scholarly journals SARS-CoV-2 Infection during Pregnancy in a Rural Midwest All-delivery Cohort and Associated Maternal and Neonatal Outcomes

2021 ◽  
Author(s):  
Haley A. Steffen ◽  
Samantha R. Swartz ◽  
J. Brooks Jackson ◽  
Kimberly A. Kenne ◽  
Patrick P. Ten Eyck ◽  
...  
Keyword(s):  
Private Insurance ◽  
Tertiary Care ◽  
Adverse Outcomes ◽  
Neonatal Outcomes ◽  
Care Hospital ◽  
Antibody Testing ◽  
University Of Iowa ◽  
Increased Risk ◽  
Maternal And Neonatal Outcomes ◽  
Cesarean Delivery Rate

Objective This study aimed to estimate the prevalence of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) among pregnant patients at the time of delivery in a rural Midwest tertiary care hospital and to examine demographics, clinical factors, and maternal and neonatal outcomes associated with SARS-CoV-2 infection during pregnancy. Study Design This prospective cohort study included all delivering patients between May 1 and September 22, 2020 at the University of Iowa Hospitals and Clinics. Plasma SARS-CoV-2 antibody testing was performed. SARS-CoV-2 viral reverse-transcription polymerase chain reaction (RT-PCR) results and maternal and neonatal outcomes were collected from the electronic medical record. Data were analyzed using univariate statistical methods with clustering for multiple births. Results In total, 1,000 patients delivered between May 1 and September 22, 2020. Fifty-eight (5.8%) were SARS-CoV-2 antibody positive. Twenty-three also tested viral positive during pregnancy. Three of 1,000 (0.3%) were viral positive on admission but antibody negative. The median age was 30 years (interquartile range [IQR]: 26–33 years) and body mass index was 31.75 kg/m2 (IQR 27.7–37.5 kg/m2). The cesarean delivery rate was 34.0%. The study population was primarily white (71.6%); however, 41.0% of SARS-CoV-2 infected patients identified as Black, 18.0% as Hispanic/Latino, 3.3% as Native Hawaiian/Pacific Islander, and only 27.9% as White (p < 0.0001). SARS-CoV-2 infection was more likely in patients without private insurance (p = 0.0243). Adverse maternal and/or neonatal outcomes were not more likely in patients with evidence of infection during pregnancy. Two SARS-CoV-2 infected patients were admitted to the intensive care unit. There were no maternal deaths during the study period. Conclusion In this largely rural Midwest population, 6.1% of delivering patients had evidence of past or current SARS-CoV-2 infection. Rates of SARS-CoV-2 during pregnancy were higher among racial and ethnic minorities and patients without private insurance. The SARS-CoV-2 infected patients and their neonates were not found to be at increased risk for adverse outcomes. Key Points

scholarly journals Use of the Maternal Foetal Triage Index- Addressing the Third Delay in Obstetrics: An Observational Study

2021 ◽  
Author(s):  
Nirzarini Vora ◽  
Nandita Maitra ◽  
Priyam Pandya
Keyword(s):  
Observational Study ◽  
Hospital Stay ◽  
Tertiary Care ◽  
Neonatal Outcomes ◽  
Care Hospital ◽  
Convenience Sample ◽  
The Third ◽  
Resource Setting ◽  
Maternal And Neonatal Outcomes ◽  
A Priority

OBJECTIVE: The Maternal Foetal Triage Index (MFTI), a five-tier scale designed by Ruhl et al (2015) has been evaluated in this study for women attending the triage area of a tertiary hospital, to examine the effect on third delay and maternal and neonatal outcomes. DESIGN: Prospective observational study SETTING: The Labour and Delivery Unit of a tertiary care hospital SAMPLE: A convenience sample of 1000 women METHODS: Assessment included maternal history, baseline vital signs and obstetric examination and categorised the woman as per the MFTI scale. Evaluation of the MFTI score was assessed based on predefined maternal and neonatal outcomes within 24h of attendance. MAIN OUTCOME MEASURES: Flow of patients to triage, presenting complaints, Duration of hospital stay, maternal and neonatal outcomes within 24h of admission. RESULTS: A priority wise distribution of subjects based on their clinical diagnosis was found to be statistically significant for anaemia, previous caesarean, postpartum haemorrhage, miscarriage and hypertensive disorders. Sixty seven percent of the subjects belonged to Priority 3-4 and the mean hospital stay duration varied from 8.26±7.68 days for Priority 1 to 3.82±2.74 days for Priority 4 ((p<0.0001). The average time spent in the triage room was 30±17minutes. A priority wise analysis of maternal and neonatal outcomes based on OBICU and NICU admissions, mortality and stillbirths was found to be significant. CONCLUSION: The MFTI scale significantly reduced the third delay, which is crucial in a high-volume, low resource setting. This also simplified handover, improved documentation and decreased time to secondary healthcare provider assessment. KEYWORDS:obstetrictriage,acuity,thirddelay,maternalmortality

Rate of teenage pregnancy in Jordan and its impact on maternal and neonatal outcomes

2017 ◽  
Vol 31 (6) ◽  
Author(s):  
Yousef S. Khader ◽  
Anwar Batieha ◽  
Rana Kareem Al fursan ◽  
Rami Al-Hader ◽  
Sa’ad S. Hijazi
Keyword(s):  
Teenage Pregnancy ◽  
Small Sample ◽  
Adverse Outcomes ◽  
Neonatal Outcomes ◽  
National Study ◽  
Premature Delivery ◽  
Discharge Data ◽  
Increased Risk ◽  
Maternity Hospitals ◽  
Maternal And Neonatal Outcomes

Abstract Objective Research regarding the adverse outcomes of adolescent childbearing has suffered from many limitations such as a small sample size and non-representative samples. This study was conducted to determine the rate of teenage pregnancy among Jordanian adolescents and its associated adverse maternal and neonatal outcomes. Methods The study is a part of a comprehensive national study of perinatal mortality that was conducted between 2011 and 2012 in Jordan. All women who gave birth after 20 weeks of gestation in 18 maternity hospitals in Jordan between 2011 and 2012 were invited to participate in the study. Consenting women were interviewed by the trained midwives in these hospitals using a structured questionnaire prepared for the purpose of this study. Additional information was also collected based on the physical examination by the midwife and the obstetrician at admission and at discharge. Data on the newborn were also collected by the pediatric nurses and the neonatologists in these hospitals. Results The overall rate of teenage pregnancy [95% confidence interval (CI) was 6.2% (5.9%, 6.5%)]. Of the studied maternal and neonatal outcomes, women aged <20 years were more likely to deliver prematurely compared to women aged 20–35 years [odds ratio (OR)=1.5, 95% CI: 1.2, 1.9; p < 0.005)]. However, the two groups of women did not differ significantly in low birth weight delivery (OR = 1.2, 95% CI: 0.9, 1.5; p = 0.167) and neonatal mortality (OR = 1.2, 95% CI: 0.8, 1.3; p = 0.491) in the multivariate analysis. Conclusion Teenage pregnancy was associated with increased risk of premature delivery, apart from the effects of socioeconomic factors.

scholarly journals COVID-19 and Pregnancy Outcome: An Experience in ‘COVID-19 Management Designated’ Tertiary Care Hospital, Rawalpindi, Pakistan

2020 ◽  
Vol 24 (Supp-1) ◽  
pp. 85-91
Author(s):  
Shazia Syed ◽  
Humera Noreen ◽  
Humaira Masood ◽  
Ismat Batool ◽  
Hina Gul ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Pregnant Women ◽  
Clinical Characteristics ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Neonatal Outcomes ◽  
Categorical Variables ◽  
Care Hospital ◽  
Case Series Study ◽  
Maternal And Neonatal Outcomes

Background: The current COVID-19 pandemic has affected almost 17.3 million victims worldwide with mortality of almost 674K. Pregnancy is one of the most susceptible conditions for COVID-19 infection, but limited data is currently available about the clinical characteristics of pregnant women with the disease. Objective; to describe the clinical characteristics, co-morbidities, management, feto-maternal, and neonatal outcome in COVID-19 positive pregnant women. Methodology: A descriptive case series study was conducted in Obs/Gynae dept of Benazir Bhutto Tertiary Care Hospital, Rawalpindi, including all asymptomatic/symptomatic COVID-19 positive pregnant women and clinical suspects (COVID-19 PCR negative women) delivered in our hospital from 01st April 2020 to 31st July 2020. Their medical records were reviewed for clinical characteristics, management, feto-maternal and neonatal outcomes. Continuous variables were expressed in Mean & Range and Categorical variables as number & Percentage. Results: During the study period a total of 17 cases were reviewed. The mean maternal age was 28.94 yrs. Primigravida (07), Multipara (10). Mean gestational age was 37 wks (range; 30-41wks). Presenting symptomatology was varied. Asymptomatic; (29%), COVID-19 specific symptoms; fever & flu (12%), fever&cough (6%), shortness of breath(SOB) alone (6%), fever & SOB(6%) and pregnancy-related manifestations were labour pains (17%), eclampsia(6%), hydrocephalous fetus (6%) and hepatic encephalopathy(6%). The commonest co-morbidity was Hypertensive disorders of pregnancy (24%). Five women (29%) required ICU care. Lower segment caesarean sections(LSCS) (59%), vaginal delivery (41%). Eleven babies delivered with good Apgar score and birth weight. Two were early neonatal deaths (ENND) and 04 were received intra-uterine fetal deaths (IUDs). Fetal demise was associated with strong obstetric risk factors. Out of 13 live-born babies, RT-PCR Covid-19 testing was done in 10 (77%) cases and was negative. One mother was expired due to complications of hepatic encephalopathy, sepsis, and burst abdomen. Conclusion; The clinical course of COVID-19 disease in pregnancy seems to be no different from non-pregnant women. Clinical manifestations are diverse and infection contracted in the third trimester of pregnancy is associated with good feto-maternal and neonatal outcomes.

scholarly journals Maternal and neonatal outcomes in pregnancies complicated by maternal obesity

2019 ◽  
Vol 8 (2) ◽  
pp. 474
Author(s):  
Sudha Menon ◽  
Sivaprasad K.
Keyword(s):  
High Risk ◽  
Maternal Obesity ◽  
Gestational Hypertension ◽  
Tertiary Care ◽  
Adverse Outcomes ◽  
Neonatal Outcomes ◽  
Induction Of Labour ◽  
Large For Gestational Age ◽  
Obese Women ◽  
Maternal And Neonatal Outcomes

Background: Maternal obesity imparts elevated maternal and neo natal adverse outcomes. Aim of the study was to evaluate and analyse the maternal and neonatal outcomes in obese mothers.Methods: This was a prospective case control study in a tertiary care high risk referral center. Antenatal women with first trimester Body mass index (BMI) of more than 30 Kg/m2 constituted the cases and those antenatal women with BMI <25 Kg/m2 formed the controls.Results: Mean age was slightly more (28.6±4.3 years vs 26.3±3.6 years: P<0.0001) in the obese group. Obese women were significantly more likely to have  of gestational diabetes (OR 5.2, 95% CI 3.2-8.7 P<0.00001), gestational hypertension (Or 3.5, 95% CI 2.1-5.9 P<0.0001) , induction of labour (OR 2.5, 95% CI 1.8-3.6 P<0.0001), failed induction of labour (OR 2.4, 95% CI 1.3-4.2 P=0.003), Preeclampsia (OR 2.8, 95% CI 1.6-4.9 P=0.0002), Caesarian section (Or 4.0, 95% CI 2.9-5.9 P<0.0001) and Postpartum hemorrhage (OR 4.0,95% CI 1.1-14.3 P=0.034), prolonged hospital stay (OR 12.8, 95% CI 7.7-21.1 P<0.0001)  and adverse neonatal outcomes such as low(<7) Apgar (OR 3.2, 95% CI 1.1-10.0 P=0.03), Large for gestational age babies (OR 3.1, 95% Cl 2.1-4.5 P<0.0001) and transfer to new born nursery (OR 3.4, 95% CI 2.3 -5.2 P<0.0001).Conclusions: Maternal obesity in pregnancy is high risk and has many adverse maternal and neonatal outcomes warranting specialized antenatal, intranatal and post-natal care.

scholarly journals Use of the Maternal Foetal Triage Index: Addressing the Third Delay in Obstetrics

2021 ◽  
Author(s):  
Nirzarini Mukul Vora ◽  
Nandita Krishnakant Maitra
Keyword(s):  
Tertiary Care ◽  
Vital Signs ◽  
High Volume ◽  
Tertiary Hospital ◽  
Neonatal Outcomes ◽  
Care Hospital ◽  
Convenience Sample ◽  
The Third ◽  
Maternal And Neonatal Outcomes ◽  
One Year

Abstract PURPOSE: While several scales have been developed specifically for obstetric triage, the Maternal Foetal Triage Index (MFTI), a five-tier scale designed by Ruhl et al (2015) has been evaluated for women attending the triage area of a tertiary hospital. This study intends to evaluate the effect of MFTI score on third delay and maternal and neonatal outcomes.METHODS: A prospective observational study was conducted over a convenience sample of 1000 subjects who attended the Labour and Delivery Unit of a tertiary care hospital over a period of one year. Assessment included maternal history, baseline vital signs and obstetric examination. The woman was categorised as per the MFTI scale and directed to the appropriate area for further management. Evaluation of the MFTI score was assessed based on predefined maternal and neonatal outcomes within 24h of attendance.RESULTS: A priority wise distribution of subjects based on their clinical diagnosis was found to be statistically significant for anaemia, previous caesarean section, postpartum haemorrhage, miscarriage and hypertensive disorders. Sixty seven percent of the subjects belonged to Priority 3-4 and the mean hospital stay duration varied from 8.26±7.68 days for Priority 1 to 3.82±2.74 days for Priority 4 (p<0.0001). The average time spent in the triage room was 30±17minutes. Maternal and neonatal outcomes were analysed according to priority based on OBICU admissions, mortality, NICU admissions and stillbirths and found to be significant.CONCLUSION: The MFTI scale significantly reduced the third delay, which is crucial in a high-volume, low-resource emergency obstetric setting. This also simplified handover of subjects, improved documentation and decreased time to secondary healthcare provider assessment.

Obstetrical, maternal and neonatal outcomes in pregnancies affected by muscular dystrophy

2018 ◽  
Vol 46 (7) ◽  
pp. 791-796 ◽  
Author(s):  
Adriano Petrangelo ◽  
Eman Alshehri ◽  
Nicholas Czuzoj-Shulman ◽  
Haim A. Abenhaim
Keyword(s):  
Cohort Study ◽  
Muscular Dystrophy ◽  
Large Population ◽  
The United States ◽  
Population Based ◽  
Adverse Outcomes ◽  
Neonatal Outcomes ◽  
Increased Risk ◽  
Maternal And Neonatal Outcomes ◽  
Adverse Pregnancy

Abstract Objective: Pregnancies in women affected by a muscular dystrophy are at an increased risk of adverse maternal and neonatal outcomes due to the effect of the disease on the muscular, cardiac and respiratory systems. We sought to evaluate the risk of adverse outcomes within a large population-based cohort study. Methods: We used the data extracted from the Nationwide Inpatient Sample (NIS) to conduct a retrospective population-based cohort study consisting of over 12 million births that occurred in the United States between 1999 and 2013. Births to mothers with muscular dystrophy were identified using the International Classification of Diseases, Ninth Revision (ICD-9) codes and were compared with births to mothers with no maternal muscular dystrophy. Unconditional logistic regression analysis was used to evaluate the adjusted effect of muscular dystrophy on maternal and neonatal outcomes. Results: During the 14-year study period, there was an increasing trend in the incidence of muscular dystrophy, with a cumulative incidence of 7.26 in 100,000 births. Women with muscular dystrophy and their neonates were at a significantly increased risk of adverse pregnancy outcomes: specifically, an increased risk of preeclampsia, preterm premature rupture of membranes, preterm labor, venous thromboembolism, cardiac dysrhythmia, requiring a blood transfusion and giving birth by cesarean section. Neonates born to affected mothers were at a significantly higher risk of being born preterm, with a congenital malformation and suffering intrauterine growth restriction. Conclusion: The risk of several adverse maternal and neonatal outcomes is increased in pregnant women with muscular dystrophy. As such, additional surveillance in order to mitigate the risk of adverse outcomes is warranted in these pregnancies.

scholarly journals COVID-19 Infection and Disease Severity not associated with Increased Parity among Pregnant Women

2021 ◽  
Vol 5 (5) ◽  
Author(s):  
Katharine A. Marsden ◽  
Patrick P. Ten Eyck ◽  
Timothy N. Maxwell ◽  
Claire N. Castaneda ◽  
Kimberly A. Kenne ◽  
...  
Keyword(s):  
Disease Severity ◽  
Maternal Age ◽  
Tertiary Care ◽  
Care Hospital ◽  
Linear Modeling ◽  
Antibody Testing ◽  
Modeling Framework ◽  
University Of Iowa ◽  
Nulliparous Women ◽  
Plasma Antibody

Aim: To compare prevalence and disease severity of Severe Acute Respiratory Syndrome Coronavirus 2 (COVID-19) among multiparous and nulliparous pregnant patients at a rural Midwest tertiary care hospital; parity used as a surrogate for having additional children, assessing if exposure to other coronaviruses is protective for COVID-19. Methods: Retrospective cohort study included all patients who delivered at the University of Iowa between May 1, 2020 and September 22, 2020. Reverse transcriptase polymerase chain reaction and plasma antibody testing for COVID-19 were performed on women at the time of delivery. Demographics and outcome information were obtained from the electronic medical record. Adjusted odds ratio estimates for COVID-19 risk factors were obtained through the generalized linear modeling framework. Results: In 1,001 delivering patients, 6.2% tested positive for COVID-19 by either viral or antibody tests. Comparing infection rates by parity strata revealed no significant distinctions, with 5.4% of nulliparous women and 6.7% of multiparous women positive by either test (p=0.41). Odds of COVID-19 infection decreased by 6.2% for each year of maternal age (p=0.02). Conclusion: No significant associations were found between parity and prevalence or severity of COVID-19 infection in this population. Increasing maternal age and decreased COVID-19 frequency demonstrated a significant association.

scholarly journals PREVALENCE AND FETO-MATERNAL OUTCOMES IN GESTATIONAL DIABETES MELLITUS AT A TERTIARY CARE HSOPITAL

2021 ◽  
pp. 1-3
Author(s):  
Sanjana Patil ◽  
Rameshwari Malshetty
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Tertiary Care ◽  
Adverse Outcomes ◽  
Neonatal Outcomes ◽  
Care Hospital ◽  
Family History Of Diabetes ◽  
Geographical Regions ◽  
History Of

Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with the onset or first recognition during pregnancy with or without remission after the end of pregnancy. Worldwide prevalence of GDM is reported between 1.4 – 14 percent. The data regarding prevalence and outcomes of GDM will help in planning and allocation of resources and the preventive strategies at the hospital and community level. There are few studies conducted in this region describing the prevalence, associated risk factors, maternal and neonatal outcomes associated with GDM. This was retrospective study conducted at a tertiary care hospital in India. Data was obtained from January 2018 to January 2019. Women between 24-28 weeks of gestation were included in the study. The information collected included the following parameters: age, residence status, gravid status, family history of diabetes or history of diabetes in first degree relative, past history of GDM. Neonatal outcomes like stillbirths, macrosomia, hyperbilirubinemia were recorded. Most common age of presentation of GDM was 26-30 years. Gravida < 3 accounted for most of the cases. Urban residents accounted for 55.8% of the cases. Most of the cases of GDM had at least one risk factor like history of hypertension or diabetes mellitus. Most common adverse maternal outcome was cephalopelvic disproportion followed by Casearean section and least common was abruptio placentae. Most common adverse fetal outcome was hyperbilirubinemia followed by macrosomia and least common was stillbirth. Early diagnosis and appropriate treatment of GDM will help in preventing maternal and fetal adverse outcomes and delay development of diabetes in high-risk individuals. The prevalence of GDM is going to increase in the near future exponentially, hence there is need for various community-based prevalence studies in different geographical regions of India to determine the exact prevalence and regional differences of GDM.

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