Fatal poisoning of pregnant women by peganum harmala L.: A case reports

Abstract Background As pregnancy is a physiological prothrombotic state, pregnant women may be at increased risk of developing coagulopathic and/or thromboembolic complications associated with COVID-19. Methods Two biomedical databases were searched between September 2019 and June 2020 for case reports and series of pregnant women with a diagnosis of COVID-19 based either on a positive swab or high clinical suspicion where no swab had been performed. Additional registry cases known to the authors were included. Steps were taken to minimise duplicate patients. Information on coagulopathy based on abnormal coagulation test results or clinical evidence of disseminated intravascular coagulation (DIC), and on arterial or venous thrombosis, were extracted using a standard form. If available, detailed laboratory results and information on maternal outcomes were analysed. Results One thousand sixty-three women met the inclusion criteria, of which three (0.28, 95% CI 0.0 to 0.6) had arterial and/or venous thrombosis, seven (0.66, 95% CI 0.17 to 1.1) had DIC, and a further three (0.28, 95% CI 0.0 to 0.6) had coagulopathy without meeting the definition of DIC. Five hundred and thirty-seven women (56%) had been reported as having given birth and 426 (40%) as having an ongoing pregnancy. There were 17 (1.6, 95% CI 0.85 to 2.3) maternal deaths in which DIC was reported as a factor in two. Conclusions Our data suggests that coagulopathy and thromboembolism are both increased in pregnancies affected by COVID-19. Detection of the former may be useful in the identification of women at risk of deterioration.

Download Full-text

Cryptococcosis in pregnancy and the postpartum period: Case series and systematic review with recommendations for management

Medical Mycology ◽

10.1093/mmy/myz084 ◽

2019 ◽

Vol 58 (3) ◽

pp. 282-292

Author(s):

Katelyn A Pastick ◽

Elizabeth Nalintya ◽

Lillian Tugume ◽

Kenneth Ssebambulidde ◽

Nicole Stephens ◽

...

Keyword(s):

Survival Rate ◽

Pregnant Women ◽

Amphotericin B ◽

Cryptococcal Meningitis ◽

Treatment Guidelines ◽

Case Reports ◽

Case Series ◽

First Trimester ◽

Secondary Prophylaxis ◽

Fetal Survival

Abstract Cryptococcal meningitis causes 15% of AIDS-related deaths. Optimal management and clinical outcomes of pregnant women with cryptococcosis are limited to case reports, as pregnant women are often excluded from research. Amongst pregnant women with asymptomatic cryptococcosis, no treatment guidelines exist. We prospectively identified HIV-infected women who were pregnant or recently pregnant with cryptococcosis, screened during a series of meningitis research studies in Uganda from 2012 to 2018. Among 571 women screened for cryptococcosis, 13 were pregnant, one was breastfeeding, three were within 14 days postpartum, and two had recently miscarried. Of these 19 women (3.3%), 12 had cryptococcal meningitis, six had cryptococcal antigenemia, and one had a history of cryptococcal meningitis and was receiving secondary prophylaxis. All women with meningitis received amphotericin B deoxycholate (0.7–1.0 mg/kg). Five were exposed to 200–800 mg fluconazole during pregnancy. Of these five, three delivered healthy babies with no gross physical abnormalities at birth, one succumbed to meningitis, and one outcome was unknown. Maternal meningitis survival rate at hospital discharge was 75% (9/12), and neonatal/fetal survival rate was 44% (4/9) for those mothers who survived. Miscarriages and stillbirths were common (n = 4). Of six women with cryptococcal antigenemia, two received fluconazole, one received weekly amphotericin B, and three had unknown treatment courses. All women with antigenemia survived, and none developed clinical meningitis. We report good maternal outcomes but poor fetal outcomes for cryptococcal meningitis using amphotericin B, without fluconazole in the first trimester, and weekly amphotericin B in place of fluconazole for cryptococcal antigenemia.

Download Full-text

Systematic review to investigate the safety of induction and augmentation of labour among pregnant women with iron-deficiency anaemia

BMJ Open ◽

10.1136/bmjopen-2018-021793 ◽

2018 ◽

Vol 8 (12) ◽

pp. e021793 ◽

Cited By ~ 1

Author(s):

Kathryn Bunch ◽

Nia Roberts ◽

Marian Knight ◽

Manisha Nair

Keyword(s):

Systematic Review ◽

Iron Deficiency ◽

Pregnant Women ◽

Iron Deficiency Anaemia ◽

Case Reports ◽

Case Series ◽

Severe Anaemia ◽

Risk Of Bias ◽

Deficiency Anaemia ◽

Increased Risk

ObjectiveTo conduct a systematic review to investigate the safety of induction and/or augmentation of labour compared with spontaneous-onset normal labour among pregnant women with iron-deficiency anaemia.DesignSystematic review.SettingStudies from all countries, worldwide.PopulationPregnant women with iron-deficiency anaemia at labour and delivery.InterventionAny intervention related to induction and/or augmentation of labour.Outcome measuresPrimary: Postpartum haemorrhage (PPH), heart failure and maternal death. Secondary: Emergency caesarean section, hysterectomy, admission to intensive care unit.MethodWe searched 10 databases, including Medline and Embase, from database inception to 1 October 2018. We included all study designs except cross-sectional studies without a comparator group, case reports, case series, ecological studies, and expert opinion. The searches were conducted by a healthcare librarian and two authors independently screened and reviewed the studies. We used the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approachto ascertain risk of bias and conducted a narrative synthesis.ResultsWe identified 3217 journal articles, 223 conference papers, 45 dissertations and 218 registered trials. Ten articles were included for full-text review and only one was found to fulfil the eligibility criteria. This was a retrospective cohort study from India, which showed that pregnant women with moderate and severe anaemia could have an increased risk of PPH if they underwent induction and/or augmentation of labour, but the evidence was weak (graded as ‘high risk of bias’).ConclusionThe best approach is to prevent anaemia, but a large number of women in low-to-middle-income countries present with severe anaemia during labour. In such women, appropriate peripartum management could prevent complications and death. Our review showed that at present we do not know if induction and augmentation of labour is safe in pregnant women with iron-deficiency anaemia and further research is required.PROSPERO registration numberCRD42015032421.

Download Full-text

Antiviral Treatment on Pregnancy with COVID-19 Infection : A Systematic Review

Indonesian Journal of Obstetrics & Gynecology Science ◽

10.24198/obgynia.v4n2s.329 ◽

2021 ◽

Vol 4 (2s) ◽

pp. 78-85

Author(s):

Tigor Peniel Simanjuntak ◽

◽

Angela Putri Kakerissa ◽

Grady Ivan Kurniawan

Keyword(s):

Systematic Review ◽

Side Effects ◽

Pregnant Women ◽

Gestational Age ◽

Treatment Duration ◽

Case Reports ◽

Antiviral Treatment ◽

Inclusion Criteria ◽

Duration Of Treatment ◽

Retrospective Case

Abstract Objective to evaluate antiviral treatment, duration, and side effects on pregnant women based on gestational age and severity of COVID-19 infection. Method: a systematic review of antiviral treatment, duration, and side effects on pregnant women based on gestational age and severity of COVID-19 infection. Systematic review was conducted following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) Statement. Result 948 papers accessed through Pubmed, Scopus, Science Direct, Cohcrane, and other with keywords “Antiviral”, “Pregnancy” “Pregnant” “Coronavirus” “COVID-19” “SARS-CoV-2”. Duplicate papers were excluded (n=302), topics and abstracts that do not meet the criteria (n=612), and 25 papers that did not meet the inclusion criteria. 9 papers that meet the inclusion criteria (case reports and cohort retrospective case study) discussed 20 pregnant women with COVID-19 infection (16 moderate and severe cases received Remdesivir, 3 moderate and mild cases received Lopinavir-ritonavir combination, and 1 moderate case received Arbidol). Conclusion, remdesivir is an antiviral frequently used in pregnancy on trimester II and III with severe COVID-19 infection with a duration of treatment of 5-10 days. Remdesivir should be monitored because some show side effects of increasing liver function. Key word: Antiviral, Pregnant, COVID-19

Download Full-text

Anticoagulation in pregnant women with mechanical heart valve prostheses: Case reports and a literature review

Nigerian Postgraduate Medical Journal ◽

10.4103/npmj.npmj_344_20 ◽

2021 ◽

Vol 28 (1) ◽

pp. 68

Author(s):

PhilipAlaba Adebola ◽

FolasadeA Daniel ◽

YusufA Oshodi ◽

Abidoye Gbadegesin ◽

OlagokeK Ale ◽

...

Keyword(s):

Literature Review ◽

Pregnant Women ◽

Heart Valve ◽

Case Reports ◽

Mechanical Heart Valve ◽

Heart Valve Prostheses ◽

Valve Prostheses

Download Full-text

Prevalence and predictors of HIV-syphilis co-infection among HIV-infected pregnant women in China, 2011-2018

10.21203/rs.3.rs-21898/v1 ◽

2020 ◽

Author(s):

Qian Wang ◽

Xiao-Yan Wang ◽

Xiaomeng Ma ◽

Lori M Newman ◽

Li-Xia Dou ◽

...

Keyword(s):

Logistic Regression ◽

Pregnant Women ◽

Junior High School ◽

Case Reports ◽

Care Service ◽

Trend Test ◽

Hiv Positive ◽

Syphilis Infection ◽

Transmitted Infection ◽

Sexually Transmitted

Abstract Background The co-infection of Human Immunodeficiency Virus (HIV) and syphilis is risky for pregnant women and their expected children. In 2015, the Integrated Prevention of Mother-to-Child Transmission (iPMTCT) programwas established to offer all pregnant women with free screening, counseling, and testing of HIV and syphilis during regular obstetric inspections. To summarize the phase progress of this program, we reported the trends of maternal HIV-syphilis co-infection in China. We tried to socioeconomic factors associated with HIV-syphilis co-infection to inform the stratified control strategy for future work. Methods We obtained the prevalence data of HIV and syphilis over 2011–2018 by reviewing the Sexually Transmitted Infection (STI) monthly update reporting to the central surveillance system. With health status, background characteristics, and health outcomes reported, we collected the case reports from 2,578 HIV-positive pregnant women who accepted the screening at the local clinic. The trends of HIV and syphilis prevalence were examined using the Cochran-Armitage trend test. Logistic regression was applied to detect the features associated with syphilis infection among HIV-positive women and the potential risk factor to neonatal death. Results The prevalence of HIV decreased from 0.076–0.039% among registered pregnant women but increased slightly to 0.054% in 2018. The trend of syphilis prevalence in HIV-infected pregnant women fluctuated slightly around an average of 1.80% (p = .378). Multivariate logistic regression indicated finishing education of junior high school or below (aOR: 1.79, 95%CI: 1.31–2.43; p < .001), on regular Antiretroviral Therapy (ART) (aOR: 1.89, 95%CI: 1.47–2.45; p < .001) and exposed HIV from injective drug use (aOR: 5.49, 95%CI: 3.51–8.61; p < .001) are associated with high syphilis infection risk. Syphilis co-infection with HIV (aOR: 2.81, 95%CI: 1.32–5.96; p < .007) significantly increases the risk of newborns death. Conclusion Syphilis infection is still very prevalent in HIV-positive pregnant women five years after the implementation of iPMTCT program. Promoting the health education for maternal infection of STIs and increasing the availability of early intervention to link more marginalized women with care service should be the focuses of work in the next stage.

Download Full-text

Maternal Coronavirus Infections and Neonates Born to Mothers with SARS-CoV-2: A Systematic Review

Healthcare ◽

10.3390/healthcare8040511 ◽

2020 ◽

Vol 8 (4) ◽

pp. 511

Author(s):

Waldemar Naves do Amaral ◽

Carolina Leão de Moraes ◽

Ana Paula dos Santos Rodrigues ◽

Matias Noll ◽

Jalsi Tacon Arruda ◽

...

Keyword(s):

Systematic Review ◽

Pregnant Women ◽

Case Reports ◽

Signs And Symptoms ◽

Fetal Distress ◽

Intrauterine Fetal Death ◽

Fetal Outcomes ◽

Fetal Movements ◽

Pregnancy And Delivery ◽

The Impact

The coronavirus disease 2019 (COVID-19) pandemic is continuously affecting the lives of all people. Understanding the impact of COVID-19 on pregnancy in terms of morbidity, mortality, and perinatal maternal and fetal outcomes is essential to propose strategies for prevention and infection control. Here, we conducted a systematic review to investigate pregnant women infected with COVID-19 in terms of signs and symptoms, type of delivery, comorbidities, maternal and neonatal outcomes, and the possibility of vertical transmission. A search on Embase and PubMed databases was performed on 31 October 2020. Observational studies and case reports on pregnant women infected with COVID-19 were included without language restrictions. The 70 selected studies included a total of 1457 pregnant women diagnosed with COVID-19 in the first, second, and third trimesters of pregnancy. The most common signs and symptoms were fever, cough, and nausea. The most frequent comorbidities were obesity, hypertensive disorders, and gestational diabetes. Among maternal and fetal outcomes, premature birth (n = 64), maternal death (n = 15), intrauterine fetal death or neonatal death (n = 16), cases of intrauterine fetal distress (n = 28), miscarriage (n = 7), decreased fetal movements (n = 19), and severe neonatal asphyxia (n = 5) were the most frequent. Thirty-nine newborns tested positive for SARS-CoV-2. Additionally, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA was detected in the placenta (n = 13) and breast milk (n = 6). This review indicates that COVID-19 during pregnancy can result in maternal, fetal, and neonatal complications. In addition, SARS-CoV-2 viral exposure of neonates during pregnancy and delivery cannot be ruled out. Thus, we highlight the need for long-term follow-up of newborns from mothers diagnosed with COVID-19 to establish the full implications of SARS-CoV-2 infection in these children.

Download Full-text

Case Reports on Diabetes-Related Outcomes for Pregnant Women in the National Diabetes Prevention Program

Clinical Diabetes ◽

10.2337/cd18-0104 ◽

2019 ◽

Vol 37 (4) ◽

pp. 395-397 ◽

Cited By ~ 1

Author(s):

Natalie Dawn Ritchie ◽

Stefka Fabbri ◽

Katherine Ann Sauder

Keyword(s):

Pregnant Women ◽

Prevention Program ◽

Diabetes Prevention ◽

Case Reports ◽

Diabetes Prevention Program

Download Full-text

Human Poisoning from Poisonous Higher Fungi: Focus on Analytical Toxicology and Case Reports in Forensic Toxicology

Pharmaceuticals ◽

10.3390/ph13120454 ◽

2020 ◽

Vol 13 (12) ◽

pp. 454

Author(s):

Estelle Flament ◽

Jérôme Guitton ◽

Jean-Michel Gaulier ◽

Yvan Gaillard

Keyword(s):

Analytical Methods ◽

Case Reports ◽

Forensic Toxicology ◽

Analytical Techniques ◽

Ibotenic Acid ◽

Biological Matrices ◽

Analytical Toxicology ◽

Fatal Poisoning ◽

Toxicological Analysis ◽

Chemical Structures

Several families of higher fungi contain mycotoxins that cause serious or even fatal poisoning when consumed by humans. The aim of this review is to inventory, from an analytical point of view, poisoning cases linked with certain significantly toxic mycotoxins: orellanine, α- and β-amanitin, muscarine, ibotenic acid and muscimol, and gyromitrin. Clinicians are calling for the cases to be documented by toxicological analysis. This document is therefore a review of poisoning cases involving these mycotoxins reported in the literature and carries out an inventory of the analytical techniques available for their identification and quantification. It seems indeed that these poisonings are only rarely documented by toxicological analysis, due mainly to a lack of analytical methods in biological matrices. There are many reasons for this issue: the numerous varieties of mushroom involved, mycotoxins with different chemical structures, a lack of knowledge about distribution and metabolism. To sum up, we are faced with (i) obstacles to the documentation and interpretation of fatal (or non-fatal) poisoning cases and (ii) a real need for analytical methods of identifying and quantifying these mycotoxins (and their metabolites) in biological matrices.

Download Full-text

Vertical transmission of SARS-CoV-2: a brief literature review

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20203355 ◽

2020 ◽

Vol 9 (8) ◽

pp. 3515

Author(s):

Moukit Mounir ◽

Assia El Ouardi ◽

Abdellah Babahabib ◽

Mehdi El Hassani ◽

Jaouad Kouach

Keyword(s):

Pregnant Women ◽

Vertical Transmission ◽

Retrospective Studies ◽

Case Reports ◽

Limited Data ◽

Careful Evaluation ◽

Infected Pregnant Woman ◽

Maternal Fetal Transmission ◽

Using Data ◽

Acid Test

As COVID-19 virus is still spreading, more infections in pregnant women are likely to be seen. At this time, very little is known about vertical transmission of SARS-COV-2 from infected pregnant woman to her infant. Authors reviewed the risk of vertical transmission of COVID-19 by using data of published articles and official websites up to May 11, 2020. The searches revealed 16 articles (12 case reports/series and 4 retrospective studies) collectively comprising 194 infected pregnant women with COVID-19. 140 cases of neonates delivered from pregnant women with COVID-19 were collected. The SARS-COV-2 nucleic acid test, in day 2, was positive in 4 newborns. Based on limited data, there is no evidence for vertical transmission of COVID-19. Some studies suggestive of maternal-fetal transmission deserve careful evaluation before a definitive finding.

Download Full-text