Comparison of the Mode of Delivery between COVID and Non-COVID Pregnancies
Authors: Najam Saima , Aqeel Shehla , Hassan Syeda Ifra 
Published: September 2021

Background: The pregnant women and the newborn infants represent the vulnerable population in every society. Therefore Improvement efforts for the survival and the well being of the mothers and the neonates is indisputably a global priority especially during this pandemic of severe acute respiratory syndrome caused by a novel corona virus, called Covid-19. declared by the WHO ( World Health Association ) as global pandemic on March 11,2020. This pandemic has significantly altered the life styles of the pregnant women, boosting their apprehensions and concerns and importing great impacts on their health management. Current evidence suggests that the pregnant women are not at increased risk of Covid -19 as compared to the other adults. Similarly the condition is not severe in them. At the place of the current study the mode of delivery of the Covid patients is individualized and based on severity of the Covid infection and purely on the obstetric indications, as the evidence suggests that no mode of delivery is superior in terms of prevention of the vertical transmission.
Objective: We performed this study to compare the mode of delivery between the pregnant Covid and the non Covid pregnant population with the null hypothesis that the Covid effected pregnant patients are more prone to have caesarean section as compared to non Covid pregnant females and they are more prone to have CTG (cardiotocographic) abnormalities.
Material and Methods: It was a retrospective observational study done to compare the mode of delivery and the rate of CTG abnormalities in the study and the control group as the primary outcome. The secondary outcome was duration of active phase of the first stage, second and third stage of the labour between the pregnant Covid and the non Covid pregnant population for a period of 6 months (First January 2021 -30th June 2021) in labor ward of Dr. Sulaiman Al-Habib Hospital, Sweidi, Riyadh, Saudi Arabia. The study population comprised of 100 pregnant patients meeting our inclusion and exclusion criteria. The number of patients in each group was equal.
Results: No statistically significant difference was observed in the age, parity and ethnicity of both the groups. The rate of caesarean section was 38% (n=19) in the Covid group while in the control group it was 10% (n=05), the difference is statistically significant as shown by the P-Value of 0.004. No significant difference in the CTG abnormalities was found in both the groups. However statistically significant reduction in the active phase of the first, second and third stage of labour was noted in the study population.
Conclusion: We hereby prove our null hypothesis that the Covid-19 effected pregnant patients are prone to have higher caesarean section rate, however no difference in rate of CTG (cardiotocographic) abnormalities was observed in both the groups. Significant reduction in the duration of all stages of the labour was also noticed which is a fruit of thought for the upcoming research.

Key words: Pregnancy, labour, caesarean section, Covid-19, duration of labour.