scholarly journals Universal SARS-Cov-2 Screening in Women Admitted for Delivery in a Large Managed Care Organization

2020 ◽  
Vol 37 (11) ◽  
pp. 1110-1114 ◽  
Author(s):  
Michael J. Fassett ◽  
Lawrence D. Lurvey ◽  
Lyn Yasumura ◽  
Marielle Nguyen ◽  
Joseph J. Colli ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Southern California ◽  
Hospital Inpatient ◽  
Care Organization ◽  
Test Results ◽  
Kaiser Permanente ◽  
Universal Testing ◽  
Outpatient Physician ◽  
Key Points ◽  
Integrated Health Care System

Objective The coronavirus disease 2019 (COVID-19) pandemic has created a need for data regarding the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in pregnant women. After implementing universal screening for COVID-19 in women admitted for delivery, we sought to describe the characteristics of COVID-19 in this large cohort of women. Study Design An observational study of women admitted to labor and delivery units in Kaiser Permanente Southern California (KPSC) hospitals between April 6 and May 11, 2020 who were universally offered testing for SARS-CoV-2 infection (n = 3,963). Hospital inpatient and outpatient physician encounter, and laboratory records were used to ascertain universal testing levels, test results, and medical and obstetrical histories. The prevalence of SARS-CoV-2 infection was estimated from the number of women who tested positive during labor per 100 women delivered. Results Of women delivered during the study period, 3,923 (99.0%) underwent SARS-CoV-2 testing. A total of 17 (0.43%; 95% confidence interval: 0.23–0.63%) women tested positive, and none of them were symptomatic on admission. There was no difference in terms of characteristics between SARS-CoV-2 positive and negative tested women. One woman developed a headache attributed to COVID-19 3 days postpartum. No neonates had a positive test at 24 hours of life. Conclusion The findings suggest that in pregnant women admitted for delivery between April 6 and May 11, 2020 in this large integrated health care system in Southern California, prevalence of SARS-CoV-2 test positive was very low and all patients were asymptomatic on admission. Key Points

Comparing Two Testing Strategies: Universal versus Symptomatic SARS-CoV-2 Testing in Obstetric Patients

2021 ◽  
Author(s):  
Oluyemi A. Aderibigbe ◽  
Justin R. Lappen ◽  
Megan Albertini ◽  
Kelly S. Gibson
Keyword(s):  
Pregnant Women ◽  
Clinical Performance ◽  
Geographic Region ◽  
Secondary Outcome ◽  
Continuous Variables ◽  
University Hospitals ◽  
Chi Square ◽  
Universal Testing ◽  
Key Points ◽  
The University

Objective To compare universal severe acute respiratory syndrome coronvirus-2 (SARS-CoV-2) testing to symptomatic testing at two large academic centers. Study Design We performed a retrospective cohort study comparing the approach to testing at two academic centers in Northeast Ohio. The study period started with the inception of symptomatic testing for SARS-CoV-2 at both institutions in March 2020. Women younger than 18 years were excluded. The primary outcome was the SARS-CoV-2 positivity rate in symptomatic pregnant patients at both institutions. Our coprimary outcome was the additional positivity rate obtained from universal testing at the University Hospitals. The secondary outcome of interest was the percentage of SARS-CoV-2 screen positive mothers with screen positive neonates. Data were analyzed using Mann–Whitney U test for continuous variables with chi-square and Fisher's exact tests for proportions. Results During the study period, 144 pregnant women with symptoms of coronavirus disease 2019 (COVID-19) were tested at MetroHealth of which 27 resulted as positive for SARS-CoV-2 (18.7% positivity rate). University Hospitals tested 392 pregnant women with symptoms of COVID-19 of which 67 resulted as positive for SARS-CoV-2 (positivity rate 17.0%). In the universal testing program at University Hospitals, an additional 2,870 tests were performed on asymptomatic pregnant women of which 30 were positive for SARS-CoV-2 (1.0% positivity rate).There were no SARS-CoV-2 positive infants in our cohort, and all cases of maternal critical illness occurred in symptomatic patients. Conclusion Universal and symptomatic testing approaches demonstrated similar clinical performance within a single geographic region in obstetric patients. Key Points

scholarly journals Usefulness of COVID-19 screen-and-test approach in pregnant women: an experience from a country with low COVID-19 burden

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Anja Šterbenc ◽  
Tanja Premru Sršen ◽  
Miha Lučovnik ◽  
Marijana Vidmar Šimic ◽  
Lili Steblovnik ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Medical Records ◽  
Maternity Hospital ◽  
Clinical Suspicion ◽  
Protective Equipment ◽  
Test Results ◽  
Hospital Database ◽  
Test Strategies ◽  
Universal Testing ◽  
High Clinical Suspicion

AbstractObjectivesInformation on the usefulness of screen-and-test strategies of pregnant women for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is lacking.MethodsWe retrospectively reviewed the Ljubljana Maternity Hospital database and searched for pregnant women, who were admitted to the hospital between March 15 and May 16, 2020, for a planned procedure or hospitalization. Their medical records were examined and SARS-CoV-2 test results were retrieved.ResultsDuring the two-month period analyzed, there were a total of 265 scheduled admissions of pregnant women to our hospital. Two hundred two (76.2%) were tested for SARS-CoV-2 1 day prior to admission. All tested negative for SARS-CoV-2 RNA, regardless of having coronavirus disease 2019 (COVID-19)-compatible signs or symptoms (n=28) or not (n=174).ConclusionsIn a population with a low SARS-CoV-2 burden, usefulness of universal testing of pregnant women before admission to the hospital is limited. We recommend that obstetric units in regions with low SARS-CoV-2 burden enforce rational use of personal protective equipment and diligent screening protocols using targeted questionnaires, whereas SARS-CoV-2 laboratory testing should be performed only in screen-positives: those with high clinical suspicion of COVID-19 and/or suspected epidemiological history.

scholarly journals Haemostatic and thrombo-embolic complications in pregnant women with COVID-19: a systematic review and critical analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Juliette Servante ◽  
Gill Swallow ◽  
Jim G. Thornton ◽  
Bethan Myers ◽  
Sandhya Munireddy ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Pregnant Women ◽  
Clinical Evidence ◽  
Case Reports ◽  
Standard Form ◽  
Test Results ◽  
Maternal Deaths ◽  
High Clinical Suspicion ◽  
Increased Risk ◽  
Definition Of

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.

scholarly journals Caring for Pregnant Patients with COVID-19: Practical Tips Getting from Policy to Practice

2020 ◽  
Vol 37 (08) ◽  
pp. 850-853 ◽  
Author(s):  
Viktoriya London ◽  
Rodney McLaren ◽  
Janet Stein ◽  
Fouad Atallah ◽  
Nelli Fisher ◽  
...  
Keyword(s):  
New York ◽  
Pregnant Women ◽  
National Standards ◽  
Key Points ◽  
High Prevalence ◽  
Psychosocial Challenges ◽  
Novel Coronavirus ◽  
Hospital Protocols ◽  
Zip Code

Novel coronavirus disease 2019 (COVID-19) is a pandemic with most American cases in New York. As an institution residing in a high-prevalence zip code, with over 8,000 births annually, we have cared for over 80 COVID-19-infected pregnant women, and have encountered many challenges in applying new national standards for care. In this article, we review how to change outpatient and inpatient practices, develop, and disseminate new hospital protocols, and we highlight the psychosocial challenges for pregnant patients and their providers. Key Points

A Comprehensive Assessment Across the Healthcare Continuum: Risk of Hospital-Associated Clostridium difficile Infection Due to Outpatient and Inpatient Antibiotic Exposure

2015 ◽  
Vol 36 (12) ◽  
pp. 1409-1416 ◽  
Author(s):  
Sara Y. Tartof ◽  
Gunter K. Rieg ◽  
Rong Wei ◽  
Hung Fu Tseng ◽  
Steven J. Jacobsen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Southern California ◽  
Skilled Nursing Facility ◽  
Antibiotic Exposure ◽  
Kaiser Permanente ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
Transfer Factors ◽  
Adjusted Risk

BACKGROUNDLimitations in sample size, overly inclusive antibiotic classes, lack of adjustment of key risk variables, and inadequate assessment of cases contribute to widely ranging estimates of risk factors for Clostridium difficile infection (CDI).OBJECTIVETo incorporate all key CDI risk factors in addition to 27 antibiotic classes into a single comprehensive model.DESIGNRetrospective cohort study.SETTINGKaiser Permanente Southern California.PATIENTSMembers of Kaiser Permanente Southern California at least 18 years old admitted to any of its 14 hospitals from January 1, 2011, through December 31, 2012.METHODSHospital-acquired CDI cases were identified by polymerase chain reaction assay. Exposure to major outpatient antibiotics (10 classes) and those administered during inpatient stays (27 classes) was assessed. Age, sex, self-identified race/ethnicity, Charlson Comorbidity Score, previous hospitalization, transfer from a skilled nursing facility, number of different antibiotic classes, statin use, and proton pump inhibitor use were also assessed. Poisson regression estimated adjusted risk of CDI.RESULTSA total of 401,234 patients with 2,638 cases of incident CDI (0.7%) were detected. The final model demonstrated highest CDI risk associated with increasing age, exposure to multiple antibiotic classes, and skilled nursing facility transfer. Factors conferring the most reduced CDI risk were inpatient exposure to tetracyclines and first-generation cephalosporins, and outpatient macrolides.CONCLUSIONSAlthough type and aggregate antibiotic exposure are important, the factors that increase the likelihood of environmental spore acquisition should not be underestimated. Operationally, our findings have implications for antibiotic stewardship efforts and can inform empirical and culture-driven treatment approaches.Infect. Control Hosp. Epidemiol. 2015;36(12):1409–1416

Development of an Experimental Device to Study Real Connecting-Rod Bearings Functioning in Severe Conditions

2007 ◽  
Vol 129 (3) ◽  
pp. 647-654 ◽  
Author(s):  
Philippe Michaud ◽  
Aurelian Fatu ◽  
Bernard Villechaise
Keyword(s):  
General Principle ◽  
Test Bench ◽  
Numerical Models ◽  
Experimental Device ◽  
Test Results ◽  
Connecting Rod ◽  
Compression Loading ◽  
Key Points ◽  
Loading System

The paper presents a new experimental device made to analyze the thermoelastohydrodynamic (TEHD) behavior of connecting-rod bearings functioning in severe conditions. First, it focuses on the test bench description. The general principle of the test bench and then the main original technological solutions used with respect to the functional specifications are detailed. Two numerical models are described. They were developed in order to design and to validate two central components of the experimental device. Finally, the paper comments on the test results used to understand and validate the traction∕compression loading system, which is one of the key points in the test bench behavior.

scholarly journals Hubungan Mean Arterial Pressure (MAP) Dengan Preeklamsia Pada Ibu Hamil Di Puskesmas Bontobangun Kabupaten Bulukumba

2020 ◽  
Vol 5 (2) ◽  
pp. 138-145
Author(s):  
Ely Kurniati ◽  
Rusnawati
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Pregnant Women ◽  
Sampling Method ◽  
Blood Pressure Measurement ◽  
Test Results ◽  
Historical Cohort ◽  
Measurement Results ◽  
History Of ◽  
The Mean

Preeclampsia complicates 4-7% of pregnancies and remains the leading cause of maternal and fetal morbidity and mortality worldwide. Despite improvements in health care over the last decade, preeclampsia remains the second most common cause of maternal mortality in Indonesia. This study aims to determine whether the mean arterial pressure (MAP) is related to the incidence of preeclampsia in pregnant women at the Bontobangun Puskesmas, Bulukumba district for the period 2018 to 2019. This research uses a descriptive-analytic approach with Historical Cohort Studies, namely by looking at the cohort book of the history of blood pressure measurement results for pregnant women at the Bontobangun Public Health Center, Bulukumba Regency for the period 2018 to 2019. Determining the sample using the sampling method taken by purposive sampling. 31 samples of pregnant women who experienced preeclampsia and 31 controls were pregnant women with normal conditions who had certain criteria (matching) with the sample. The results explained that from the paired T-test results, the value of α> 0.037 so that it is said that there is a relationship between mean artery pressure (MAP) and the incidence of preeclampsia in pregnant women at Bontobangun puskesmas for the period 2018-2019.

scholarly journals Penyembuhan Pranic Healing terhadap Kesehatan Tubuh Fisik Primigravida Trimester III

2019 ◽  
Vol 2 (2) ◽  
pp. 134-145
Author(s):  
Cahyaning Puji Astuti ◽  
Melyana Nurul Widyawati
Keyword(s):  
Pregnant Women ◽  
Controlled Trial ◽  
Test Group ◽  
Health Condition ◽  
Wilcoxon Test ◽  
P Value ◽  
Test Results ◽  
Third Trimester ◽  
Physical Energy ◽  
Post Test

This study aims to improve the physical health condition of third trimester primigravida pregnant women. The method in this study uses a randomized controlled trial design. This type of research uses pre-test & post-test group design. The results of this study indicate that the results of organ energy as an indicator of physical body health have increased the frequency of pre and post test. The repeated ANOVA test showed a decrease in both groups. While the Wilcoxon test results showed that there were differences in the post test 2 energy organs p = 0.013 (<0.05), post test 3 p value 0.001 (<0.05). Conclusion, pranic healing therapy can increase the physical energy of pregnant women.   Keywords: Organ Energy, Trimester III Pregnancy, Pranic Healing, Primigravida

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