Complications Of Severe and Very Severe Variants of Covid-19 Infection in Pregnant Women

Abstract

Introduction: The causative agent of COVID - 19 coronavirus infection is the new SARS-CoV-2 virus. In March 2020, the World Health Organization announced a pandemic of coronavirus infection (SARS-CoV-2). By mid-March 2021, 119 million people worldwide had contracted this infection, 94.7 million had recovered and 2.6 million had died. In Kazakhstan, 1.39 million people fell ill with this infection, 1.29 million people recovered, and 19 thousand people died. Physiological changes in the immune, cardiovascular and respiratory systems during pregnancy make it possible to make an assumption that pregnant women are especially vulnerable to the effects of pathogenic infectious agents and the development of a serious infection, which, in turn, can lead to increased morbidity and mortality of the mother and fetus. Premature birth is more common in pregnant women with pneumonia, premature babies with low body weight are born, and the frequency of cesarean sections is high.
Materials and Methods: The work with the subjects was carried out in accordance with the clinical protocol" coronavirus infection in pregnant, giving birth and giving birth women (Covid-19)", which is the Helsinki Declaration of the World Medical Association (World Medical Association Declaration of Helsinki 1964, edited 2013) and approved by the Joint Commission on the quality of medical services of the Ministry of health of the Republic of Kazakhstan on August 5, 2021. Clinical observations and studies were carried out in the period from April 2020 to May 2022 for pregnant and postpartum women in the"City Infectious Diseases Hospital"(Symkent, Kazkhstan), "Perinatal centers" of the Turkestan region and the cities of Shymkent. In order to implement the 1st stage of the study, a total of 120 pregnant women were subjected to comprehensive examinations. The diagnosis of COVID-19 in pregnant women was made based on epidemiological Anamnesis, complexes of clinical symptoms characteristic of this disease, and the results of laboratory and instrumental examinations. Pregnant healthy and with coronavirus
Results: For complicated forms of COVID-19 in pregnant women, primary clinical signs are characteristic (in order of differentiation) compared to mild forms: shortness of breath (82.1%), unproductive cough (83.4%), hemorrhagic syndrome (20%), myalgia (44.6%) (p<0.05). La-borator criteria for severe course of COVID-19 in pregnant women are: anemia (77.8%), leukopenia (21.4%) or leukocytosis (27.1%), thrombocytopenia (24.2%), hypercoagulation (29.2%), increased AST activity (34.2%), increased CFC (7.8%) (p<0.05). The most important confaunders of the severe course of COVID-19 in pregnant women who have survived severe conditions are: lack of preventive measures (Di 3,2-25,4), second Di 1,5-125) and Third (Di 1,8-156) gestational trimester, excess body weight and obesity ( Di 1,0 -7,5), smoking (Di 1,1-8,9), comorbidities of the respiratory organs (Di: 2,5-35,9), the presence of sexually transmitted infections (Di 4,6 - 91,2). The most important factors of maternal mortality in COVID-19 are: late seeking medical help and etiotropic therapy.
Conclusion: Pregnant women with pandemic flu are at risk of premature birth, regardless of the severity of COVID-19 and gestational age with the flu. A characteristic complication of childbirth in patients with influenza in the III trimester of pregnancy is untimely discharge of amniotic fluid. The largest number of complications in the postpartum period was observed in women in labor, complicated by influenza in the acute phase of the disease