scholarly journals COVID-19 OUTCOMES IN PREGNANCY: A REVIEW OF 275 SCREENED STUDIES

Author(s):  
Rupalakshmi Vijayan ◽  
Hanna Moon ◽  
Jasmine Joseph ◽  
Madiha Zaidi ◽  
Chhaya Kamwal ◽  
...  

In December 2019, a novel strain of severe acute respiratory syndrome (SARS-CoV-2), was declared as a cause of respiratory illness, called coronavirus 2019 (COVID-19), characterized by fever and cough. In diagnostic imaging, the afflicted population showed pathognomonic findings of pneumonia. What started out as an epidemic in China, rapidly spread across geographical locations with a significant daily increase in the number of affected cases. According to the World Health Organization (WHO) reports, the range of worldwide mortality is 3 to 4%. Maternal adaptations and immunological changes predispose pregnant women to a prolonged and severe form of pneumonia, which results in higher rates of maternal, fetal, and neonatal morbidity and mortality. There is limited data about the consequences of COVID-19 in pregnancy, thereby limiting the prevention, counseling, and management of these patients. The objective of this literature review is to explore pregnancy and perinatal outcomes of COVID-19, complications, morbidity, and mortality in this sub-population. We conducted a literature review pertaining to COVID-19 and pregnancy in databases such as: PubMed, Google Scholar, and Science Direct. The studies we chose to focus on were systematic reviews, meta-analysis, case series, and case reports. Twenty four articles were reviewed regarding COVID-19 and pregnancy, complications and their outcomes. Due to immunological changes during pregnancy as evidenced by the flaring of auto-immune diseases; pregnant women may be at an increased risk for infection. Women (19.7%) who had underlying comorbidities such as gestational DM, HTN, hypothyroidism, and autoimmune disease, COPD, or HBV infection were considered high risk. The most common maternal outcomes were premature rupture of membranes (PROM) and pre-eclampsia. Asthma was the most common comorbidity associated with maternal mortality. The most common neonatal complications were fetal distress leading to NICU admissions and preterm birth <37 weeks. The most common laboratory changes were elevated CRP and lymphocytopenia. Most patients underwent C-section due to their underlying comorbidities. Pregnant and lactating women did not shed viral particles through their vaginal mucus and milk, as evidenced by negative nucleic-acid tests of these secretions. Neonatal infections as demonstrated by positive RT-PCR were rare, but direct evidence supporting intrauterine transmission was not confirmed. Direct evidence indicating vertical transmission of COVID-19 is not available, but risk for transmission cannot be ruled out. Pregnant women should be closely monitored due to increased risk of adverse outcomes.

2018 ◽  
Vol 5 (1) ◽  
pp. 28
Author(s):  
Marijana Bucalo ◽  
Anastasija Stojšić Milosavljević ◽  
Bojana Babin

High blood pressure in pregnancy is a significant problem and has long been causing the attention of perinatologists. Hypertensive disorders in pregnancy are the leading cause of morbidity and mortality of mothers and fetuses. About 8% of pregnancies complicate high blood pressure. It is estimated that 192 women die daily due to hypertensive complications during pregnancy. Hypertension in pregnancy is not a single entity but it includes: pre-existing hypertension; gestational hypertension; pre-pregnancy existing hypertension complicated by gestational hypertension with proteinuria; prenatally unclassified hypertension. The aim of this paper is to point to the problem of hypertension in pregnancy and the importance of its early detection.It’s a literature review. The literature review period is from 2003-2013. The literature review was carried out in the Hinari, Pubmed and Google Scholar databases.A total of 50 scientific and professional papers in English and Serbian have been examined, of which work is included. 17. By reviewing the summary of each paper, all articles that did not report hypertension in pregnancy were excluded. Through research that was conducted, it was concluded that pregnancy is a significant problem in pregnancy and is therefore the leading cause of morbidity and mortality of both mothers and fetuses. However, the decision to introduce antihypertensive therapy and the choice of an adequate drug during pregnancy should be based on the assessment of the benefits and risks for each pregnant woman individually. Thus, the role of the health care nurse in gynecology and obstetrics has the primary goal and task to preserve and improve the health of women through a series of preventive-promotional activities, all of which are covered through primary, secondary, and tertiary prevention.A literature review lists the risk factors that can cause hypertension in pregnancy, including: age of the patient - under 20 and over 35 years, vascular and renal pathology, gestational diabetes, obesity or malnutrition, pheochromocytoma, systemic lupus, poor living conditions, there is and increased risk in first-born patients. Women who have been hypertensive during their first pregnancy have a higher risk of subsequent pregnancy.


Author(s):  
Nastaran Ghandali ◽  
Hoda Sabati ◽  
Ali Emami ◽  
Masumeh Dadashaliha

The pregnancy process involves many physiological changes, including weight gain, hormonal, metabolic and immune changes. One of the effective factors in this process is infection caused by microorganisms. Originally, before the advent of antibiotics, pregnancy was known as a risk factor for severe complications of pneumococcal pneumonia. Among viral infections, the 2009 flu pandemic issued a newer warning that some infections may disproportionately affect pregnant women and cause miscarriage and its complications during pregnancy. Generalization of pregnancy as a condition of suppression of the general immune system or increased risk is misleading and prevents the establishment of adequate guidelines for the treatment of pregnant women during epidemics. Viral infection has also become an important factor in pregnancy conditions. The recent outbreak of Ebola and other viral outbreaks and epidemics shows how pregnant women show worse outcomes (such as preterm delivery and fetal adverse outcomes) than the general population and non-pregnant women. The purpose of this article is studying pathogenesis of microorganisms and the risks which pose to the mother and the fetus. In order to investigate these factors, from 120 article prepared from google scholar and Pub med, Elsevier database. Knowing these factors can increase the ability to treat the infections in a timely manner and prevent their effects on the fetus and the patient.


2020 ◽  
Vol 3 (2) ◽  
pp. 158-166
Author(s):  
Hazari Komal Sundeep ◽  
Paulose Litty ◽  
Kurien Nimmi ◽  
Mohammad Hozaifah ◽  
A Elgergawi Taghrid Faek ◽  
...  

Pneumonia caused by the Novel coronavirus disease 2019 (COVID-19) is a highly infectious disease and the ongoing outbreak has been declared as a Pandemic by the World health organization. Pneumonia is a serious disease in pregnancy and requires prompt attention. Viral pneumonia has higher morbidity and mortality compared to bacterial pneumonia in pregnancy. All efforts are well exerted to understand the newly emerged disease features but still some areas are gray. The treatment is primarily supportive with antivirals, steroids, anticoagulation and antibiotics for secondary bacterial infection. Severe cases require intensive care monitoring with oxygen support, mechanical ventilation. Investigational therapies include convalescent plasma, cytokine release inhibitors and other immunomodulatory agents like interferons. The mortality appears driven by the presence of severe Adult Respiratory Syndrome (ARDS) and organs failure. COVID pandemic is a challenging and stressful socio-economic situation with widespread fear of infection, disease and death. In the specialty of obstetrics and gynecology, studies are being conducted to ascertain the manifestation of disease in pregnant women and the fetal outcome. The aim of our case series is to describe the demographics, clinical characteristics, laboratory and radiological findings, feto- maternal outcome of severe and critical COVID pneumonia in pregnant women in Latifa Hospital.


Author(s):  
Shaghayegh Rahmani ◽  
Sonia Norkhomami ◽  
Behzad Shahi ◽  
Mahjoubeh Keykha

Introduction: In March 2020, the World Health Organization introduced the Coronavirus disease 2019 (COVID-19) pandemic as a global health concern and predicted that without any changes in the transmission process, the disease would reach its peak in April. Hence, it was not unreasonable to expect the referral of pregnant women in all trimesters. Since respiratory illnesses can increase the risk of infectious diseases and maternal mortality, it is justifiable to consider COVID-19-positive cases as high-risk pregnancies. Case presentation: The present study introduced six pregnant women with COVID-19 and discussed the points to consider in managing these patients. Conclusions: Pregnant women are at increased risk in all epidemics of infectious diseases due to their physiological and immunological changes. Moreover, the safety of the fetus is another important issue to consider.


2021 ◽  
pp. 9-11
Author(s):  
Hari Kishan Boorugu

COVID-19 pandemic has affected humankind in a major way. Pregnant women are as susceptible to SARS-COV-2 infection as non-pregnant population. Infections prevention is paramount as pregnancy is associated with increased risk of severe illness, admission to intensive care and mechanical ventilation. Pregnancy poses unique challenges in view of paucity of information regarding safety of drugs used in management of patients with COVID-19 infection. Fortunately SARS-COV-2 infection during pregnancy does not appear to cause congenital anomalies. Vaccination should not be withheld based on pregnancy and lactation status.


F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 362
Author(s):  
Jerome Bouaziz ◽  
Marc Even ◽  
Frederique Isnard-Bogillot ◽  
Eli Vesale ◽  
Mariam Nikpayam ◽  
...  

Coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), continues to escalate worldwide and has become a pressing global health concern. This article comprehensively reviews the current knowledge on the impact of COVID-19 over pregnant women and neonates, as well as current recommendations for their management. We also analyse previous evidences from viral respiratory diseases such as SARS, Middle East respiratory syndrome, and influenza that may help to guide clinical practice during the current pandemic. We collected 23 case reports, case series, and case-control studies (18 from China) comprising 174 pregnant women with COVID-19. The majority of mothers showed a clinical presentation of the disease similar to that of non-infected adults. Preliminary evidences point towards a potentially increased risk of pregnancy adverse outcomes in women with COVID-19, with preterm delivery the most frequently observed (16.7%) followed by fetal distress (9.77%). The most commonly reported adverse neonatal outcomes included respiratory symptoms (7.95%) and low birth weight (6.81%). A few studies reported other maternal comorbidities that can influence these outcomes. Mothers with other comorbidities may be at higher risk of infection. Mother-to-child transmission of SARS-CoV-2 appears unlikely, with no study observing intrauterine transmission, and a few cases of neonatal infection reported a few hours after birth. Although the WHO and other health authorities have published interim recommendations for care and management of pregnant women and infants during COVID-19 pandemic, many questions remain open. Pregnant women should be considered in prevention and control efforts, including the development of drugs and vaccines against SARS-CoV-2. Further research is needed to confirm the exact impact of COVID-19 infection during pregnancy. To fully quantify this impact, we urgently need to integrate the current knowledge about viral characteristics, epidemiology, disease immunopathology, and potential therapeutic strategies with data from the clinical practice.


2021 ◽  
pp. 1753495X2110060
Author(s):  
Jade Eccles-Smith ◽  
Stephanie Hopkins ◽  
Jennifer Conn ◽  
Stephanie Johnston ◽  
Rebecca Szabo ◽  
...  

Paragangliomas are rare neuroendocrine neoplasms which are often catecholamine-secreting and associated with familial syndromes. Described here are three women with a variety of pathology: isolated secretory paraganglioma diagnosed in pregnancy, secretory metastatic paraganglioma in pregnancy and non-secretory metastatic paraganglioma in pregnancy. Whilst paragangliomas are associated with morbidity and mortality during pregnancy, good maternal and fetal outcomes can be achieved through individualised care within the context of a multidisciplinary team. Although paragangliomas are associated with morbidity and mortality in pregnancy, good maternal and fetal outcomes can be achieved through individualised care within the context of a multidisciplinary team.


2021 ◽  
Vol 3 (4) ◽  
pp. 25-27
Author(s):  
Nusrat Mahjabeen ◽  
Shaikh Zinnat Ara Nasreen ◽  
Safinaz Shahreen

The incidence of maternal and fetal morbidities and mortalities are very high in anemic patients. According to WHO anemia is the most common medical disease in pregnancy in south east Asian region.  18-20 pregnant women are anemic in developed countries as compared to the incidence is as high as 40% to 75% in south east Asian region. According to Center of Disease Control (CDC) anemia in pregnancy means hemoglobin is less than 11 g/dl (Hematocrit; {Hct} < 33%) in the first and third trimester and less than 10.5 g/dl (Hct < 32%) in the second trimester. According to World Health Organization (WHO), anemia in pregnancy is defined as Hb level is less than 11gm/dl. As physiological hemodilution occurs during pregnancy, pregnant women are at higher risk of anemia and more commonly iron deficiency anemia. The aim of the study is to compare the risk of PROM between anemic pregnant women and non-anemic pregnant women. It is a prospective observational study held in Z.H.Sikder women’s medical college & hospital from April,2020 to march,2021. 100 cases of anemic and 100 cases of non-anemic pregnant women were purposively taken as study population. The prevalence of PROM equaled to 64% in pregnant anemic group. In bivariable analysis, the risk factors of anemia such as, maternal working condition, socio economic status and maternal age were studied. The risk of PROM is higher in anemic pregnant women than in non-anemic pregnant women. Doctors and healthcare workers should be more careful to prevent and treat anemia in pregnancy to avoid the adverse outcomes.


2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Tabeta Seeiso ◽  
Mamutle M. Todd-Maja

Antenatal care (ANC) literacy is particularly important for pregnant women who need to make appropriate decisions for care during their pregnancy and childbirth. The link between inadequate health literacy on the educational components of ANC and maternal mortality in sub-Saharan Africa (SSA) is undisputable. Yet, little is known about the ANC literacy of pregnant women in SSA, with most studies inadequately assessing the four critical components of ANC literacy recommended by the World Health Organization, namely danger signs in pregnancy; true signs of labour; nutrition; and preparedness for childbirth. Lesotho, a country with one of the highest maternal mortality rates in SSA, is also underexplored in this research area. This cross-sectional study explored the levels of ANC literacy and the associated factors in 451 purposively sampled women in two districts in Lesotho using a structured questionnaire, making recourse to statistical principles. Overall, 16.4 per cent of the participants had grossly inadequate ANC literacy, while 79.8 per cent had marginal levels of such knowledge. The geographic location and level of education were the most significant predictors of ANC literacy, with the latter variable further subjected to post hoc margins test with the Bonferroni correction. The participants had the lowest scores on knowledge of danger signs in pregnancy and true signs of labour. Adequate ANC literacy is critical to reducing maternal mortality in Lesotho. Improving access to ANC education, particularly in rural areas, is recommended. This study also provides important recommendations critical to informing the national midwifery curriculum.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1402.1-1402
Author(s):  
R. Pinheiro Torres ◽  
M. H. Fernandes Lourenco ◽  
A. Neto ◽  
F. Pimentel Dos Santos ◽  
I. Silva ◽  
...  

Background:Juvenile idiopathic arthritis (JIA), one of the most common chronic diseases in children, can be classified in seven different categories according to its onset presentation. Concerns about pregnancy outcomes play a secondary role in disease approach. However, recent data showed an increased risk of pre-term birth in women with JIA instead the small patient samples analysed.Objectives:In this review, our aim is to describe the current available knowledge on JIA adverse, maternal and fetal, outcomes.Methods:A systematic literature review was conducted since January of 2000 until December 2020, by searching the PubMed and Embase bibliographic databases. The search was limited to articles in English language, presenting a comparator group (healthy individuals or patients without known auto-immune rheumatic diseases) and at least one clinical outcome of interest. Two independent reviewers screened the titles and abstracts followed by a full-text review to assess papers regarding their eligibility.Results:Ten observational studies out of 1560 references, fulfilled the inclusion criteria, of which, 9 were retrospective and 1 prospective. A total of 6.214 women with JIA (with 6.811 pregnancies) and 18.659.513 healthy controls (with 21.339.194 pregnancies) were included in this review.Concerning maternal outcomes, delivery by caesarian section (CS) was more frequent among JIA women (in 4 out of 6 studies). Pre-eclampsia was referred in 3 out of 6 studies and a higher risk of vaginal bleeding and placenta previa in one additional study. No study found an increased risk for gestational diabetes or hypertension in pregnant women with JIA.Regarding fetal outcomes, 8 studies revealed significantly increased of pre-term birth (only in first births in one study) but one study didn’t show any increased risk. Two studies showed a higher risk of small gestational age (SGA) and in another 2, increased risk for low birth weight (LBW). No evidence of increased risk of major congenital malformations.Conclusion:This systematic review suggests an increased risk for pre-eclampsia, preterm birth, delivery by CS, SGA and LBW, among pregnant women with JIA. Conclusions should be carefully interpreted, giving the heterogeneity of studied populations regarding demography, disease type, disease activity, and prescribed medication.Disclosure of Interests:None declared


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