COVID-19 parturients
(4.3±1.6 days versus 3.3±0.6 days, p=0.02). One COVID-19 parturient developed severe disease and expired. Apart
from this case, the maternal and neonatal outcomes were comparable between the two groups. Mild thrombocytopenia
was seen in COVID-19 parturients. One neonate had a positive reverse transcriptase polymerase chain reaction (RT-
PCR) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on first day of life.
Conclusions: COVID-19 parturients who undergo CD have a longer length of hospital stay than non-COVID-19
parturients. Severe disease is likely to be associated with longer length of hospital stay. Intraoperative hypotension,
maternal and neonatal outcome is not significantly different between COVID-19 and non COVID-19 although mild
thrombocytopenia is seen in COVID-19 parturients. While vertical transmission of SARS-CoV-2 may be possible, more
data is needed regarding vertical transmission is needed.
Keywords: Caesarean section, COVID-19, Intraoperative hypotension, Length of stay, Spinal anaesthesia, Vertical
transmission
DOI: https://dx.doi.org/10.18203/2320-6012.ijrms20214699