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Vaginal delivery in COVID-19 pregnancies: experience from a referral center in a high-prevalence area

Objective: We aimed to describe mode of delivery and perinatal results among COVID-19 confirmed infected women. Design: Prospective cohort of consecutive pregnant women with confirmed SARS-CoV-2 infection, and comparison of perinatal outcome with expected values on an historical cohort. Setting: A tertiary referral center in Barcelona, Spain. Population: Pregnant women with SARS-CoV-2 confirmed infection. Methods: SARS-CoV-2 infected women managed under a standard protocol who delivered during the period March 13th - April 25th, were evaluated. Data on baseline maternal characteristics, COVID-19 disease parameters, clinical management, mode of delivery, and perinatal outcome were collected. Relevant perinatal data were compared with the expected values observed in an historical control of our center. Main Outcome and Measure: Rate of vaginal delivery among COVID-19 pregnancies. Secondary outcomes were maternal or neonatal complications, and vertical transmission of SARS-CoV-2. Results: A total of 21 women with COVID-19 delivered at our center during the study period: 42.9% had moderate or severe respiratory infection. 14 out of 21 (66.7%) delivered vaginally. Three out of 7 caesarean sections were maternal indicated because of maternal worsening secondary to COVID infection. Preterm delivery occurred in 4 cases (19%), half of them related to COVID-19. There were no differences between the observed and the expected perinatal outcomes. Conclusions: In the absence of severe maternal complications, vaginal delivery among pregnant women with COVID-19 infection is a safe option, both for the mother and the baby, with similar perinatal outcomes than expected in a non-infected cohort and with no evidence of vertical transmission.