scholarly journals 524. COVID 19 Infection in Pregnant Women and Newborn Infants at a Single U.S. Center: What Disparities, Testing and Isolation Practices can Teach Us

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S328-S329
Author(s):  
ingrid Y Camelo ◽  
Marisol Figueira ◽  
Vishakha Sabharwal
Keyword(s):  
Pregnant Women ◽  
Medical Center ◽  
Horizontal Transmission ◽  
False Negative ◽  
Newborn Infants ◽  
Nasopharyngeal Swab ◽  
Chronic Hypertension ◽  
Positive Polymerase Chain Reaction ◽  
Term Newborns ◽  
C 30

Abstract Background COVID-19 transmission from mother to infant suggests that vertical and horizontal transmission of COVID-19 are possible. Here we describe the demographic and clinical characteristics and outcomes of SARS-CoV-2 positive pregnant women and their newborns. Summarized Characteristics of 19 COVID-19 Positive Mothers that Delivered 3/31/20–6/17/20 at Boston Medical Center Methods We collected data from the electronic medical records of pregnant women. Data composed of maternal demographics and morbidities, and symptoms of COVID-19. Descriptive statistics were used to analyze data. Women had positive polymerase chain reaction (PCR) testing done by nasopharyngeal swabs. Each newborn was tested for SARS_CoV-2 by RT_PCR with a nasopharyngeal swab at 24 hours, 48 hours, and day 5 of life. Results 36 women met criteria to be included in this study. 22% had chronic hypertension, 8% had asthma, one had chronic HIV and hepatitis C, 30% had pregnancy-related morbidities including pregnancy-induced hypertension (19%), cholestasis of pregnancy (8%) and gestational diabetes(3%) (Table1) Of the 32 deliveries to date, 17 (53% delivered vaginally and 15 (47%) via C-section. Of the 15 C-sections, 6 (40%) were due to complications related to COVID-19. 38% (14/36) women developed hypoxia. Five newborns (15%) born to SARS-CoV-2 positive mothers had positive PCR testing for SARS-CoV-2. 2 of them were born prematurely and by C section secondary to COVID 19 infection respiratory deterioration. One premature infant tested positive for RT-PCR for SARS-CoV-2 on days 1, 2, and 5. The other one was positive on day 2. The two full-term newborns who tested positive by PCR for COVID 19 after delivery, were not delivered secondary to COVID 19 complications. One infant who was separated from his mother was negative by PCR at days 1,2 and 5 but tested positive later after being in contact with his mother. Conclusion Our population of pregnant mothers had a high incidence of cesarean section secondary to COVID 19 infection complications. They also had a high frequency of chronic health conditions. Infants born to mothers with COVID-19 can have positive PCR tests for SARS-CoV-2 suggesting that both, vertical and horizontal mother to infant transmission is possible. Infants had negative tests before positive tests, suggesting false negative testing may have occurred. Disclosures All Authors: No reported disclosures

scholarly journals 539. Prevalence of Symptomatic and Asymptomatic COVID-19 Infection in Pregnant Women and Their Infants in an Urban Hospital

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S337-S337
Author(s):  
Krystina L Woods ◽  
Angela Gabasan ◽  
Deborah Schwing ◽  
Brian Wagner ◽  
Lisa Eiland ◽  
...  
Keyword(s):  
New York ◽  
Pregnant Women ◽  
Newborn Infants ◽  
Nasopharyngeal Swab ◽  
Urban Hospital ◽  
Birth Parent ◽  
Global Pandemic ◽  
Increased Risk ◽  
Symptomatic Woman ◽  
The One

Abstract Background COVID-19 is an emerging pathogen that has caused a global pandemic, with New York City as one of its epicenters. Data are still forthcoming if pregnant women are more vulnerable to COVID-19, as they are with influenza. Additionally, it is not known if infants born to COVID-19 positive women are at risk of being infected at birth. Methods In March 2020, our hospital instituted a policy of testing all pregnant women presenting for active labor and scheduled C-section or induction of labor, with a nasopharyngeal swab that was sent for RT-PCR qualitative SARS-CoV-2 assay (Roche Cobas® 6800). Upon birth, infants were also tested, unless the parent did not give consent. We retrospectively reviewed the COVID-19 test results of all pregnant women and their infants, from March 23 through May 31, 2020 using our infection control surveillance system (VigiLanz®). We also reviewed the electronic medical record (EPIC®) for documentation of any symptoms consistent with COVID-19 infection either prior to hospitalization or during the hospital stay. Results A total of 415 women and 72 infants were tested for SARS-CoV-2. Of the 415 women tested, 41 (9.9%) were positive. Of the 72 infants tested, 2 (2.8%) were positive and concordant with their birth parent. Only 1 (2.4%) of the women who tested positive was symptomatic. The remaining 40 (97.6%) women did not report any symptoms of COVID-19 during labor. Neither of the two positive infants displayed any signs or symptoms of COVID-19. Of the 41 women who were positive, 5 did not consent to have their infant tested. The one symptomatic woman who tested positive for COVID-19 had an infant who tested negative by PCR. Conclusion During the first wave of the COVID-19 pandemic, we found 9.9% (41/415) of pregnant women presenting for labor tested positive for SARS-CoV-2. Among the 41 women who tested positive, only 1 (2.4%) had symptoms on presentation and only 2 newborn infants tested positive. Our data suggests that pregnant women may not be at increased risk for complications from COVID-19 disease and are not likely to transmit the disease to their infants during labor. Disclosures All Authors: No reported disclosures

418 The Berlin Questionnaire in Pregnancy Predominantly Identifies Obesity

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A165-A166
Author(s):  
Louise O’Brien ◽  
Rivkah Levine ◽  
Galit Levi Dunietz
Keyword(s):  
Pregnant Women ◽  
Medical Center ◽  
Perinatal Outcomes ◽  
Poor Performance ◽  
Berlin Questionnaire ◽  
Chronic Hypertension ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Positive Score ◽  
In Pregnancy

Abstract Introduction Obstructive sleep apnea (OSA) is common in pregnant women and is a risk factor for poor perinatal outcomes. The Berlin Questionnaire (BQ) is a validated OSA screening tool that is often used in pregnancy. However, it performs poorly in this population, likely attributed to the scoring paradigm that primarily identifies obesity. Moreover, the associations between the BQ and pregnancy outcomes are often those same outcomes that are obesity-related. Therefore, this study examined associations between each of the three BQ domains, independently and jointly, in relation to gestational diabetes (GDM) and hypertensive disorders of pregnancy (HDP). Methods Pregnant third-trimester women aged at least 18 years with a single fetus were recruited from a tertiary medical center. All women completed the BQ, which includes three domains: snoring; sleepiness; and obesity/high blood pressure (BMI/BP). The latter domain was further examined as two separate sub-domains: obesity or chronic hypertension. A positive response in 2-of-3 domains identifies high OSA risk. Medical records were accessed for diagnoses of GDM and HDP. Results Of 1,588 women, 44% had a positive BQ. Women with positive domains of snoring exclusively, sleepiness exclusively, or their combination did not have an increased risk of GDM or HDP. However, women without snoring or sleepiness, but with a positive score on the BMI/BP domain had increased odds of GDM (OR 2.0, 95%CI 1.3–3.3) and HDP (OR 2.9, 95%CI 1.6–5.5). Any positive score in domain combinations that included BMI/BP had increased odds of GDM and HDP compared with negative scores in all domains. A positive score in BMI/BP-alone, BMI/BP-and-sleepiness, BMI/BP-and-snoring, and an intersection of all three domains, had increased HDP odds compared with controls: OR 2.9 (95%CI 1.6–5.5), OR 2.2 (95%CI 1.1–4.4), OR 2.9 (95%CI 1.5–5.7), and OR 4.6 (95%CI 2.6–8.6), respectively. Women absent of positive BMI/BP domain but with a positive score in the other two domains (or their combination) had similar odds of GDM and HDP as controls. Conclusion The poor performance of the BQ in screening for OSA risk in pregnant women may be attributed to its predominant reliance on identification of obesity. Support (if any) NIH NHLBIHL089918

Treatment of maternal hyperthyroidism with antithyroid agents and changes in thyrotrophin and thyroxine in the newborn

1981 ◽  
Vol 97 (2) ◽  
pp. 186-195 ◽  
Author(s):  
B.-A. Lamberg ◽  
E. Ikonen ◽  
K. Teramo ◽  
G. Wägar ◽  
K. Österlund ◽  
...  
Keyword(s):  
Laboratory Test ◽  
Cord Blood ◽  
Pregnant Women ◽  
Newborn Infants ◽  
Antithyroid Drug ◽  
Clinical Indication ◽  
Antithyroid Drugs ◽  
Serum Thyroxine ◽  
Antithyroid Agents ◽  
Serum Tsh

Abstract. Eleven pregnant women with concomitant hyperthyroidism were treated with antithyroid drugs. At monthly intervals serum thyroxine (T4) and triiodothyronine (T3) were measured with radioimmunoassay, the Sephadex uptake of radioactive triiodothyronine (T3U) determined and the free T4 and T3 indices calculated (FT4I, FT3I). TSH-binding inhibiting immunoglobulins (TBII) were determined by the radiomembrane assay. Serum TSH and T4 were measured at delivery from cord blood and/or from the newborn infants some days after birth. Serum TSH was significantly elevated in one infant. There was an inadequate post-partal rise in serum T4 concentration in this child and in another who showed only a marginal elevation of TSH. The mothers of these infants were given carbimazole in doses of 30 and 25 mg/day, respectively, at the time of delivery. No significant changes were seen in other infants, the daily doses being 20 mg of carbimazole or less. There was no clinical indication of hypo- or hyperthyroidism in any of the newborn. The TBII were positive in most patients and there was a trend of normalization during treatment. No relationship between the dose of antithyroid drug and the level of TBII could be seen. During treatment the dose was adjusted according to the FT3I values. This seems to be an adequate laboratory test for this purpose.

Scoring System for the Diagnosis of COVID-19

2020 ◽  
Vol 13 (1) ◽  
pp. 413-414 ◽  
Author(s):  
Mohamed Farouk Allam
Keyword(s):  
Scoring System ◽  
Clinical Symptoms ◽  
False Negative ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
Pcr Assay ◽  
Negative Results ◽  
False Negative Results ◽  
Symptoms And Signs

Due to the international spread of COVID-19, the difficulty of collecting nasopharyngeal swab specimen from all suspected patients, the costs of RT-PCR and CT, and the false negative results of RT-PCR assay in 41% of COVID-19 patients, a scoring system is needed to classify the suspected patients in order to determine the need for follow-up, home isolation, quarantine or the conduction of further investigations. A scoring system is proposed as a diagnostic tool for suspected patients. It includes Epidemiological Evidence of Exposure, Clinical Symptoms and Signs, and Investigations (if available). This scoring system is simple, could be calculated in a few minutes, and incorporates the main possible data/findings of any patient.

Effects of Self-Service Blood Pressure Measurement in Outpatient Obstetrics Clinics on waiting time, satisfaction of pregnant women in a tertiary hospital: Cross-sectional Survey (Preprint)

2020 ◽  
Author(s):  
Wanhua Xie ◽  
Yunhe Gao ◽  
Weichi Tan
Keyword(s):  
Blood Pressure ◽  
Pregnant Women ◽  
Waiting Time ◽  
Pressure Measurement ◽  
Medical Center ◽  
Blood Pressure Measurement ◽  
Outpatient Service ◽  
The Self ◽  
Clinical Practices ◽  
Self Service

BACKGROUND In the conventional method, the blood pressure values of pregnant women were measured by nurses in the obstetrics outpatient clinics, and then were entered into the computer system.The pregnant women should wait for long time to complete this process.We hypothesized that the self-service blood pressure measurement by pregnant women could be a better option rather than measuring the blood pressure by nurses. OBJECTIVE This study aimed to analyze the effect of self-service blood pressure measurement in obstetrical outpatient clinic on waiting time, satisfaction of pregnant women and outpatient volume, and provide reference for the optimization of outpatient service processes. METHODS This was a cross-sectional study. The waiting time and satisfaction degree of pregnant women, as well as the outpatient volume in the Obstetrics Outpatient Clinic were compared on the use of self-service blood pressure measurement system with the conventional method. A total of 519 pregnant women in the obstetrics outpatient clinics of Guangzhou Women and Children’s Medical Center in China participated in the satisfaction survey. The sample means were compared with t-test. RESULTS Compared to wait a longer queue for blood pressure measured by nurses, after using the self-service blood pressure measurement system, the waiting time of pregnant women for blood pressure measurement was significantly reduced from (18.57±9.68) min to (2.39±1.96) min (P<0.001). In addition, the satisfaction degree of pregnant women was significantly increased (P<0.001), and the monthly outpatient volume was significantly increased (P=0.02,P<0.05). CONCLUSIONS This study showed that after implementation of self-service blood pressure measurement, the waiting time of the pregnant women for blood pressure measurement was decreased significantly, while the satisfactory degree and outpatient flow were increased significantly, improving the cost-effectiveness.Therefore, this method is worth to be popularized in clinical practices. Relevance to clinical practice: How to use medical intelligence in clinical practices, replace manual works by self-service devices to address the high outpatient flow, high work load of medical personnel, and improve the experience of patients in seeking medical services are the most concerned issues by both patients as well as hospital managers.This study demonstrated that the self-service blood pressure measurement as a promising strategy in clinical practices and provided reference for the optimization of outpatient service processes. CLINICALTRIAL This study was approved by the Ethics Committee of the Guangzhou Women and Children’s Medical Center (approval number:SFE-KL-46401; Supplementary file 4). All the pregnant women included in this study signed the informed consent form.

Does genetically-defined ancestry predict booking blood pressure in pregnant women with chronic hypertension?

2019 ◽  
Vol 17 ◽  
pp. S11
Author(s):  
Frances Conti-Ramsden ◽  
Raquel Iniesta ◽  
Phil Chowienczyk ◽  
Lucy C. Chappell
Keyword(s):  
Blood Pressure ◽  
Pregnant Women ◽  
Chronic Hypertension

scholarly journals Newborns at risk of Covid-19 ― lessons from the last year

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Malika D. Shah ◽  
Ola Didrik Saugstad
Keyword(s):  
Horizontal Transmission ◽  
Mode Of Delivery ◽  
Newborn Infants ◽  
World Health ◽  
Premature Delivery ◽  
Mortality And Morbidity ◽  
Skin Contact ◽  
Cord Clamping ◽  
Increased Risk ◽  
Health Organization

Abstract After more than 1 year of the SARS-CoV-2 pandemic, a great deal of knowledge on how this virus affects pregnant women, the fetus and the newborn has accumulated. The gap between different guidelines how to handle newborn infants during this pandemic has been minimized, and the American Academy of Pediatrics (AAP)’s recommendations are now more in accordance with those of the World Health Organization (WHO). In this article we summarize present knowledge regarding transmission from mother to the fetus/newborn. Although both vertical and horizontal transmission are rare, SARS-CoV-2 positivity is associated with an increased risk of premature delivery and higher neonatal mortality and morbidity. Mode of delivery and cord clamping routines should not be affected by the mother’s SARS-CoV-2 status. Skin to skin contact, rooming in and breastfeeding are recommended with necessary hygiene precautions. Antibodies of infected or vaccinated women seem to cross both the placenta and into breast milk and likely provide protection for the newborn.

scholarly journals Evaluation of SARS-CoV-2 antigen-based rapid diagnostic kits in Pakistan: formulation of COVID-19 national testing strategy

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Umar Saeed ◽  
Sara Rizwan Uppal ◽  
Zahra Zahid Piracha ◽  
Azhar Rasheed ◽  
Zubair Aftab ◽  
...  
Keyword(s):  
Gold Standard ◽  
Injection Drug Users ◽  
Drug Users ◽  
Diagnostic Testing ◽  
False Negative ◽  
Cross Sectional Study ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
Cross Sectional ◽  
Negative Results

AbstractRapid diagnosis of SARS-CoV-2 during pandemic enables timely treatment and prevention of COVID-19. Evaluating the accuracy and reliability of rapid diagnostic testing kits is crucial for surveillance and diagnosis of SARS-CoV-2 infections in general population, injection drug users, multi-transfused populations, healthcare workers, prisoners, barbers and other high risk populations. The aim of this study was to evaluate performance and effectiveness of nasopharyngeal swab (NSP) and saliva based rapid antigen detection testing kits in comparison with USFDA approved triple target gold standard real-time polymerase chain reaction. A cross-sectional study was conducted on 33,000 COVID-19 suspected patients. From RT-PCR positive patients, nasopharyngeal swab (NSP) and saliva samples were obtained for evaluation of rapid COVID-19 testing kits (RDT). 100/33,000 (0.3%) of specimens were RT-PCR positive for SARS-CoV-2. Among RT-PCR positive, 62% were males, 34% were females, and 4% were children. The NSP-RDT (Lepu Medical China) analysis revealed 53% reactivity among males, 58% reactivity among females, and 25% reactivity among children. However saliva based RDT (Lepu Medical China) analysis showed 21% reactivity among males and 23% among females, and no reactivity in children. False negative results were significantly more pronounced in saliva based RDT as compared to NSP-RDT. The sensitivity of these NSP-RDT and saliva based RDT were 52% and 21% respectively. The RDTs evaluated in this study showed limited sensitivities in comparison to gold standard RT-PCR, indicating that there is a dire need in Pakistan for development of suitable testing to improve accurate COVID-19 diagnosis in line with national demands.

scholarly journals NESTROFT—A Cost-Effective Mass Screening Tool for the Detection of β-Thalassemia Carrier Status in Anemic Pregnant Women: A Step Toward Reducing the National Disease Burden

2021 ◽  
Author(s):  
Manasi Gosavi ◽  
Ramesh Chavan ◽  
M. B. Bellad
Keyword(s):  
Pregnant Women ◽  
Effective Mass ◽  
Mass Screening ◽  
Predictive Value ◽  
Screening Tool ◽  
Hematological Parameters ◽  
False Negative ◽  
Cost Effective ◽  
Mean Corpuscular Hemoglobin ◽  
Carrier Status

Abstract Introduction β-Thalassemias are inherited hemoglobinopathies commonly encountered in practice. With chances of a promising cure being rare, the prevention of births with this disorder should assume priority, especially in low-resource countries. This can be achieved by the implementation of a mass screening program that is reliable and, at the same time, cost-effective. Objectives This study focuses on the utility of Naked Eye Single Tube Red Cell Osmotic Fragility Test (NESTROFT) as a mass screening tool to detect thalassemia carriers. Hematological parameters that may predict carrier status were also evaluated. Materials and Methods Hemoglobin estimation was performed on all consented pregnant women. If the patient was found to have hemoglobin < 11 g/dL, the blood sample was subjected to other routine hematological tests along with peripheral smear examination. NESTROFT was performed using 0.36% saline solution. Confirmation was done using high-performance liquid chromatography (HPLC). Statistical Analysis Data obtained were tabulated using version 21 of the Statistical Package for Social Sciences. Means, standard deviations, and percentages were used to describe the sample. Chi-square test and Students’ “t” test were used to identify differences between the groups. Results Of 441 pregnant women enrolled, 206 were found to be anemic. Nineteen (9.2%) of the anemic pregnant women were detected to be carriers of hemoglobinopathies. Among the hematological parameters, mean red blood cell count and reticulocyte count were higher, while mean corpuscular hemoglobin concentration was lower in carriers. Also, carriers were more likely to present with microcytic hypochromic anemia. NESTROFT showed a sensitivity of 84.21%, specificity of 96.25%, a positive predictive value of 69.56%, and a negative predictive value of 98.36%. A false-positive result was seen in 3.74% of the tests, while a false negative result was seen in 15.78% of the tests. Conclusions NESTROFT (0.36%) can be used as a simple and cost-effective mass screening tool for the detection of carrier status. This should be followed by confirmation using HPLC or hemoglobin electrophoresis.

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