1887
Volume 2022, Issue 3
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

Background: Pregnancy affects a woman's susceptibility to and severity of certain infectious diseases. Central neuraxial block for analgesia during labor is superior to nonneuraxial methods in efficacy, safety, and maternal satisfaction. Although Coronavirus disease (COVID-19) can be vertically transmitted from mother to fetus, little is known about the effects of COVID-19 on pregnant women or about anesthesia management and the risk of adverse effects related to neuraxial techniques in women with untreated COVID-19 during gestation.

Aim: This investigation assesses the effects of neuraxial analgesia during labor of COVID-19-positive parturients on their hemodynamic stability.

Results: The study was conducted on 64 patients and involved 32 parturients positive for SARS-CoV-2 by polymerase chain reaction (PCR) and a similar number of control “negative” patients. The affected group had an uneventful course during gestation. Seven were positive for ground-glass opacities on chest X-rays, and none underwent computed tomography (CT) scans. Two neonates were PCR-positive for SARS-CoV-2, and all 32 neonates were released from the hospital. No clinical differences were observed between the neonates in the COVID-19 and control groups. Although parturients in both groups were hemodynamically stable, hemodynamic stability was subnormal in the COVID-19 group regarding blood pressure, oxygen saturation, heart rate, and body temperature. None of the women in either group required a vasopressor or oxygen supplementation during delivery. No other clinical differences were observed between the COVID-19 and control groups.

Conclusion: This is the first case-controlled study testing the anesthetic implications of neuraxial labor analgesia in pregnant, COVID-19-positive women. Although management of neuraxial labor analgesia did not differ in pregnant women positive and negative for COVID-19, their hemodynamic characteristics differed significantly. Therefore, care is required to prevent adverse outcomes in pregnant women positive for COVID-19.

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2022-07-11
2022-09-29
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References

  1. Bauer ME, Bernstein K, Dinges E, Delgado C, El-Sharawi N, Sultan P, et al. Obstetric anesthesia during the COVID-19 pandemic. Anesth Analg. 2020;:131: 7–15. doi:10.1213/ANE.0000000000004856.
    [Google Scholar]
  2. Bampoe S, Odor PM, Lucas DN. Novel coronavirus SARS-CoV-2 and COVID-19. practice recommendations for obstetric anaesthesia: what we have learned thus far. Int J Obstet Anesth. 2020;:43: 1–8. doi:10.1016/j.ijoa.2020.04.006.
    [Google Scholar]
  3. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020;:323: 1061. doi:10.1001/jama.2020.1585.
    [Google Scholar]
  4. Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med. 2020;:382: 1199–1207. doi:10.1056/NEJMoa2001316.
    [Google Scholar]
  5. Fridman D, Kuzbari O, Minkoff H. Novel influenza H1N1 in pregnancy: a report of two cases. Infect Dis Obstet Gynecol. 2009;:2009: 514353. doi:10.1155/2009/514353.
    [Google Scholar]
  6. Alyamani O, Abushoshah I, Tawfeeq NA, Al Dammas F, Algurashi FA. Considerations and recommendations for obstetric anesthesia care during COVID-19 pandemic—Saudi Anesthesia Society Guidelines. Saudi J Anaesth. 2020;:14: 359–364. doi:10.4103/sja.SJA_310_20.
    [Google Scholar]
  7. Jain K, Bhatia N, Grewal A, Pandya ST, Gupta S, Bagga R, et al. Management of pregnant laboring women during COVID-19 pandemic. J Anaesthesiol Clin Pharmacol. 2020;:36: S91–S96. doi:10.4103/joacp.JOACP_258_20.
    [Google Scholar]
  8. Jung H, Kwak K-H. Neuraxial analgesia: a review of its effects on the outcome and duration of labor. Korean J Anesthesiol. 2013;:65: 379–384. doi:10.4097/kjae.2013.65.5.379.
    [Google Scholar]
  9. Klöhr S, Roth R, Hofmann T, Rossaint R, Heesen M. Definitions of hypotension after spinal anaesthesia for caesarean section: literature search and application to parturients. Acta Anaesthesiol Scand. 2010;:54: 909–921. doi:10.1111/j.1399-6576.2010.02239.x.
    [Google Scholar]
  10. Lassi ZS, Ana A, Das JK, Salam RA, Padhani ZA, Irfan O, et al. A systematic review and meta-analysis of data on pregnant women with confirmed COVID-19: clinical presentation, and pregnancy and perinatal outcomes based on COVID-19 severity. J Glob Health. 2021;:11: 05018. doi:10.7189/jogh.11.05018.
    [Google Scholar]
  11. Kaye R, Chang CWD, Kazahaya K, Brereton J, Denneny JC. COVID-19 anosmia reporting tool: initial findings. Otolaryngol Head Neck Surg. 2020;:163: 132–134. doi:10.1177/0194599820922992.
    [Google Scholar]
  12. Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet. 2020;:395: 809–815. doi:10.1016/S0140-6736(20)30360-3.
    [Google Scholar]
  13. Breslin N, Baptiste C, Miller R, Fuchs K, Goffman D, Gyamfi-Bannerman C, et al. Coronavirus disease 2019 in pregnancy: early lessons. Am J Obstet Gynecol MFM. 2020;:2: 100111. doi:10.1016/j.ajogmf.2020.100111.
    [Google Scholar]
  14. Yang H, Wang C, Poon LC. Novel coronavirus infection and pregnancy. Ultrasound Obstet Gynecol. 2020;:55: 435–437. doi:10.1002/uog.22006.
    [Google Scholar]
  15. Thornburg KL, Jacobson SL, Giraud GD, Morton MJ. Hemodynamic changes in pregnancy. Semin Perinatol. 2000;:24: 11–4. doi:10.1016/s0146-0005(00)80047-6.
    [Google Scholar]
  16. Chen R, Zhang Y, Huang L, Cheng B-H, Xia Z-Y, Meng Q-T. Safety and efficacy of different anesthetic regimens for parturients with COVID-19 undergoing cesarean delivery: a case series of 17 patients. Can J Anaesth. 2020;:67: 655–663. doi:10.1007/s12630-020-01630-7.
    [Google Scholar]
  17. Guan W-J, Ni Z-Y, Hu Y, Liang W-H, Ou C-Q, He J-X, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;:382: 1708-1720. doi:10.1056/NEJMoa2002032.
    [Google Scholar]
  18. Bauer ME, Chiware R, Pancaro C. Neuraxial procedures in COVID-19 positive parturients: a review of current reports. Anesth Analg. 2020 [cited 4 Sep 2020]. doi:10.1213/ANE.0000000000004831.
    [Google Scholar]
  19. Koyyalamudi V, Sidhu G, Cornett EM, Nguyen V, Labrie-Brown C, Fox CJ, et al. New labor pain treatment options. Curr Pain Headache Rep. 2016;:20: 11. doi:10.1007/s11916-016-0543-2.
    [Google Scholar]
  20. Hawkins JL. Epidural analgesia for labor and delivery. N Engl J Med. 2010;:362: 1503–10. doi:10.1056/NEJMct0909254.
    [Google Scholar]
  21. Hu L-Q, Zhang J, Wong CA, Cao Q, Zhang G, Rong H, et al. Impact of the introduction of neuraxial labor analgesia on mode of delivery at an urban maternity hospital in China. Int J Gynaecol Obstet. 2015;:129: 17–21. doi:10.1016/j.ijgo.2014.10.030.
    [Google Scholar]
  22. Wong SF, Chow KM, Leung TN, Ng WF, Ng TK, Shek CC, et al. Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome. Am J Obstet Gynecol. 2004;:191: 292–297. doi:10.1016/j.ajog.2003.11.019.
    [Google Scholar]
  23. Capobianco G, Saderi L, Aliberti S, Mondoni M, Piana A, Dessole F, et al. COVID-19 in pregnant women: a systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2020;:252: 543–558. doi:10.1016/j.ejogrb.2020.07.006.
    [Google Scholar]
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  • Article Type: Research Article
Keyword(s): CoronavirusesCOVID-19Neuraxial labor analgesiaNormal delivery and Pregnancy
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