Impact of COVID-19 status on patients receiving neuraxial analgesia during labor : a national retrospective-controlled study

Abstract EN

Background: Pregnancy affects a woman's susceptibility to and severity of certain infectious diseases.

Central neuraxial block for analgesia during labor is superior to nonneuraxial methods in efficacy, safety, and maternal satisfaction.

Although Coronavirus disease (COVID-19) can be vertically transmitted from mother to fetus, little is known about the effects of COVID-19 on pregnant women or about anesthesia management and the risk of adverse effects related to neuraxial techniques in women with untreated COVID-19 during gestation.

Aim: This investigation assesses the effects of neuraxial analgesia during labor of COVID-19-positive parturients on their hemodynamic stability.

Results: The study was conducted on 64 patients and involved 32 parturients positive for SARS-CoV-2 by polymerase chain reaction (PCR) and a similar number of control “negative” patients.

The affected group had an uneventful course during gestation.

Seven were positive for ground-glass opacities on chest X-rays, and none underwent computed tomography (CT) scans.

Two neonates were PCR-positive for SARS-CoV-2, and all 32 neonates were released from the hospital.

No clinical differences were observed between the neonates in the COVID-19 and control groups.

Although parturients in both groups were hemodynamically stable, hemodynamic stability was subnormal in the COVID-19 group regarding blood pressure, oxygen saturation, heart rate, and body temperature.

None of the women in either group required a vasopressor or oxygen supplementation during delivery.

No other clinical differences were observed between the COVID-19 and control groups.

Conclusion: This is the first case-controlled study testing the anesthetic implications of neuraxial labor analgesia in pregnant, COVID-19-positive women.

Although management of neuraxial labor analgesia did not differ in pregnant women positive and negative for COVID-19, their hemodynamic characteristics differed significantly.

Therefore, care is required to prevent adverse outcomes in pregnant women positive for COVID-19.