Ciclo gravidico-puerperal COVID-19 - análise do desfecho obstétrico das pacientes internadas em uma maternidade pública de Belo Horizonte, Minas Gerais

Abstract

INTRODUCTION: Humanity has experienced a historic moment, marked by the fight against Covid-19, a viral infection that contributes to the development of acute distress syndrome (SARS). According to the WHO, pregnant women are considered a risk group due to the high risk of morbidity and mortality. In most cases, it can cause the same signs and symptoms as the general population, but with different severity. OBJECTIVE: To carry out an analysis of the epidemiological profile, sociodemographic aspects, clinical care and obstetric stages of pregnant and postpartum women hospitalized with Covid-19. METHODOLOGY: quantitative, descriptive - comparative and cross-sectional study at the Júlia Kubitschek Hospital of the Hospital Foundation of the state of Minas Gerais between March 2020 and March 2022. Univariate analysis of frequencies and means, using the Qui-square and T Student's tests and analysis multivariate and final model adjustment using multiple logistic regression and likelihood test. RESULTS: After evaluating 176 medical records of pregnant and postpartum women, 144 progressed to resolution of the pregnancy in the same maternity ward and 44 were admitted to the intensive care sector. It appears that 87.9% were black or mixed race, 71% were aged between 20 and 34 years, 51.8% were single and 56% had unplanned pregnancies. The absence of much of the sociodemographic data in the medical records was extremely common. Correlation between the use of oxygen, thrombosis, use of therapeutic and prophylactic enoxaparin in relation to maternal mortality achieved statistical relevance. The prenatal modality did not have an established causal relationship. Significant association between thrombosis and maternal mortality with OR=16.8 (95% CI1.29-217.31), p=0.03. The maternal ICU time was significant in relation to the stage of fetal development, with a significant association with the need for oxygen OR=4.37 (95% CI 2.42-10.24), p<0.001. DISCUSSION: In comparison with the statistics of common pregnancies, we can see that Covid-19 infection increases adverse events during pregnancy and neonatal, in addition to having an aggravating factor in the pregnancy and puerperal cycle. Enoxaparin was used in prophylactic doses in moderate and severe conditions and modified to therapeutic doses in suspected or diagnosed thromboembolic events, causing an increase in the number of postpartum hemorrhage. In local studies, there was an even higher rate of ATB use, compared to 70.5% in the hospital under analysis. Furthermore, as reported in the literature, a very significant worsening was seen in the first days of postpartum. CONCLUSION: Further studies are still needed to better understand all aspects of Covid-19, a more representative search to identify interfering factors in relation to hospitalizations of pregnant women, treatments and maternal-fetal outcomes remains necessary.