1. Peripartum anesthetic management of women with SARS-CoV-2 infection in eight medical centers across three European countries: prospective cohort observation study.
- Author
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Ioscovich, Alexander, Guasch, Emilia, Brogly, Nicolas, Shatalin, Daniel, Manrique-Muñoz, Susana, Sánchez Royo, Maria Elena, Zimro, Sabastine, Ginosar, Yehuda, Lages, Neusa, Weinstein, Jacob, Berkenstadt, Haim, Greenberger, Chaim, Lazutkin, Alexey, Izakson, Alexander, Ioscovich, Daniel, Orbach-Zinger, Sharon, and Weiniger, Carolyn F.
- Subjects
PERIPARTUM cardiomyopathy ,MEDICAL centers ,CESAREAN section ,ANESTHESIA in obstetrics ,ACADEMIC medical centers ,SARS-CoV-2 - Abstract
Objective: Several reports of obstetric anesthesia management have been published since the onset of the COVID-19 pandemic. We aimed to collect high-quality broad and detailed data from different university medical centers in several European Society of Anesthesiologist countries. Methods: This prospective observational survey was performed in eight medical centers in Spain, Israel and Portugal from 1
st April to 31st July 2020. Institutional review board approval was received at each participating center. Inclusion criteria: all women with a positive test for COVID-19. Retrieved data included maternal, delivery, anesthetic, postpartum details, and neonatal outcomes. Descriptive data are presented, and outcomes were compared for women with versus without respiratory signs and symptoms. Results: Women with respiratory symptoms (20/12.1%) had significantly higher mean (standard deviation) temperature (37.2 C (0.8) versus 36.8 C (0.6)), were older (34.1 (6.7) years versus 30.5 (6.6)) and had higher body mass index kg m-2 – (29.5 (7.5) versus 28.2 (5.1)). Women with respiratory symptoms delivered at a significantly earlier gestational age (50% < 37 weeks) with a 65% cesarean delivery rate (versus 22.1% in the group without respiratory symptoms) and 5- fold increased rate of emergency cesarean delivery, 30% performed under general anesthesia. A higher rate of intrauterine fetal death (3%) was observed than expected from the literature (0.2–0.3%) in developed countries. There was no evidence of viral vertical transmission. Conclusion: Well-functioning neuraxial analgesia should be available to manage laboring women with respiratory symptoms, as there is a higher frequency of emergency cesarean delivery. We report a higher rate of undiagnosed parturient and intrauterine fetal death. [ABSTRACT FROM AUTHOR]- Published
- 2022
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