Optimization of the management of pregnant women with new COVID-19 coronavirus infection: An open prospective cross-sectional study

Background. Many studies indicate that pregnant women are at risk for severe morbidity, adverse gestational outcomes, and mortality following SARS-CoV-2 (COVID-19) infection. Such patients have higher rates of abortion at various times, preterm delivery, preeclampsia, caesarean section, and delivery of low birth weight (LBW) newborns. Aim. To improve pregnancy and childbirth outcomes in women with COVID-19 by optimizing diagnostic and treatment interventions. Materials and methods. An open-label prospective continuous cross-sectional study enrolled 114 patients following SARS-CoV-2 infection. In 32 pregnant women of the main group with a high risk of obstetric complications, the treatment approach included endotheliotropic agent sulodexide and acetylsalicylic acid in addition to the standard of care for the underlying disease. Results. The severe course of COVID-19 in pregnant women is associated with the high rate of placental disorders (odds ratio – OR 6.1; 95% confidence interval – CI 2.6–14.9), fetal growth retardation (OR 5.6; 95% CI 1.2–30.2), preeclampsia (OR 8.5; 95% CI 3.4–22.4), premature birth (OR 14.1; 95% CI 5.8–38.4), surgical delivery (OR 8.5; 95% CI 4.1-18.1), low birth weight of newborns (OR 18.0; 95% CI 6.4–62.2), hospitalization in the neonatal intensive care unit (OR 25.4; 95% CI 6.4–67.0). Conclusion. Improving the management of pregnant women with COVID-19 by identifying a high-risk group for gestational complications, based on their early diagnosis, timely delivery, and use of acetylsalicylic acid and endotheliotropic agents to prevent venous thromboembolic complications, in addition to the standard of care, reduces the frequency of placental disorders by 2.3 times, severe preeclampsia – by 2.9 times, premature birth at 28–37 weeks – by 2 times, surgical delivery by cesarean section – by 1.6 times, delivery of low birth weight newborns – by 2.3 times, hospitalization in the intensive care unit of newborns – by 2.5 times.