Jayati Kusari Basu1, Lawrence Chauke2, Terrance Magoro3. 1. Department of Obstetrics and Gynecology, Charlotte Maxeke Johannesburg Academic Hospital and Ekurhuleni Health District, University of Witwatersrand, Germiston, South Africa. 2. Department of Obstetrics and Gynecology, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa. 3. Ekurhuleni District Department of Health, Ekurhuleni Health District, Germiston, South Africa.
Abstract
OBJECTIVE: To determine the COVID 19 related maternal deaths among South African pregnant women at Ekurhuleni health district in South Africa and to compare with similar studies. STUDY DESIGN: Retrospective review of all maternal deaths from all health care facilities from April to September 2020 were conducted using COVID registers and maternity case records. Human Research Ethics Committee of the University of Witwatersrand approved the study. Data included total live births, maternal mortality ratio (MMR), age, ethnicity, place of admission, parity, pregnancy status, antenatal complications, gestational age (GA) at delivery, GA at COVID 19 diagnosis, GA at death, symptoms, comorbidity, investigations (HIV, platelets, lymphocytes and LDH), and fetal outcome. Descriptive statistics (mean ± standard deviation, number and percentages) were calculated. RESULTS: Six women died from COVID. All were African. Mean age was 33.5 (SD ± 4.3) years majority (83%) were multiparous. The mean GA at the time of diagnosis was 35 (± 5.8) weeks. All had dyspnea at presentation. All had hypertension. HIV rate (50%) was higher than the national rate. High lactic dehydrogenase was the commonest laboratory abnormality. Rate of macerated stillborn (66%) was very high. CONCLUSION: To date, there are no African studies reporting on maternal mortality from COVID 19. This study provided valuable insight into maternal deaths due to COVID among South African women. COVID 19 is a novel cause of maternal death that has increased the death rate among South African pregnant women. Hypertensive women are at increased risk of death. They should be routinely tested for COVID. Women are at risk of death during the third trimester of pregnancy. High rate of stillborn is a concern. Decision to deliver earlier should be an option. High HIV rate and LDH count should alert health care workers to perform these tests among all COVID positive mothers.
OBJECTIVE: To determine the COVID 19 related maternal deaths among South African pregnant women at Ekurhuleni health district in South Africa and to compare with similar studies. STUDY DESIGN: Retrospective review of all maternal deaths from all health care facilities from April to September 2020 were conducted using COVID registers and maternity case records. Human Research Ethics Committee of the University of Witwatersrand approved the study. Data included total live births, maternal mortality ratio (MMR), age, ethnicity, place of admission, parity, pregnancy status, antenatal complications, gestational age (GA) at delivery, GA at COVID 19 diagnosis, GA at death, symptoms, comorbidity, investigations (HIV, platelets, lymphocytes and LDH), and fetal outcome. Descriptive statistics (mean ± standard deviation, number and percentages) were calculated. RESULTS: Six women died from COVID. All were African. Mean age was 33.5 (SD ± 4.3) years majority (83%) were multiparous. The mean GA at the time of diagnosis was 35 (± 5.8) weeks. All had dyspnea at presentation. All had hypertension. HIV rate (50%) was higher than the national rate. High lactic dehydrogenase was the commonest laboratory abnormality. Rate of macerated stillborn (66%) was very high. CONCLUSION: To date, there are no African studies reporting on maternal mortality from COVID 19. This study provided valuable insight into maternal deaths due to COVID among South African women. COVID 19 is a novel cause of maternal death that has increased the death rate among South African pregnant women. Hypertensive women are at increased risk of death. They should be routinely tested for COVID. Women are at risk of death during the third trimester of pregnancy. High rate of stillborn is a concern. Decision to deliver earlier should be an option. High HIV rate and LDH count should alert health care workers to perform these tests among all COVID positive mothers.
Authors: Jean B Nachega; Nadia A Sam-Agudu; Rhoderick N Machekano; Philip J Rosenthal; Sonja Schell; Liesl de Waard; Adrie Bekker; Onesmus W Gachuno; John Kinuthia; Nancy Mwongeli; Samantha Budhram; Valerie Vannevel; Priya Somapillay; Hans W Prozesky; Jantjie Taljaard; Arifa Parker; Elizabeth Agyare; Akwasi Baafuor Opoku; Aminatu Umar Makarfi; Asara M Abdullahi; Chibueze Adirieje; Daniel Katuashi Ishoso; Michel Tshiasuma Pipo; Marc B Tshilanda; Christian Bongo-Pasi Nswe; John Ditekemena; Lovemore Nyasha Sigwadhi; Peter S Nyasulu; Michel P Hermans; Musa Sekikubo; Philippa Musoke; Christopher Nsereko; Evans K Agbeno; Michael Yaw Yeboah; Lawal W Umar; Mukanire Ntakwinja; Denis M Mukwege; Etienne Kajibwami Birindwa; Serge Zigabe Mushamuka; Emily R Smith; Edward J Mills; John Otokoye Otshudiema; Placide Mbala-Kingebeni; Jean-Jacques Muyembe Tamfum; Alimuddin Zumla; Aster Tsegaye; Alfred Mteta; Nelson K Sewankambo; Fatima Suleman; Prisca Adejumo; Jean R Anderson; Emilia V Noormahomed; Richard J Deckelbaum; Jeffrey S A Stringer; Abdon Mukalay; Taha E Taha; Mary Glenn Fowler; Judith N Wasserheit; Refiloe Masekela; John W Mellors; Mark J Siedner; Landon Myer; Andre-Pascal Kengne; Marcel Yotebieng; Lynne M Mofenson; Eduard Langenegger Journal: Clin Infect Dis Date: 2022-06-08 Impact factor: 20.999