key: cord-0908266-0yvm0ou3
authors: Khoiwal, Kavita; Agarwal, Anchal; Mittal, Anmol; Gaurav, Amrita; Chawla, Latika; Mundhra, Rajlaxmi; Bahadur, Anupama; Chaturvedi, Jaya
title: The lethal effect of the second wave of COVID‐19 on pregnant women: a matter of concern
date: 2021-10-04
journal: Int J Gynaecol Obstet
DOI: 10.1002/ijgo.13951
sha: cae3f37915a57dbd7406201234de4a83ffc72a1b
doc_id: 908266
cord_uid: 0yvm0ou3

The lethal second wave of COVID‐19 hit pregnant women terribly with regards to disease severity, requirement of invasive ventilation, and maternal mortality.

Sodium valproate increases the level of γ-aminobutyric acid in the brain, inhibiting the enzymes that catabolize γ-aminobutyric acid. It has a direct membrane-stabilizing effect by affecting potassium channels. Phenytoin prevents seizures as a non-specific sodium-channel blocker; it targets almost all voltage-gated sodiumchannel subtypes. These two mechanisms may partially explain the decreased FHR variability in our patient's infant.

The International League Against Epilepsy Task Force on Women and Pregnancy recommends that multiple doses of AEDs should be avoided if possible. 3 Sodium valproate and phenytoin increase fetal anomalies. 4 Our patient's neurologist continued to prescribe these AEDs during her pregnancy as a last resort because of her severe side effects with the other AEDs. There was minimal FHR variability without deceleration, no neonatal asphyxia, and no other reasons for decreased FHR variability in this case, which led to the hypothesis that this rare combination of AEDs might have suppressed the FHR variability. Our observations may help to estimate fetal wellbeing when similar cases are encountered.

The authors have no conflicts of interest. I B UTI O N S   MM, KO, MK, KN, and TI were involved in study design and data   interpretation. MM, KO, MK, KN, and TI were involved in the data analysis. All authors critically revised the report, commented on drafts of the manuscript, and approved the final report. 

This is an intramural project performed at AIIMS Rishikesh.

The authors have no conflicts of interest. Values presented as n (%).

*Statistical significance at P < 0.05.

Were pregnant women more affected by COVID-19 in the second wave of the pandemic?

First and second waves of coronavirus disease-19: a comparative study in hospitalized patients in Reus

Ministry of Health and Family Welfare. COVID-19