Advanced management tactics for high-risk pregnant women with moderate novel coronavirus infection COVID-19

Aim: to assess efficacy and safety of using colloidal silicon dioxide as an adjunct therapy in managing high-risk pregnant women with moderate COVID-19. Materials and Methods. A prospective comparative study was conducted by enrolling 62 pregnant women hospitalized with moderate COVID-19. Metabolic charts and delivery records were subsequently reviewed. Participants were divided into two groups: Group 1 (n = 32) received standard treatment, while Group 2 (n = 30) received standard treatment plus colloidal silicon dioxide. Clinical and laboratory markers of endotoxemia, pregnancy progression, and outcomes were assessed. Results. It was found that in Group 2 vs. Group 1 mean length of the following symptoms was significantly shorter: hyperthermia – by 2.4 days (p = 0.011), tachycardia – by 2.2 days (p = 0.037), weakness – by 2.1 days (p = 0.137), and headache – by 1.7 days (p = 0.042). In addition, women from Group 2 also showed significantly lower C-reactive protein and interleukin-6 levels (p = 0.006 and p = 0.019, respectively) as well as lacked blood flow disturbances at significantly more frequent level primarily Grade 1B uteroplacental insufficiency. Grade III blood flow disturbances were observed in one patient in Group 1 but none in Group 2. Regarding delivery outcomes, 97 % of Group 1 pregnancies resulted in live births (mean body length – 49.25 ± 1.75 cm, mean birth weight – 3126 ± 245.6 g), with vacuum extraction observed in 9 % of cases and cesarean section – in 31 %. One case of antepartum fetal demise occurred. In Group 2, all pregnancies resulted in live births (mean body length – 51.5 ± 2.5 cm, mean birth weight – 3360 ± 260 g), with vacuum extraction in 3 % of cases and cesarean section – in 30 %. While some patients exhibited combinations of these parameters, no significant inter-group differences were found. Assessing neonatal condition at one minute postpartum revealed significantly more cases of mild asphyxia in Group 1; the number of newborns without asphyxia was twice as high in Group 2 (p = 0.021). Conclusion. Comparing course of pregnancy, delivery, neonatal condition, and management of high-risk pregnant women with moderate COVID-19 using the proposed methodology suggests its high efficacy and safety.