Results
Eight of the pregnant women aged at 25-31years, all of them were at the
third trimester, two of them were multipara, six of them were primipara.
The time from onset to delivery were 2-8 days. Case 3 complicated with
mild anemia and thrombocytopenia, the platelet count was 90G/L, case 8
complicated with premature rupture of membranes, case 2 and case 5
complicated with mild anemia(table 1). Three of the eight pregnant women
had pneumonia related symptoms, case 1 had dry cough, case 5 had
intermittent fever and general weakness on the third day before
delivery, the maximum body temperature was 38 degrees, the body
temperature was normal at the time of delivery, case 6 had fever and dry
cough from a week before delivery, the maximum body temperature was 39
degrees, and she was still febrile at the time of delivery. The oxygen
saturation of all eight prenatal pregnant women was higher than 93% in
resting state, no one had shortness of breath. According to the 7th
edition of New Coronavirus Pneumonia Prevention and Control Program[6], there was no pneumonia changes on lung CT in
case 3,7,8, they were mild cases, the rest five cases were normal
cases(table 1). Case 6 had a maximum body temperature to 40 degree, with
severe cough, needed high flow rate of oxygen to maintain oxygen
saturation, and the lowest oxygen saturation was 90% at rest. Her
pneumonia aggravated after childbirth and became a severe case. Four
days after delivery, her pneumonia gradually started to improve, body
temperature and cough were getting relieved, oxygen saturation turned
normal at rest. Pneumonia in the rest seven puerperants was not getting
worse after childbirth. In laboratory examination, there were 6
cases(case1,2,4,5,6,7) of lymphocytopenia and 2 cases(case5,6) of
leukocytopenia. Pregnant women who were hospitalized before March 2020
were not able to carry out the detection of SARS-COV-2 IgM/G when they
were in hospital,case 3, case 7 and case 8 were positive for SARS-COV-2
IgM/G(table 1).
In all eight cases labor progressed smoothly. Postpartum hemorrhage was
defined as a cumulative blood loss of greater than or equal to 1,000 mL
or blood loss accompanied by signs or symptoms of hypovolemia within 24
hours after the birth process [7]. The amount of
bleeding was evaluated by weighing method and comparison of hemoglobin
before and after delivery[8]. No postpartum
hemorrhage occurred(table 2). In order to deliver the fetuses as soon as
possible to reduce the risk of mother to child transmission of the
SARS-COV-2, perineum lateral resection was performed in all the patients
except the multipara in the second stage of labor.
Case 6 experienced wound healing complication, the incision of perineum
was split after the suture was removed, and it healed one week later. To
other patients with lateral incisions, sutures were removed on the 5th
day postnatal, and healed well(table 2). Hospital discharge
standards[6] included patients with no fever for 3
days or more, no obvious self-conscious symptoms, negative SARS-COV-2
PCR twice in a row, obvious absorption of pulmonary inflammation on CT.
The hospital stay of all eight patients were 4-23 days(table 2).
Eight livebirths were recorded, no perinatal death, no low birth weight
no fetal distress was observed, case 6 had Amniotic fluid stained with
feces. All eight livebirths had a 1-min Apgar score of 8 and a 5-min
Apgar score of 9 (table 3). Throat swabs and anal swabs of all the
newborns were negative for the presence of SARS-CoV-2. Six of the
newborns were sent to neonatology department for medical observation,
the length of stay were 3-15days. Newborn 5 and newborn 6 had pneumonia
during hospitalization(table 3).
Seven of the family accepted follow-up after a month since they gave
birth, case 3 accepted follow-up on call only. No maternal and newborn
deaths were recorded, case 6 reported to have dry cough occasionally, no
abnormal or vaginal bleedings were reported(table 4,5). Detection of
SARS-CoV-2 nucleic acid in throat swabs of all the seven parturient
women were negative. SARS-COV-2
IgM/G was positive in the venous blood of case 5 and case 6. Case 7 and
case 8 had positive results of SARS-COV-2 IgG , the other five were
negative(table 4). All the eight infants were gaining weight and no
infant was hospitalized again. All the seven infants’ throat swabs and
anal swabs were negative for SARS-COV-2 nucleic acid detection, and
SARS-COV-2 IgM/G were all negative in venous blood.