Stillbirths higher among Covid-positive pregnant women in second wave

Gynaecologists in Noida and Ghaziabad have reported a rise in stillbirths among pregnant women who either had Covid-19 or recovered from it in the second wave that hit the country in April

Gynaecologists in Noida and Ghaziabad have reported a rise in stillbirths among pregnant women who either had Covid-19 or recovered from it in the second wave that hit the country in April.

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The deaths occur mostly in those women whose condition deteriorates suddenly into severe form of the illness, and that most recover without reporting complications, doctors said. They added that without a proper scientific study, it’d not be possible to establish how widespread the cases were or how the disease was linked to stillbirths.

While miscarriages occur between the first and third month of pregnancy, stillbirths -- medically called intrauterine fetal deaths (IUFDs) -- mostly happens beyond at a more advanced stage after the second trimester (24 weeks).

Gynaecologist Dr. Manisha Ranjan said that about 10 percent of her patients since April reported sudden IUFDs.

“Last time, none of our Covid pregnant patients had suffered IUFDs. However this year, not just me but a number of my colleagues too have reported this and miscarriages among these patients. Covid-19 is causing severe vasculitis (inflammation of the blood vessels) among pregnant women which is leading to IUFD cases where the suddenly the patient is losing their baby even in the third trimester,” said Dr Ranjan, Consultant Gynaecologist & Obstetrician from Motherhood Hospital, Noida.

She added that maternal mortality rate too has also increased. “Patients’ condition deteriorates suddenly. I lost two patients in the last one month this way,” she said.

Dr Neha Mishra, Gynaecologist at Government Institute of Medical Sciences, Greater Noida also agreed.

“We haven’t seen many cases of miscarriages among Covid-positive pregnant women but it seems that it is affecting the fetus in the advance stages of pregnancy,” she said. “We have seen three cases of IUFD since April. We lost two Covid-positive women who were in last trimester too.”

Lack of oxygen was another reason was a reason that could contribute to the deaths, said Dr Aradhna Singh, Gynaecologist at Fortis Hospital, Noida.

“It is not that all pregnant patients are suffering from severe form of Covid, there are several who developed just mild symptoms and their babies turned out fine too,” said Dr Aradhna Singh. “If the mother is unable to get oxygen, the baby also doesn’t get it which leads to stillbirths. I have had three such cases.”

At Yashoda Hospital & Research Centre, Nehru Nagar, the gynaecology department head reported six cases of IUFD. “In three cases, the fetus died in the fifth or sixth month, while the rest died in the eighth or ninth month,” said Dr Shashi Arora, head of department of obstetrics, gynaecology & IVF and vice chairperson of the hospital.

In March, in a research paper in the medical journal The Lancet, doctors reviewed of 40 studies from 17 countries and found that maternal deaths and stillbirths had risen by a third. The authors pointed to a disruption to services due to lockdown and the fear of attending healthcare facilities.

Dr. Ranjana Becon, Gynecologist at Columbia Asia Hospital, Ghaziabad said more studies were required.

“There is no empirical evidence right now to establish the connection between Covid-19 and these deaths, but Covid seems to be the only reason why healthy pregnancies are ending like this,” said Dr Becon, adding that there had been five IUFDs at the hospital.

“Yes, incidents of IUFDs among Covid-posititve pregnant women have increased this year by 5-10 percent. Stress or raised level of D-Dimer which causes thrombosis (formation of blood clots) in vessels leading to pregnancy loss could be a cause. However, more evidence based research is required to establish this,” said Dr Deepa, senior gynaecologist at Yashoda Hospital, Kaushambi.