scholarly journals An Unusual Presentation of COVID-19 Associated Multisystem Inflammatory Syndrome in Adults (MIS-A) in a Pregnant Woman

2022 ◽  
Vol 2022 ◽  
pp. 1-5
Author(s):  
Mohamed Rishard ◽  
Suren Perera ◽  
Kushan Jayasinghe ◽  
Amila Rubasinghe ◽  
Sanjaya Athapaththu ◽  
...  
Keyword(s):  
Pregnant Woman ◽  
Pregnant Women ◽  
Respiratory Illness ◽  
Severe Illness ◽  
Obstetric Outcomes ◽  
Rare Presentation ◽  
Diagnostic Dilemma ◽  
Increased Risk ◽  
Inflammatory Syndrome ◽  
In Pregnancy

Based on available literature, pregnant women are at an increased risk of severe illness from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, compared to nonpregnant women. Consequences of coronavirus disease 2019 (COVID-19) in pregnancy have many implications in women’s lives other than unfavorable obstetric outcomes. In addition to managing acute respiratory illness and symptoms, caregivers should be equipped to detect and manage the short-term, intermediate, and long-term consequences of SARS-CoV-2 infection as well. Many pregnant women can remain asymptomatic and continue their pregnancy without being diagnosed. Pregnancy outcomes and consequences of SARS-CoV-2 infected yet asymptomatic mothers have not been very well explained. Reports of a new multisystem inflammatory syndrome in children (MIS-C) and multisystem inflammatory syndrome in adults (MIS-A) following COVID-19 have been described. However, MIS-A in pregnancy is an extremely rare presentation that can cause a huge diagnostic dilemma to caregivers. We describe the successful management of a pregnant woman with MIS-A following SARS-CoV-2 infection.

COVID-19 IN PREGNANCY AND LITERATURE REVIEW

2021 ◽  
pp. 9-11
Author(s):  
Hari Kishan Boorugu
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Literature Review ◽  
Pregnant Women ◽  
Congenital Anomalies ◽  
Severe Illness ◽  
Increased Risk ◽  
Pregnancy And Lactation ◽  
In Pregnancy

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.

scholarly journals The presence of lupus nephritis additionally increases the risk of preeclampsia among pregnant women with systemic lupus erythematosus

Lupus ◽  
2021 ◽  
pp. 096120332110047
Author(s):  
Katarina Bremme ◽  
Sonja Honkanen ◽  
Iva Gunnarsson ◽  
Roza Chaireti
Keyword(s):  
Caesarean Section ◽  
Lupus Nephritis ◽  
Pregnant Women ◽  
Lupus Erythematosus ◽  
Premature Birth ◽  
Renal Involvement ◽  
Significant Risk ◽  
Obstetric Outcomes ◽  
Increased Risk ◽  
Renal Lupus

Introduction Pregnant women with systematic lupus erythematosus (SLE) have an increased risk of obstetric complications, such as preeclampsia and premature births. Previous studies have suggested that renal involvement could further increase the risk for adverse obstetric outcomes. Aims: The aim of this study was to compare the obstetric outcomes in a Swedish cohort of patients with SLE with and without lupus nephritis (LN). Patients and methods The study was conducted as a retrospective observational study on 103 women with SLE, who gave birth at the Karolinska University Hospital between the years 2000-2017. Thirty-five women had previous or active LN and 68 women had non-renal lupus. Data was collected from digital medical records. The outcomes that were analysed included infants born small for gestational age (SGA), premature birth, preeclampsia, SLE- or nephritis flare and caesarean section. Results Women with LN, both with previous and with renal flare during pregnancy suffered from pre-eclampsia more often compared to women with non-renal lupus (25.7% vs 2.9%, p = 0.001) and this complication was associated with premature birth (p = 0.021) and caesarean section (p = 0.035). Conclusions Lupus nephritis is a significant risk factor for adverse obstetric outcomes in women with SLE, including preeclampsia. Those patients could benefit from more frequent antenatal controls and more vigorous follow-up.

scholarly journals Prenatal electrocardiogram testing and postpartum depression: A population-based cohort study

2021 ◽  
pp. 1753495X2110125
Author(s):  
Jonathan S Zipursky ◽  
Deva Thiruchelvam ◽  
Donald A Redelmeier
Keyword(s):  
Cohort Study ◽  
Postpartum Depression ◽  
Pregnant Women ◽  
Odds Ratio ◽  
Population Based ◽  
Relative Increase ◽  
Organic Disease ◽  
Increased Risk ◽  
Clinical Clue ◽  
In Pregnancy

Background Cardiovascular symptoms in pregnancy may be a clue to psychological distress. We examined whether electrocardiogram testing in pregnant women is associated with an increased risk of subsequent postpartum depression. Methods We conducted a population-based cohort study of pregnant women who delivered in Ontario, Canada comparing women who received a prenatal ECG to women who did not. Results In total, 3,238,218 women gave birth during the 25-year study period of whom 157,352 (5%) received an electrocardiogram during prenatal care. Receiving an electrocardiogram test was associated with a one-third relative increase in the odds of postpartum depression (odds ratio 1.34; 95% confidence interval 1.29–1.39, p < 0.001). Conclusion The association between prenatal electrocardiogram testing and postpartum depression suggests a possible link of organic disease with mental illness, and emphasizes that cardiovascular symptoms may be a clinical clue to the presence of an underlying mood disorder.

scholarly journals P–384 First trimester pregnancy outcomes after confirmed SARS-CoV–2 infection in the community; a nationwide prospective longitudinal study of 10,000 pregnant women from the COVID–19 pandemic

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
N Balachandren ◽  
M Davies ◽  
J Hall ◽  
D Mavrelos ◽  
E Yasmin
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
First Trimester ◽  
Severe Illness ◽  
Healthy Controls ◽  
Household Contacts ◽  
Increased Risk ◽  
Early Miscarriage ◽  
Study Participants ◽  
Prospective Longitudinal

Abstract Study question Are pregnant women in the community with confirmed diagnosis of SARS-CoV–2 infection, at increased risk of an early miscarriage? Summary answer Women diagnosed with COVID–19 in their first trimester were not at increased risk of an early miscarriage. What is known already: In the earliest stages of the pandemic, the Human Fertilisation and Embryology Authority and the European Society of Human Reproduction and Embryology, independently advised against starting assisted reproductive treatments. At the time of this recommendation, among other reasons, there were concerns about the complications of SARS-CoV–2 during pregnancy and the potential for vertical transmission. We now having growing evidence that pregnant women are at an increased risk of severe illness along with higher rates of preterm births in those with severe acute respiratory syndrome. However, data on the impact of community infections of SARS-CoV–2 in early pregnancy has been sparse. Study design, size, duration This is an online survey study undertaken in the UK between May and November 2020. Pregnant women at any stage in their pregnancy were invited to participate in the study. Study participants were asked to complete online surveys at the end of each trimester. 10, 430 women were recruited to take part in the study. Participants/materials, setting, methods: We analysed pregnancy outcomes from women who were under 13 weeks gestation at the time of registration. We compared miscarriage rates among women with a confirmed diagnosis of SARS-CoV–2 infection to healthy controls. Those in the control group had not been diagnosed with or had symptoms of SARS-CoV–2 infection nor did they have any household contacts that were diagnosed with or had symptoms of SARS-CoV–2 infection. Main results and the role of chance 10, 430 pregnant women were recruited to participate in the study. 2934 were under 13 weeks gestation at the time of registration. The median age was 32.6 [IQR 29.8–35.6]. The median gestational age at registration was 8 weeks [IQR [6–10]. 246 women reported a miscarriage before 13 weeks of gestation. The overall miscarriage rate before 13 weeks of gestation was 8.4% (95% CI 7.3%–9.4%). 68 women reported a confirmed diagnosis of SARS-CoV–2 infection in their first trimester. The overall rate of confirmed SARS-CoV–2 infections in the first trimester was 2.3% (95% CI 1.8–2.9%). 3/68 (4.4%) were asymptomatic. Among those reporting symptoms, the commonest symptoms were fatigue (82%), headache (69%) and loss of smell/taste (69%). Only 38% of those with a confirmed diagnosis reported a fever. None of the 68 women with confirmed diagnosis of SARS-CoV–2 infection were hospitalised. The rate of miscarriage before 13 weeks of gestation in women who were diagnosed with SARS-CoV–2 infections was not significantly higher compared to healthy controls (11.8% versus 9.3%, p = 0.35). A further 35 women had household contacts with confirmed SARS-CoV–2 infection although they themselves had not been diagnosed. No miscarriages were reported in this group. Limitations, reasons for caution None of the 68 patients diagnosed with SARS-CoV–2 were hospitalised. We do not know whether the rate of miscarriage among hospitalised women with SARS-CoV–2 infection is the same as those with community infections. Wider implications of the findings: The overall rate of miscarriage during the pandemic was not higher than rates occurring outside of the pandemic. The rate of miscarriage among women diagnosed with SARS-CoV–2 infection was not significantly higher compared to healthy controls. This data can be used to counsel women planning a pregnancy during this pandemic Trial registration number Not applicable

scholarly journals Thyroid disorders in subfertility and early pregnancy

2020 ◽  
Vol 11 ◽  
pp. 204201882094585
Author(s):  
Samantha Anandappa ◽  
Mamta Joshi ◽  
Lukasz Polanski ◽  
Paul V. Carroll
Keyword(s):  
Pregnant Women ◽  
Thyroid Function ◽  
Current Knowledge ◽  
Thyroid Autoimmunity ◽  
Thyroid Disorders ◽  
Thyroid Function Tests ◽  
Increased Risk ◽  
Hormone Use ◽  
Current Knowledge Base ◽  
In Pregnancy

Disorders of thyroid function are common in pregnancy and have implications for foetal and maternal health. Thyroid autoimmunity, as evidenced by the presence of elevated levels of anti-thyroid antibodies (anti-TPO and anti-Tg antibodies) is associated with an increased risk of miscarriage, though the mechanism remains poorly understood. There has been considerable focus on the implications and optimal management of pregnant women with thyroid disease, especially those undergoing assisted reproduction. Pregnancy results in significant changes in thyroid physiology and these need to be understood by clinicians involved in the care of pregnant women. Guidelines for the use of thyroxine and target thyroid function tests have been produced by international bodies but it is recognised that these predominantly reflect expert opinion rather than established evidence-based practice. Importantly a number of key clinical trials have been performed to aid understanding, particularly of the consequences of hypothyroidism for mother and baby, and the effectiveness of thyroid hormone use in autoimmune and subclinical hypothyroidism. This review summarises the current knowledge base and guidance for practice relating to thyroid disorders in pregnancy and subfertility.

scholarly journals Exposure to Tobacco, Environmental Tobacco Smoke and Nicotine in Pregnancy: A Pragmatic Overview of Reviews of Maternal and Child Outcomes, Effectiveness of Interventions and Barriers and Facilitators to Quitting

2020 ◽  
Vol 17 (6) ◽  
pp. 2034 ◽  
Author(s):  
Gillian S. Gould ◽  
Alys Havard ◽  
Ling Li Lim ◽  
Ratika Kumar ◽  
Keyword(s):  
Smoking Cessation ◽  
Health Outcomes ◽  
Pregnant Women ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Systematic Reviews ◽  
Nicotine Replacement ◽  
Increased Risk ◽  
Pertinent Data ◽  
In Pregnancy

The aim of this review of reviews was to collate the latest evidence from systematic reviews about the maternal and child health outcomes of being exposed to tobacco and nicotine during pregnancy; the effectiveness of interventions designed to reduce these exposures, and barriers to and facilitators of smoking cessation during pregnancy. Two databases were searched to obtain systematic reviews published from 2010 to 2019. Pertinent data from 76 articles were summarized using a narrative synthesis (PROSPERO reference: CRD42018085896). Exposure to smoke or tobacco in other forms during pregnancy is associated with an increased risk of obstetric complications and adverse health outcomes for children exposed in-utero. Counselling interventions are modestly effective, while incentive-based interventions appear to substantially increase smoking cessation. Nicotine replacement therapy is effective during pregnancy but the evidence is not conclusive. Predictors and barriers to smoking cessation in pregnancy are also discussed. Smoking during pregnancy poses substantial risk to mother’s and child’s health. Psychosocial interventions and nicotine replacement therapy (NRT) appear to be effective in helping pregnant women quit smoking. Barriers to smoking cessation must be identified and steps taken to eradicate them in order to reduce smoking among pregnant women. More research is needed on smoking cessation medications and e-cigarettes.

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

2021 ◽  
Author(s):  
Rupalakshmi Vijayan ◽  
Hanna Moon ◽  
Jasmine Joseph ◽  
Madiha Zaidi ◽  
Chhaya Kamwal ◽  
...  
Keyword(s):  
Literature Review ◽  
Pregnant Women ◽  
Direct Evidence ◽  
Case Series ◽  
Adverse Outcomes ◽  
Morbidity And Mortality ◽  
World Health ◽  
Increased Risk ◽  
Immunological Changes ◽  
In Pregnancy

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.

scholarly journals Risk factors for illness severity among pregnant women with confirmed SARS-CoV-2 infection - Surveillance for Emerging Threats to Mothers and Babies Network, 20 state, local, and territorial health departments, March 29, 2020 -January 8, 2021

2021 ◽  
Author(s):  
Romeo R Galang ◽  
Suzanne M Newton ◽  
Kate R Woodworth ◽  
Isabel Griffin ◽  
Titilope Oduyebo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Asymptomatic Infection ◽  
Illness Severity ◽  
World Health ◽  
Severe Illness ◽  
Molecular Testing ◽  
Chronic Hypertension ◽  
Adjusted Risk ◽  
Increased Risk

Background: Pregnant women with coronavirus disease 2019 (COVID-19) are at increased risk for severe illness compared with nonpregnant women. Data to assess risk factors for illness severity among pregnant women with COVID-19 are limited. This study aimed to determine risk factors associated with COVID-19 illness severity among pregnant women with SARS-CoV-2 infection. Methods: Pregnant women with SARS-CoV-2 infection confirmed by molecular testing were reported during March 29, 2020-January 8, 2021 through the Surveillance for Emerging Threats to Mothers and Babies Network (SET-NET). Criteria for illness severity (asymptomatic, mild, moderate-to-severe, or critical) were adapted from National Institutes of Health and World Health Organization criteria. Crude and adjusted risk ratios for moderate-to-severe or critical COVID-19 illness were calculated for selected demographic and clinical characteristics. Results: Among 5,963 pregnant women with SARS-CoV-2 infection, moderate-to-severe or critical COVID-19 illness was associated with age 30-39 years, Black/Non-Hispanic race/ethnicity, healthcare occupation, pre-pregnancy obesity, chronic lung disease, chronic hypertension, cardiovascular disease, pregestational diabetes mellitus or gestational diabetes. Risk of moderate-to-severe or critical illness increased with the number of underlying medical or pregnancy-related conditions. Conclusions: Pregnant women with moderate-to-severe or critical COVID-19 illness were more likely to be older and have underlying medical conditions compared to pregnant women with asymptomatic infection or mild COVID-19 illness. This information might help pregnant women understand their risk for moderate-to-severe or critical COVID-19 illness and inform targeted public health messaging.

scholarly journals Hubungan Tekanan Darah Ibu Hamil Aterm Dengan Berat Badan Lahir di RSUP Dr. M. Djamil Padang

2013 ◽  
Vol 2 (2) ◽  
pp. 67
Author(s):  
Feby Andammori ◽  
Nur Indrawaty Lipoeto ◽  
Yusrawati Yusrawati
Keyword(s):  
Blood Pressure ◽  
Pregnant Woman ◽  
Birth Weight ◽  
Pregnant Women ◽  
Medical Record ◽  
Cross Sectional Study ◽  
T Test ◽  
Sectional Study ◽  
Cross Sectional ◽  
In Pregnancy

AbstrakTinggi rendahnya tekanan darah sistolik dan diastolik dalam kehamilan mempunyai pengaruh terhadap berat badan lahir. Penelitian ini bertujuan untuk mengidentifikasi hubungan tekanan darah ibu hamil aterm dengan berat badan lahir di RSUP dr M. Djamil Padang. Metode penelitian : Penelitian yang dilakukan merupakan survei analitik dengan menggunakan studi komparatif dengan design penelitian Cross Sectional Study. Penelitian menggunakan data sekunder yang diambil dari sub bagian Rekam Medik (Medical Record) RSUP dr. M. Djamil Padang bulan Januari 2010 – Desember 2012 dengan jumlah sampel 34 orang ibu hamil yang tidak hipertensi dan 34 orang ibu hamil yang mengalami hipertensi dalam kehamilannya. Hasil penelitian : Ditemukan rata-rata berat badan lahir bayi yang dilahirkan oleh kelompok ibu yang tidak mengalami hipertensi pada kehamilannya adalah 3.408 (SD 307) gram dan rata-rata berat badan lahir bayi yang dilahirkan oleh kelompok ibu yang mengalami hipertensi pada kehamilannya adalah 2.799 (SD 413) gram. Dari hasil uji analisis Independent Sample T-test diperoleh hasil ditemukan adanya hubungan tekanan darah ibu hamil dengan berat badan lahir di RSUP dr. M. Djamil Padang p = 0,00 (p < 0,05). Kesimpulan : Pemeriksaan kehamilan secara teratur penting untuk mengantisipasi adanya peningkatan tekanan darah ibu hamil yang dapat berpengaruh terhadap berat bayi lahir.Kata kunci: tekanan darah, berat badan lahir, ibu hamilAbstractHigh and low level of systolic and diastolic blood pressure in pregnancy has impact to birth weight. This research is purposed to identify the relation between aterm pregnant blood pressure and birth weight.Methods : This research is analytical survey which used comparative study with Cross Sectional Study design. This research used secondary data taken from Medical Record in RSUP dr. M. Djamil Padang since Januari 2010 until December 2012 with number of samples are 34 pregnant women who have not hypertension and 34 pregnant women who have hypertension in pregnancy.The results: Research found that average of birth weight from non-hypertension pregnant woman is about 3,408 (SD 307) gr and average of birth weight from hypertension pregnant woman is about 2,799 (SD 413) gr. The result from Independent sample T-test analysis found that there is a relation between blood pressure in pregnancy with birth weight at RSUP dr. M.Djamil Padang p = 0.00 (p<0.05).Conclusion: Regular antenatal care is important to anticipate an increase in maternal blood pressure can affect birth weight.Keywords: blood pressure, birth weight, pregnant women

scholarly journals Prevalence of asymptomatic Plasmodium falciparuminfection, anaemia and use of ITNs among pregnant women yet to receive IPTp in parts of southern Ghana

2020 ◽  
pp. 36-42
Author(s):  
Leslie L Afutu ◽  
Johnson N Boampong ◽  
Neils B Quashie
Keyword(s):  
Pregnant Women ◽  
Parasite Density ◽  
Intermittent Preventive Treatment ◽  
Malaria In Pregnancy ◽  
Asymptomatic Malaria ◽  
Nested Polymerase Chain Reaction ◽  
Increased Risk ◽  
The Mean ◽  
To Receive ◽  
In Pregnancy

Background: Asymptomatic malaria in pregnancy evades most fever-based surveillance systems yet causes significant morbidities such as anaemia in the pregnant woman and low birth weight in the neonate. Objective:This study determined the prevalence of asymptomatic malaria and its association with anaemia among pregnant women who are yet to receive their first dose of Sulphadoxine-Pyrimethamine (SP) as intermittent preventive treatment of malaria in pregnancy (IPTp). Information on the use of insecticide treated nets(ITNs)as vector control by the pregnant women was also sought. Methods: This is a cross-sectional hospital-based study conducted in the Western Region of Ghana. Pregnant women at gestational ages, 16-26 wkwere included. A structured questionnaire was used to collect vital information from the participants. Plasmodiumparasitaemia was determined by rapid diagnostic test (MRDT), microscopy and species-specific nested polymerase chain reaction (PCR). Anaemia was classified using the level of haemoglobin. Results: A total of 413 antenatal clinic attendants were recruited. Prevalence of asymptomatic Plasmodium falciparuminfection was 13.1% by MRDT, 10.1% by microscopy and 13.8% by PCR. The mean haemoglobin was 10.73g/dL. Prevalence of anaemia was 40.49% and the mean parasite density was 149.6 parasite/μL. Pregnant women with asymptomatic malaria were 4 times more at risk of being anaemic (adjusted odds ratio with 95% confidence interval: 4.42, 1.82 -10.70)than those who did not have malaria. There was statistically significant negative correlation between parasite density and anaemia (r=0.0028, p=0.02). Conclusion: Asymptomatic P. falciparuminfection was found among some of the pregnant women and the presence of the parasites make them 4 times at increased risk of developing anaemia. Anaemia when occurring amongst such women was significantly worsened by increasing parasitaemia.

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