Características clínicas de gestantes en trabajo de parto con infección SARSCoV- 2 en la altura: serie de casos

Jorge Arturo Collantes Cubas1,; Segundo Alberto Pérez Ventura; Oscar Eduardo Morillo Montes; Galo Terrones Julcamoro; Gilmer Antonio Huancahuire Aguilar; Jorge Martín Benites Pajares; Paulino Vigil-De Gracia; Francisco José Leyva

doi:10.31403/rpgo.v66i2276

Authors

Jorge Arturo Collantes Cubas1, Obstetrician and gynecologist, Department of Obstetrics and Gynecology, Hospital Regional Docente de Cajamarca, Peru
Segundo Alberto Pérez Ventura Obstetrician and gynecologist, Department of Obstetrics and Gynecology, Hospital Regional Docente de Cajamarca, Peru
Oscar Eduardo Morillo Montes Obstetrician and gynecologist, Department of Obstetrics and Gynecology, Hospital Regional Docente de Cajamarca, Peru
Galo Terrones Julcamoro Obstetrician and gynecologist, Department of Obstetrics and Gynecology, Simón Bolívar COVID-19 Hospital, Cajamarca, Peru
Gilmer Antonio Huancahuire Aguilar Obstetrician and gynecologist, Department of Obstetrics and Gynecology, Simón Bolívar COVID-19 Hospital, Cajamarca, Peru
Jorge Martín Benites Pajares Obstetrician and gynecologist, Department of Obstetrics and Gynecology, Medimagen, Cajamarca, Peru
Paulino Vigil-De Gracia Obstetrician and gynecologist, Department of Obstetrics and Gynecology, Complejo Hospitalario Dr. Arnulfo Arias Madrid Hospital, Caja del Seguro Social, Panama
Francisco José Leyva Obstetrician and gynecologist, Department of Obstetrics and Gynecology, Complejo Hospitalario Dr. Arnulfo Arias Madrid Hospital, Caja del Seguro Social, Panama

DOI:

https://doi.org/10.31403/rpgo.v66i2276

Keywords:

Pregnancy, Coronavirus infections, COVID-19, SARS CoV-2, High Altitude, Preeclampsia, Cajamarca, Peru

Abstract

Introduction: Fewer COVID-19 cases and less lethality have been observed at high altitude compared to cases reported at sea level. There are currently no publications reporting clinical behavior of pregnant women with COVID-19 at high altitude. Methods: This is a retrospective study with review of medical records between March 6, 2020 and June 15, 2020. The first thirteen cases of pregnant women with COVID-19 who were attended at Simón Bolívar COVID-19 Hospital, located at 2750 meters above sea level, are described. The cases came from altitudes between 2 035 and 3 502 meters above sea level (masl). Statistical analysis used SPSS, version 19.0. Results: Thirteen cases of pregnant women with COVID-19 confirmed by IgM for SARS-CoV-2 were attended at 2 750 masl (9 022.31 feet) in the Peruvian Andes. Delivery by cesarean section occurred in eight cases (61.5%) and five (38.5%) delivered vaginally. There were two cases (15.4%) of preeclampsia, one with diagnosis of HELLP syndrome, prematurity and fetal death. Three cases (23.1%) developed uterine hypotonia that required Hayman or B-Lynch suture. Two cases (15.38%) were complicated with oligohydramnios and two with urinary infection. Hemoglobin levels were between 11.1 and 16 g/dL. Only one case (7.7%) was symptomatic, with mild pharyngeal pain. No vertical transmission was detected by IgM/IgG for SARS-CoV-2. Clinical evolution was favorable in the thirteen cases and they were discharged after 2 to 4 days hospitalization to continue home quarantine. Conclusions: Results in this short study show pregnant women in labor with COVID-19 by rapid IgM test for SARS-CoV-2 at high altitude were mostly asymptomatic; there was no vertical transmission, but high presence of other obstetrical complications.