Asymptomatic forms of COVID-19 in pregnant women: long-term consequences

PURPOSE: to establish the long-term effect of asymptomatic forms of COVID-19 on the course of pregnancy. METHODS & MATERIALS: An analysis of pregnancy outcomes was carried out in 40 women who had asymptomatic forms of COVID-19. RESULTS: The COVID-19 pandemic in conditions of high fertility in the southern regions of Kazakhstan caused pregnant women to become ill with coronavirus infection, including asymptomatic forms. Often asymptomatic forms remain undiagnosed and unaccounted for. We have studied cases of visits to a doctor by pregnant women for various reasons: stopping fetal movement, reducing the size of the abdomen and other complications of pregnancy. When examining them by ultrasound, oligohydroamnion was detected in 85% of cases, premature aging of the placenta, placental cysts in 27.5%, and impaired blood flow in the utero-fetal-placental circulation in 12.5%. Subsequently, 51.4% of women gave birth at full term, 48.5% gave birth prematurely, that is every second woman in the study group gave birth prematurely. In a detailed retrospective laboratory examination of women with the above pathology, IgG SARS-Cov-2 was detected in 92.5% of cases, indicating an asymptomatic coronavirus infection. The development of obstetric complications required from the medical staff reinforced observation and additional assessment, more frequent reclassification of the condition of the mother and fetus, and in some cases induction of labor. This tactic was applied in 12 cases (34.2% of the total number of women who gave birth), when prolongation of pregnancy was associated with a high risk to the health of the mother and fetus. CONCLUSION: Asymptomatic forms of COVID-19 in pregnant women have long-term consequences in the form of oligohydroamnion, premature aging of the placenta and impaired uterine blood flow. All cases of the transferred coronavirus infection in pregnant women, including asymptomatic ones, require more careful, in comparison with the generally accepted and frequent monitoring of pregnancy, in the form of control of the gravidogram, measurement of the abdominal circumference, the height of the uterine fundus, control ultrasonography of the fetus, amniotic fluid and uterine dopplerometry of fetal-placental blood flow.