Missouri doctors are concerned about an increase in serious complications in COVID-19-positive pregnant women.State news

Dr. Rebecca Hamel, OB-GYN of St. Luke’s Women’s Health North in Kansas City, said it was easy for COVID-19 and pregnant parents. People are scared.

“They are just scared,” Hamel said. “And I understand it very well. On a personal level, I’m a pregnant obstetrician. I’m in my third semester. I know you’re in your own health and your baby’s health. I understand the urge and desire and the underlying need to make sure that I am making the best possible decisions for. “

Hamel added that these fears may be justified given the continued rise in COVID-19 among young people across the state. Maternal and fetal health physicians are beginning to see new complications of concern from COVID-19 infection during pregnancy.

“Fortunately, most of my mothers have uncomplicated infections,” Hamel said. “They are okay without long-term complications, but unfortunately we absolutely see rare exceptions to it and inpatients of all gestational ages.”

She said in the first semester that OB-GYN was seeing an increase in miscarriage. Then, in the second and third semesters, they see severely ill pregnant women in increasing need for ventilation or respiratory assistance.

“If you need to focus on keeping your mother alive, at that point you will stabilize your mother as much as possible, but you are giving birth prematurely and performing an unplanned emergency caesarean section to save your mother. “I will,” said Hamel. “Because you have to give your baby to take care of it.”

As a result, doctors may give birth to young babies 32, 28, and 24 weeks gestation, and mothers are most likely to survive severe COVID symptoms.

Hamel warned that this is a necessary step, but preterm birth can also increase the risk of complications throughout the child’s life.

In addition to all these complications, doctors are also concerned about the dramatic increase in stillbirth rates in pregnant women with COVID-19 infection. This comes from some limited early data and anecdotes from OB-GYN throughout the state.

One of the regions that noticed this increase was Springfield, Missouri. Earlier this summer, Springfield was the epicenter of Delta Variant COVID-19 cases.

Stillbirth affects the birth of 1 in 160 people, according to the Centers for Disease Control and Prevention. However, 23 of the 222 women who gave birth at Mercy Hospital in Springfield in August were infected with COVID and 6 of the 23 were stillborn.

This is 1 in 37, compared to an average of 1 in 160.

Although the scope and preliminary data are limited, maternal and fetal physicians in almost every major population density area in Missouri (Columbia, St. Louis, Kansas City, Springfield) are similar. He says he is watching.

Dr. Chandler Johnson, an OB-GYN at Mercy Hospital in Springfield, said more mothers tested positive for COVID-19 almost every day.

“Some are basically asymptomatic, have just been tested positive as part of the induction or caesarean section schedule, and some are very ill, all the way to the ICU,” Johnson said. Stated.

According to Johnson, Mercy Hospital began confirming many of these with regard to negative consequences when the peak of cases occurred in early August. More stillbirths, severe complications, and an increasing number of babies “all had a very abnormal placenta.”

These placenta showed evidence of vasculitis, inflammation in nature, and restriction of blood flow to the placenta and thus to the baby.

“Unfortunately, there isn’t really a way to predict that, but there is certainly an association with COVID that affects placental blood flow and circulation, which has had some very bad consequences,” Johnson said. Said.

Dr. Geeta Swamy is an obstetrician and gynecologist at Duke University.Specialist in maternal and perinatal infections and immunization during pregnancy.She too He is a member of the COVID-19OB Expert Working Group of the American College of Obstetrics and Gynecology, investigating the effects of COVID on pregnancy.

“Thankfully, this is rarely seen, but to be honest, there are more signs when you consider how aggressive the delta variant is and how sick the youth are. It’s no surprise that they do, “how those viruses affected pregnancy,” Swami said.

She added that it is still too early to draw broad conclusions and make national recommendations, and more data is needed.

Missouri isn’t the only state to see this annoying trend. Earlier this month, at a news conference on September 9, Mississippi health doctor Thomas Dobbs said the number of pregnant women who did not survive COVID-19 infection in the state increased, as well as increased. The same is true for fetal death.

“We found that using COVID doubled the fetal mortality rate and that the baby died in the womb after 20 weeks,” Dobbs said. “It was a real tragedy.”

In Missouri, each and every maternal and fetal health physician KBIA agreed that most of these serious complications occur in unvaccinated pregnant women and strongly encouraged vaccination. ..

Hamel said it was painful to see the family experience these serious consequences.She recommends vaccination of all pregnant patients— Especially because there is no evidence of high risk of vaccine-related miscarriage, infertility, or stillbirth complications during pregnancy..

“In my opinion, maternal mortality has increased by one and stillbirth has increased by one. That is unacceptable,” Hamel said. “And it returns to the safety profile. Vaccine risk is minimal, but (COVID-19) infection and pregnancy carry considerable risk.

“What is safe? Vaccination — hand it over.”