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[SARS-CoV-2 infection in pregnant women: Tunisian series of 11 cases].

Introduction
in pregnant women, the symptoms of COVID-19 join those of the general population in most cases. However, like any population at risk, more serious symptoms can appear such as pneumonia or ARDS. In our study, we propose to define the clinical, biological and therapeutic characteristics as well as the management of a series of pregnant women suffering from COVID-19.


Methods
this is a prospective and descriptive study which brought together 11 pregnant patients affected by the Coronavirus SARS-CoV-2 in the gynecology-obstetrics department of Mohamed Tlatli hospital, Nabeul, Tunisia between 12th September and 11th November 2020.


Results
the average age is 31.18 years. Six patients were followed for a chronic disease. Gestational diabetes was the most common comorbidity. Contact with a suspected or confirmed case of COVID-19 was identified in 6 patients. The average incubation period of the virus was 5.89 days. Average term of pregnancy was 33.36 weeks with amenorrhea. The preferred route of delivery was cesarean section. The most frequently reported symptoms were fever in all patients, dry cough, dyspnea and headache in nine patients. Two patients were subsequently treated in medical intensive care for a picture of acute respiratory distress syndrome (ARDS). Both patients were put on high flow nasal oxygen therapy: Optiflow without the need for mechanical ventilation. In the remaining 9 cases, symptomatic treatment and antibiotic therapy were sufficient and the patients returned to their homes. We have had no mother-to-child transmission and no death. Breastfeeding does not seem to influence this transmission.


Conclusion
the most frequently reported symptoms were fever in all patients, followed by dry cough, dyspnea and headache. There was no mother-to-child transmission, nor transmission during breastfeeding. In general, symptomatic and antibiotic treatment was sufficient. We are currently facing the second wave of the virus. Our efforts will have to be based on a better clinical knowledge of this new coronavirus and adapt a management function accordingly.