Case of the Month #23 - obstetrics & SARS-CoV-2

Published 01/02/2022

What are the common clinical findings in pregnant women with SARS-CoV-2?

A study of over 23,000 pregnant women in the USA found that the most common symptoms reported were: cough (50.3%), headache (42.7%), and muscle aches (36.7%) (5).

A systematic review (3) found that common laboratory findings in the pregnant population included lymphopenia (35%), leucocytosis (27%), elevated procalcitonin (21%), abnormal liver chemistries (11%), and thrombocytopaenia (8%). Leukocytosis can be normal in pregnancy, and many of these other laboratory findings could be consistent with other disease states (eg pre-eclampsia).

77% of pregnant women with hospitalised SARS-CoV-2 display ground-glass opacification on chest radiograph.

Allotley et al (3) found that in this population: 

  • 49% had pneumonia
  • 30% received oxygen by cannula
  • 13% had severe disease
  • 4% were admitted to an intensive care unit (ICU)
  • 3% received invasive ventilation
  • 0.8% received extracorporeal membrane oxygenation (ECMO)
  • 0.6% died

Most notably, this study was performed prior to the second and third waves, where we have seen higher numbers of pregnant women hospitalised with this virus but reassuringly less mortality (1).