Manggala Pasca Wardhana, - and Shabrina Avi Wulandari, - and Salsabila Nabilah Rifdah, - and Ifan Ali Wafa, - and Agus Sulistyono, Agus and Aditiawarman, - and Hermanto Tri Joewono, - and Erry Gumilar, - Nine Maternal Mortalities in 2 Weeks of Second COVID-19 Surge in Indonesia: A Case Series from One Large Tertiary Center. International Journal of Health Sciences, 6 (3). pp. 1383-1390. ISSN 2550-696X; 2550-6978

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Abstract

AbstractBACKGROUND: The fluctuating COVID-19 cases among the pregnant women’s population encountered increased of cases and maternal mortality.AIM: This research aimed to describe the case of maternal deaths caused by COVID-19.CASE REPORT: We present nine serial cases of maternal death caused by COVID-19 who were admitted to Dr. Soetomo General Academic Hospital for 14 days in June. We found 32 positive COVID-19 obstetric cases and reported nine maternal deaths with a fatality rate of up to 28%. Seven of nine patients had reverse transcription-polymerase chain reaction–confirmed SARS-CoV-2 infection, while two had a positive antigen swab. Half of the patients ≥35 years old, and five of nine patients had Class I obesity as preexisting comorbidity. This study reported the death of pregnant woman at their 2nd trimester and 3rd trimester presenting infected by severe COVID-19. The usual symptoms are dyspnea, cough, fever, and decreased consciousness. The result of chest X-ray examination among eight patients showed bilateral pneumonia. Most of cases were referrals from a secondary hospital due to overload hospital capacity. Three patients were directly transferred to the tertiary hospital without receiving initial treatment. Eight of 9 patients (88.9%) were transferred to intensive care unit and intubated due to low oxygen saturation.CONCLUSION: In conclusion, the limited hospital facility and lack of intensive care capacity for obstetric cases during the second wave of the COVID-19 pandemic may enhance the probability of mortality and morbidity in pregnant women infected by COVID-19

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