Öz

Amaç: Şiddetli COVID-19 hastalığı nedeniyle yoğun bakımda yatan obstetrik hastaların özelliklerini, prognozunu, laboratuvar parametrelerini ve mortalitesini değerlendirmeyi ve mortaliteyi etkileyen faktörleri belirlemeyi amaçladık.

Gereç ve Yöntem: COVID-19 enfeksiyonu olan obstetrik hastaların tıbbi kayıtları incelendi. Yoğun bakıma yatırılan hastalar ve yenidoğanların sonuçları ayrıntılı olarak değerlendirildi.

Bulgular: Toplam 325 hasta çalışmaya dahil edildi. Yoğun bakım gereksinimi %8.6 (28/325) idi. Yoğun bakıma yatırılan 28 hasta arasında maternal mortalite oranı %53.6 (15/28) ve preterm doğum oranı %88 (24/28) idi. 27 yenidoğan ayrıntılı olarak değerlendirildi. Altı ölü doğum gerçekleşti. Yenidoğanların %40.7’sinin (11/27) 1. dakika APGAR skorları 7’den düşükken, %33.3’ünün (9/27) 5. dakika APGAR skorları 7’den düşüktü. Vücut kitle indeksi, CRP, D-dimer, LDH ve CRP/Alb oranının, yoğun bakıma ihtiyaç duyan hayatta kalan hastalara göre mortalite kohortunda anlamlı derecede daha yüksek olduğu bulundu. CRP/Alb oranı, YB’da COVID-19 ile ilişkili anne ölümünün en önemli predictor faktörü olarak bulundu.

Sonuç: Çalışmamız yoğun bakım hastalarında COVID-19 ile ilişkili anne ölümünün önemli ölçüde yüksek olduğunu ortaya koydu. CRP/Alb oranını mortalite için önemli bir prediktör olarak bulduk. Sezaryen ve erken doğum oranları COVID-19’lu yoğun bakım hastalarında anlamlı derecede yüksekti. Ek olarak, annelerin hastalığının ciddiyeti yenidoğan sonuçlarını olumsuz yönde etkiledi.

Anahtar Kelimeler: COVID-19, obstetric, ölüm oranı, yoğun bakım ünitesi

Referanslar

  1. World Health Organization (WHO). Q&A on coronaviruses (COVID-19). 2022. Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019 (Accessed on May 16, 2022).
  2. World Health Organization (WHO). Coronavirus (COVID-19). 2022. Available at: https://covid19.who.int/ (Accessed on May 16, 2022).
  3. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497-506. https://doi.org/10.1016/S0140-6736(20)30183-5
  4. Li N, Han L, Peng M, et al. Maternal and neonatal outcomes of pregnant women with coronavirus disease 2019 (COVID-19) pneumonia: a case-control study. Clin Infect Dis. 2020;71:2035-41. https://doi.org/10.1093/cid/ciaa352
  5. Jamieson DJ, Honein MA, Rasmussen SA, et al. H1N1 2009 influenza virus infection during pregnancy in the USA. Lancet. 2009;374:451-8. https://doi.org/10.1016/S0140-6736(09)61304-0
  6. Antoun L, Taweel NE, Ahmed I, Patni S, Honest H. Maternal COVID-19 infection, clinical characteristics, pregnancy, and neonatal outcome: a prospective cohort study. Eur J Obstet Gynecol Reprod Biol. 2020;252:559-62. https://doi.org/10.1016/j.ejogrb.2020.07.008
  7. Celewicz A, Celewicz M, Michalczyk M, et al. Pregnancy as a risk factor of severe COVID-19. J Clin Med. 2021;10:5458. https://doi.org/10.3390/jcm10225458
  8. Papapanou M, Papaioannou M, Petta A, et al. Maternal and neonatal characteristics and outcomes of COVID-19 in pregnancy: an overview of systematic reviews. Int J Environ Res Public Health. 2021;18:596. https://doi.org/10.3390/ijerph18020596
  9. Metz TD, Clifton RG, Hughes BL, et al. Disease severity and perinatal outcomes of pregnant patients with coronavirus disease 2019 (COVID-19). Obstet Gynecol. 2021;137:571-80. https://doi.org/10.1097/AOG.0000000000004339
  10. Hazari KS, Abdeldayem R, Paulose L, et al. Covid-19 infection in pregnant women in Dubai: a case-control study. BMC Pregnancy Childbirth. 2021;21:658. https://doi.org/10.1186/s12884-021-04130-8
  11. BahaaEldin H, El Sood HA, Samy S, et al. COVID-19 outcomes among pregnant and nonpregnant women at reproductive age in Egypt. J Public Health (Oxf). 2021;43:iii12-18. https://doi.org/10.1093/pubmed/fdab376
  12. Oncel MY, Akın IM, Kanburoglu MK, et al. A multicenter study on epidemiological and clinical characteristics of 125 newborns born to women infected with COVID-19 by Turkish Neonatal Society. Eur J Pediatr. 2021;180:733-42. https://doi.org/10.1007/s00431-020-03767-5
  13. Takemoto M, Menezes MO, Andreucci CB, et al. Clinical characteristics and risk factors for mortality in obstetric patients with severe COVID-19 in Brazil: a surveillance database analysis. BJOG. 2020;127:1618-26. https://doi.org/10.1111/1471-0528.16470
  14. Di Toro F, Gjoka M, Di Lorenzo G, et al. Impact of COVID-19 on maternal and neonatal outcomes: a systematic review and meta-analysis. Clin Microbiol Infect. 2021;27:36-46. https://doi.org/10.1016/j.cmi.2020.10.007
  15. Lassi ZS, Ana A, Das JK, 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. https://doi.org/10.7189/jogh.11.05018
  16. Andrikopoulou M, Madden N, Wen T, et al. Symptoms and critical illness among obstetric patients with coronavirus disease 2019 (COVID-19) infection. Obstet Gynecol. 2020;136:291-9. https://doi.org/10.1097/AOG.0000000000003996
  17. Karasu D, Kilicarslan N, Ozgunay SE, Gurbuz H. Our anesthesia experiences in COVID-19 positive patients delivering by cesarean section: a retrospective single-center cohort study. J Obstet Gynaecol Res. 2021;47:2659-65. https://doi.org/10.1111/jog.14852
  18. Akinosoglou K, Schinas G, Papageorgiou E, et al. COVID-19 in pregnancy: perinatal outcomes and complications. World J Virol. 2024;13:96573. https://doi.org/10.5501/wjv.v13.i4.96573
  19. Diriba K, Awulachew E, Getu E. The effect of coronavirus infection (SARS-CoV-2, MERS-CoV, and SARS-CoV) during pregnancy and the possibility of vertical maternal-fetal transmission: a systematic review and meta-analysis. Eur J Med Res. 2020;25:39. https://doi.org/10.1186/s40001-020-00439-w
  20. Salem D, Katranji F, Bakdash T. COVID-19 infection in pregnant women: review of maternal and fetal outcomes. Int J Gynaecol Obstet. 2021;152:291-8. https://doi.org/10.1002/ijgo.13533
  21. Bhatia K; Group of Obstetric Anaesthetists of Lancashire, Greater Manchester and Mersey Study Collaborators. Obstetric analgesia and anaesthesia in SARS-CoV-2-positive parturients across 10 maternity units in the north-west of England: a retrospective cohort study. Anaesthesia. 2022;77:389-97. https://doi.org/10.1111/anae.15672
  22. Chu Y, Yang J, Shi J, Zhang P, Wang X. Obesity is associated with increased severity of disease in COVID-19 pneumonia: a systematic review and meta-analysis. Eur J Med Res. 2020;25:64. https://doi.org/10.1186/s40001-020-00464-9
  23. Ganesan R, Mahajan V, Singla K, et al. Mortality prediction of COVID-19 patients at intensive care unit admission. Cureus. 2021;13:e19690. https://doi.org/10.7759/cureus.19690
  24. Özer B, Arslan Yıldız Ü, Kavaklı AS, Cengiz M, Temel H, Yılmaz M. Factors affecting mortality in COVID-19. Turk J Intensive Care. 2025;23:38-52. https://doi.org/10.4274/tybd.galenos.2024.50469
  25. Li Y, Li H, Song C, et al. Early prediction of disease progression in patients with severe COVID-19 using c-reactive protein to albumin ratio. Dis Markers. 2021;2021:6304189. https://doi.org/10.1155/2021/6304189
  26. Macfarlane AJR, Harrop-Griffiths W, Pawa A. Regional anaesthesia and COVID-19: first choice at last? Br J Anaesth. 2020;125:243-7. https://doi.org/10.1016/j.bja.2020.05.016
  27. Dashraath P, Wong JLJ, Lim MXK, et al. Coronavirus disease 2019 (COVID-19) pandemic and pregnancy. Am J Obstet Gynecol. 2020;222:521-31. https://doi.org/10.1016/j.ajog.2020.03.021
  28. Goudarzi S, Firouzabadi FD, Mahmoudzadeh F, Aminimoghaddam S. Pulmonary embolism in pregnancy with COVID-19 infection: a case report. Clin Case Rep. 2021;9:1882-6. https://doi.org/10.1002/ccr3.3709
  29. Pecks U, Mand N, Kolben T, et al. SARS-CoV-2 infection during pregnancy-an analysis of clinical data from Germany and Austria from the CRONOS registry. Dtsch Arztebl Int. 2022;119:588-94. https://doi.org/10.3238/arztebl.m2022.0266

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Karasu D, Ceylan İ, Sayan HE, Gürbüz H, Tan K, Eminoğlu Ş, et al. Yoğun bakım ünitesinde takip edilen COVID-19 hastalığı olan obstetrik hastaların sonuçlarının değerlendirilmesi. Turk J Intensive Care. 2025;23(4):257-267. https://doi.org/10.63729/TJIC.2025.671