scholarly journals SEROPREVALENCE AND CLINICAL SPECTRUM OF SARS-CoV-2 INFECTION IN THE FIRST VERSUS THIRD TRIMESTER OF PREGNANCY

Author(s):  
Francesca Crovetto ◽  
Fàtima Crispi ◽  
Elisa Llurba ◽  
Francesc Figueras ◽  
María Dolores Gómez-Roig ◽  
...  

IntroductionCase registries of pregnant women diagnosed with coronavirus disease (COVID-19) by polymerase chain reaction (PCR) have reported that the majority experienced mild infection, but up to 9% may require critical care.1 Most COVID-19 cases published were in the third trimester of pregnancy, which could reflect reporting bias, higher risk of infection or increased disease severity in late pregnancy.2 Seroprevalence studies may allow reliable estimates of the susceptibility to infection and clinical spectrum since they include asymptomatic and mild infections not tested for PCR. We evaluated the seroprevalence and clinical presentation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in pregnant women in the first and third trimester.MethodsThe study was approved by the Institutional Review Board at each institution and informed consent was obtained. We recruited 874 consecutive pregnancies attending for first trimester screening (10-16 weeks’ gestation, n=372) or delivery (n=502) from April 14 to May 5. All women were interviewed with a structured questionnaire for COVID-19 symptoms two months prior to sampling. SARS-CoV-2 IgG and IgM/IgA antibodies were tested (COVID-19 VIRCLIA® Monotest, Vircell Microbiologist, Spain; reported sensitivity 70% IgG and 89% IgM/IgA, and specificity 89% and 99% respectively). Indeterminate results were re-tested (VITROS® Immunodiagnostic Products Anti-SARS-CoV2 Total Tests, Ortho Clinical Diagnostics, USA; 100% sensitivity and specificity) and re-classified as positive or negative. Women with COVID-19 were diagnosed and managed according to standard protocols and guidelines3,4. Statistical differences were tested using the χ2 test or Student t-test as appropriate (p<0.05).ResultsA total of 125 of 874 women (14.3%) were positive for either IgG or IgM/IgA SARS-CoV-2 antibodies, 54/372 (14.5%) in the first and 71/502 (14.1%) in the third trimester. A total of 75/125 (60%) reported no symptoms of COVID-19 in the past 2 months, whereas 44 (35.2%) reported one or more symptoms, of which 31 (24.8%) had at least 3 symptoms or anosmia and 8 (6.4%) dyspnea. Overall, 7 women (5.6%) were admitted for persistent fever (>38°) despite paracetamol and dyspnea, of which 3 had signs of pneumonia on chest radiography. All 3 had criteria for severity (bilateral chest condensation, respiratory rate>30 and leukopenia) and required oxygen support but not critical care or mechanical ventilation, and they were all discharged well. The rates of symptomatic infection, hospital admission or dyspnea were significantly higher in third trimester women (Table and Figure).DiscussionThe 14.3% seroprevalence of SARS-COV-2 in pregnant women in this study was substantially larger than the contemporary rates of PCR positive cases (0.78%) reported for women 20-40y in Barcelona.5 The data confirm that COVID-19 is asymptomatic in the majority of pregnant women6 and illustrate the value of seroprevalence studies to capture the high proportion of asymptomatic or mild infections. In this study, none of the 125 pregnant women with SARS-CoV-2 infection required critical care as compared to 9% reported in cases diagnosed with PCR.1 However, the proportion of infections with symptoms or dyspnea was remarkably higher in the third trimester, and these results are in line with COVID-19 registries, reporting that 81% of hospitalized women were in late pregnancy or peripartum.1These results provide reassuring information that, even in settings with a high prevalence, SARS-CoV-2 infection in pregnancy mostly presents with asymptomatic or mild clinical forms. The susceptibility to infection seemed to be the same in the first and the third trimesters of gestation. The data further suggest that, as with other respiratory viruses, COVID-19 could be more severe and require increased surveillance in late pregnancy. These findings should be confirmed and extended with larger consecutive prevalence studies in pregnancy.

2021 ◽  
Vol 1 ◽  
pp. 1669-1673
Author(s):  
Lutfiah Febriana ◽  
Nina Zuhana

AbstractAnemia is a condition where the level of hemoglobin in the blood is less than the normal limit (<12 g%) caused by a lack of iron in the body due to malnutrition. While anemia in pregnancy is a condition where the hemoglobin level in pregnant women is <11gr% or <10.5gr% in third trimester pregnant women which generally occurs due to the hemodilution process. The purpose of this case to find out the cause of anemia in late pregnancy and the treatment that can be done to prevent complications that occur with care to routinely consume blood-added tablets (Fe) and recommend foods high in iron. This care design used a comprehensive care method for pregnant women in the third trimester who experience mild anemia (haemoglobin <10,5gr%) in Kalimade Village, Kesesi District, Pekalongan Regency. The results of this care showed an increase in hemoglobin levels in the mother. The conclusion of this case study shows that regularly consuming Fe tablets can increase hemoglobin levels in the blood so that it can prevent and treat anemia. For this reason, pregnant women are expected to routinely consume Fe tablets during pregnancy and midwives are expected to provide education about the benefits of Fe tablets to pregnant women to prevent anemia.Keywords: Haemoglobin; Anemia; Pregnancy AbstrakAnemia merupakan suatu kondisi dimana kadar haemoglobin dalam darah kurang dari batas normal (<12 gr%) yang disebabkan karena kurangnya zat besi didalam tubuh akibat kurang gizi. Sedangkan anemia pada kehamilan adalah kondisi dimana kadar haemoglobin pada ibu hamil <11gr% atau <10,5gr% pada ibu hamil trimester III yang umumnya terjadi karena adanya proses hemodilusi. Tujuan dari kasus ini yaitu untuk mengetahui penyebab terjadinya anemia pada kehamilan lanjut serta penanganan yang dapat dilakukan guna mencegah terjadinya komplikasi yang mungki terjadi dengan asuhan untuk rutin mengkonsumsi tablet tambah darah (Fe) serta anjuran mengkonsumsi makanan tinggi zat besi. Rancangan Asuhan ini menggunakan metode asuhan komprehensif pada ibu hamil trimester III yang mengalami anemia ringan (Haemoglobin <10,5gr%) di Desa Kalimade Kecamatan Kesesi Kabupaten Pekalongan. Hasil asuhan ini menunjukan adanya peningkatan kadar haemoglobin pada ibu. Simpulan studi kasus ini menunjukan bahwa dengan rutin mengkonsumsi tablet Fe dapat meningkatkan kadar Haemoglobin dalam darah sehingga dapat mencegah serta mengobati anemia. Untuk itu ibu hamil diharapkan agar rutin mengkonsumsi tablet Fe selama kehamilan. Bidan diharapkan agar bisa memberikan edukasi tentang manfaat tablet Fe pada ibu hamil guna mencegah terjadinya anemia.Kata kunci: Haemoglobin; Anemia; Kehamilan


2018 ◽  
Vol 6 (2) ◽  
pp. 16
Author(s):  
Mezzi Wulandari Arenza ◽  
Ni Wayan Tianing ◽  
I Putu Adiartha Griadhi

ABSTRACTSleep disturbance in the third trimester pregnant women is caused by discomfort, an increasingly largeabdominal condition, back pain, frequent urination, fetal movement, heartburn, cramps in the legs, tiredness, difficultygetting started, and physiological changes. Sleep disorders result in decreased quality of sleep. Pregnant women whohave poor sleep quality are at risk of longer labor, cesarean delivery, premature birth, and even infant mortality. The aimof this research is to know the difference of pregnant exercise combination and back massage in improving the sleepquality of third trimester pregnant women. This research use experiment method with quasi experiment approach andresearch design is pre and post test with control design. Sample are 18 people, divided into 2 groups, 9 people intreatment groups given pregnancy exercise and back massage and 9 people in control group is given only pregnantexercise. Intervention is given 8 times. Pittsburgh Sleep Quality Index (PSQI) questionnaire used for measured of sleepquality. The result of different test of unpaired group, in the treatment group got difference of average 4,556 and controlgroup got difference mean 2,333 with p=0,004 (p<0,05). These results showed that there was a significant differencebetween the treatment group and the control group in improving the sleep quality of the third trimester pregnant women.In conclusion, there are differences in the addition of back massage combination in pregnancy exercise intervention inimproving sleep quality of third trimester pregnant women.Keyword : Pregnancy Exercise, Back Massage, Sleep Quality, Third Trimester.


2020 ◽  
Vol 7 (10) ◽  
pp. 2086
Author(s):  
Bonifacio Caballero ◽  
Daniel Caballero

The emergence of the new corona virus infection that occurred in Wuhan, the capital city of China's Hubei province in December 2019 initially labeled 2019-nCoV and later named SARS-CoV-2, has spread in several countries around the world and subsequently raised concerns about the possibility of vertical transmission from the mother to the fetus, producing its disease named COVID-19. Around 12 articles about pregnant women infected with COVID-19 and their newborns have been published between February 10 and April 4, 2020. So far, there are few reports on newborns. There is currently evidence of vertical transmission from pregnant women with COVID-19 infection during the third trimester. The results of this report suggest that currently there is evidence of intrauterine infection caused by vertical transmission in women who develop COVID-19 pneumonia and die in late pregnancy. However, most of these newborns have been asymptomatic or mildly symptomatic, but as the outbreak and information are changing rapidly, it is recommended to continue to check for updates.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Józefa Dąbek ◽  
Oskar Sierka ◽  
Halina Kulik ◽  
Zbigniew Gąsior

Abstract Background The vaccine is a preparation of biological origin containing antigens that stimulate the body’s immune system to produce acquired immunity. Vaccines can contain killed or “live” (attenuated) microorganisms as well as fragments of these (antigens). Although many vaccines are used routinely in pregnancy to provide a seroprotective immune response for mother, fetus and neonate there is much controversy over their use during this unique time. The aim of the study was to find out about the knowledge of adult Poles on the use of preventive vaccinations during pregnancy. Methods The study involved 700 people (100%) aged 18 to 80 years ($$ \overline{x} $$ x ¯ = 32.16 ± 16.46). Most of the respondents were women (511; 73%). The study consisted of 9 questions about preventive vaccinations of pregnant women and 5 questions about members of the studied group. The aforementioned questions formed the basis of the preparation of the presented article. Results A significant part of respondents (322; 46%) did not have knowledge on the topic of safeness of using preventive vaccinations during pregnancy, 196 (28%) respondents believed that such procedure is not safe. Most of the respondents (371; 53%) did not know about the possibility of using “live” vaccines during pregnancy. 14 (2%) of respondents believed that pregnancy should be terminated in case of administration of a “live” vaccine to a pregnant woman. According to 294 (42%) respondents, vaccinations with “live” vaccines should be completed at least 3 months before the planned pregnancy. The subjects were not aware of the issue of post-exposure vaccination against tetanus and rabies among pregnant women. The respondents’ responses were divided on the issue of the safest trimester of pregnancy for vaccine administration. Almost 1/3 of the respondents (203; 29%) indicated the third trimester as the safest for their performance. Conclusion The knowledge of the surveyed group, the majority of whom were women, about the use of vaccinations before and during pregnancy was unsatisfactory. There is a need to educate the public about the benefits and risks of performing or avoiding preventive vaccinations during pregnancy.


1979 ◽  
Author(s):  
A. Schieppati ◽  
M. M. Cossu ◽  
E. Rossi ◽  
G. Remuzzi

Increased platelet consumption has been suggested to occur in women who develop pre-eclampsia and to play a pathogenetic role in this disorder. The approach to this problem was difficult until a non radioisotopic technique was developed to measure platelet lifespan (Stuart et al. , NEJM 1975, 292, 1310). Malondiafdehyde (MDA) is measured in platelet rich plasma (challenged with thrombin) before and at intervals after ingestion of 500 mg aspirin. The time taken for MDA values to return to baseline levels after aspirin is equal to platelet lifespan. A study is in progress to compare platelet lifespan in healthy non pregnant women, in women in the third trimester of uncomplicated pregnancy and in patients with pre-eclamps. The results obtained so far suggest that platelet lifespan in pregnancy, either normal or complicated with mild pre-eclampsia, is within the normal range. Indeed platelet lifespan was 7.6 , 9.6, 10.5, and 9.5 days in 4 women with uncomplicated pregnancy and , 10.0, 11.7, and 9.0 days In 3 patients with mild pre-eclampsia. Platel ellifespan in non pregnant women ranged between 9.4 and 12.2 days.


2018 ◽  
Vol 9 (1) ◽  
Author(s):  
Elly Dwi Masita

Physical changes and psychology in pregnancy is one stressor in pregnancy. Preliminary studies showed that 98% of pregnant women experience anxiety third trimester. As a result of the pregnancy is maternal anxiety will experience periods of abnormal labor so as to improve maternal and infant mortality. Objective: This study aimed to determine the effect of perineal massage in primiparous mothers anxiety in the third trimester to the third trimester pregnant women in the BPS. Istiqomah, S.Keb.Bid. Methods: This research is pre-experimental design with a population statistical comparison group of pregnant women in the third trimester of BPS. Istiqomah. S.Keb.Bid premises sample of 20 pregnant women were divided into 10 groups of 10 samples of treated and control groups. Sampling nonprobality sample with quota sampling technique. The instrument of this study using a questionnaire anxiety. Results: Of the 10 treatment group gained 9 (90%) of the study subjects experienced a lower level of anxiety while the control group of 10 4 (40%) of research subjects experienced lower levels of anxiety and test results Mann - Whitney was obtained p = 0.005 (p < 0.05), which means there is perineal massage effect on the level of anxiety in the third trimester pregnant women. Conclusion: There is the effect of perineal massage on the level of anxiety in the third trimester pregnant women with p = 0.005


Author(s):  
Olivia Nakiyemba ◽  
Susan Obore ◽  
Milton Musaba ◽  
Julius Wandabwa ◽  
Paul Kiondo

Pica is the craving and purposive eating of nonfood items. It is common worldwide and presents among vulnerable populations like children and pregnant women. Its etiology and health consequences are not well understood. The aim of this study was to determine the prevalence and covariates of pica among pregnant women attending antenatal clinic at Kawempe hospital in Uganda. We conducted a cross-sectional study from July 2019 to December 2019. Participants in this study were 307 pregnant women who had come to attend antenatal clinic at the hospital. The prevalence of pica was computed. Bivariate and multivariable analysis was done to establish the factors that were independently associated with pica. The prevalence of pica was 57%. The most common type of pica was geophagia (eating clay and sand) followed by pagophagia (eating ice). Of the women who practiced pica, half consumed the nonfood items daily. Factors independently associated with pica were being in the third trimester (adjusted OR [aOR]: 3.60; 95% CI: 1.36–9.48] and having nausea in pregnancy (aOR: 2.11; 95% CI: 1.20–3.70). At Kawempe hospital, pica is common among women who attend the antenatal clinic and is associated with having nausea in pregnancy and being in the third trimester. Health workers need to counsel pregnant women about the dangers of pica so as to reduce helminth infections and micronutrient deficiency associated with it.


2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Aynur Kızılırmak ◽  
Sermin Timur ◽  
Bahtışen Kartal

This study aims to investigate insomnia experienced by pregnant women and factors associated with it. This study was designed as hospital-based, descriptive, and cross-sectional research. The participants were 486 people chosen with nonprobability random sampling method. The data were collected through Women’s Health Initiative Insomnia Rating Scale, Beck Depression Inventory, and Interview Form. Insomnia prevalence in women participating in this study was found 52.2%. The results of logistic regression analysis showed that the risk of insomnia was 2.03 times higher for those in the third trimester than those in the first and second trimesters, 2.19 times higher for those 20 years old and over than younger ones, and 2.63 times higher for those who had depression syndrome than those who did not. Insomnia in pregnant women who participated in this study was found to be at high rates.


1972 ◽  
Vol 69 (2) ◽  
pp. 410-412 ◽  
Author(s):  
Alan K. Munson ◽  
Michael E. Yannone ◽  
J. Robert Mueller

ABSTRACT Plasma unconjugated 17β-oestradiol was measured at 8 a.m., 4 p.m. and 10 p. m. in eleven normal females during the third trimester of pregnancy. The late evening values were significantly lower than those observed at 8 a. m. Marked differences in plasma levels were noted for some individuals at the three periods of sampling. A slight diurnal variation in plasma 17β-oestradiol appears compatible with the present concept of oestrogen biosynthesis in late pregnancy.


Healthcare ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. 135
Author(s):  
Ioannis Kakoulidis ◽  
Costas Thomopoulos ◽  
Ioannis Ilias ◽  
Stefanos Stergiotis ◽  
Stefanos Togias ◽  
...  

Gestational diabetes mellitus (GDM) is associated with hypertensive disorders in pregnancy. Alpha-methyl-DOPA (αMD) is a commonly used medication for hypertension in pregnant women. This medication may be associated with alteration in insulin resistance and glucose homeostasis. The aim of the present study was to investigate in 152 pregnant women whether the demands of exogenous insulin in glucocorticoid-treated women during pregnancy are different between those with GDM and hypertension treated with αMD and those without hypertension. In the group of women with GDM under insulin treatment, who received αMD for hypertension, the increase in insulin needs was relatively lower by at least 30% of the pre-admission insulin dose compared to all of the remaining women not receiving αMD in the same group (9 women vs. 50 women, p = 0.035). Our work raises the hypothesis that αMD can favorably modulate insulin sensitivity in the third trimester of pregnancy in previously insulin-treated women with gestational diabetes who receive glucocorticoids.


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