Nine Maternal Mortalities in 2 Weeks of Second COVID-19 Surge in Indonesia: A Case Series from One Large Tertiary Center

• Main Authors: Manggala Pasca Wardhana, -, Shabrina Avi Wulandari, -, Salsabila Nabilah Rifdah, -, Ifan Ali Wafa, -, Agus Sulistyono, -, Aditiawarman, -, Hermanto Tri Joewono, -, Erry Gumilar Dachlan, -
• Format: Article PeerReviewed
• Language: English; English; English; English; Indonesian
• Published: Scientific Foundation SPIROSKI 2022
• Subjects: R Medicine (General); RG Gynecology and obstetrics
• Online Access: https://repository.unair.ac.id/126146/1/Karil%2026.pdf; https://repository.unair.ac.id/126146/2/Artikel%2026.pdf; https://repository.unair.ac.id/126146/3/Similarity%2026.pdf; https://repository.unair.ac.id/126146/7/28.%20Nine%20Maternal%20Mortalities%20in%202%20Weeks%20of%20Second%20COVID-19.pdf; https://repository.unair.ac.id/126146/8/28.%20Nine%20Maternal%20Mortalities%20in%202%20Weeks%20of%20Second%20COVID%2019.pdf; https://repository.unair.ac.id/126146/; https://oamjms.eu/index.php/mjms/article/view/9415; https://doi.org/10.3889/oamjms.2022.9415
• Institution: Universitas Airlangga

BACKGROUND: 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.