Impact of COVID-19 Pandemic on Obstetric Emergencies

Type of study Retrospective observational study and data were obtained from medical records only and Institutional ethics committee clearance was obtained prior to the conduct of the study.
Place of study Department of Obstetrics and Gynaecology, Swaroop Rani Hospital, MLN Medical College, Prayagraj.
Duration of study 30 months [15 months of prepandemic period (March 2018 to May 2019) and 15 months of pandemic period (March 2020 to May 2021)].
India had its first COVID-19 case on January 27, 2020, in Kerala [4 (link)], but Prayagraj had the first case on March 22, 2020, and lockdown was applied from March 23, 2020.
Based on the data from the Johns Hopkin’s Resource Centre pandemic period in India was divided into three phases: ‘pandemic-wave1 rising (Mar-Sep 2020)’, ‘pandemic-wave1 receding (Oct20-Feb21)’ and ‘pandemic-wave 2 rising (Mar-May 2021)’ [5 ].
Inclusion criteria All obstetric emergencies in prepandemic period and all non-COVID-19 Obstetric emergencies in pandemic period.
Exclusion criteria COVID-19 infected pregnant patients.
All the patients were divided in two groups:
Study group- All non-COVID-19 obstetric emergencies in pandemic period.
Control group- All obstetric emergencies in pre-pandemic period.
Parameters analyzed and compared were:

Monthly hospital births.

Obstetric referrals and bad state referrals.

General condition of the patient was assessed using critical, unstable, potentially unstable and stable (CUPS) assessment and critical, unstable, potentially unstable patients were ascertained as the bad state referral while stable patients as average state referral.

Monthly non-COVID-19 maternal mortalities.

Causes of maternal mortality:(i)

Postpartum hemorrhage (PPH).

(ii)

Eclampsia.

(iii)

Pre-eclampsia.

(iv)

Septic abortion (sepsis following spontaneous or induced abortion).

(v)

Puerperal infection.

(vi)

Uterine rupture.

(vii)

Heart failure in pregnancy or postpartum.

(viii)

Jaundice with Hepatic Encephalopathy.

(ix)

Antepartum Hemorrhage (APH).

In cases of multiple co-morbidities, the primary complication was ascertained as main cause of death.
- GRSI score and its impact on hospital births and non-COVID-19 maternal mortalities.
We used the time series data on the Government Response Stringency Index (GRSI) to calculate monthly average GRSI scores for India.