scholarly journals Persistent Fetal SVT in a COVID-19 Positive Pregnancy

2022 ◽  
Vol 2022 ◽  
pp. 1-4
Author(s):  
Gloria Wang ◽  
Eric Stapley ◽  
Sara Peterson ◽  
Jessica Parrott ◽  
Cecily Clark-Ganheart
Keyword(s):  
Vaginal Delivery ◽  
Vertical Transmission ◽  
Gestational Age ◽  
Induction Of Labor ◽  
Potential Complication ◽  
Third Trimester ◽  
Transplacental Therapy ◽  
New Onset

Background. Rapid introduction and spread of SARS-CoV-2 have posed unique challenges in understanding the disease, role in vertical transmission, and in developing management. We present a case of a patient with COVID-19 infection and fetus with new-onset fetal SVT. Case. A 26-year-old gravida 4 para 2012 with third trimester COVID-19 infection was diagnosed with new onset fetal SVT. Successful cardioversion was achieved with flecainide. The patient was followed outpatient until induction of labor at 39 and 3/7 weeks of gestational age resulting in an uncomplicated vaginal delivery. Postpartum course was uncomplicated. Conclusion. Fetal SVT is a potential complication of maternal COVID-19 infection. The use of transplacental therapy with flecainide is an appropriate alternative to digoxin in these cases.

scholarly journals Analysis of Factors Associated With Variability and Acidosis of the Umbilical Artery pH at Birth

2021 ◽  
Vol 9 ◽  
Author(s):  
María Luisa Mayol Pérez ◽  
José Manuel Hernández Garre ◽  
Paloma Echevarría Pérez
Keyword(s):  
Vaginal Delivery ◽  
Gestational Age ◽  
Umbilical Artery ◽  
Perinatal Asphyxia ◽  
Total Duration ◽  
Induction Of Labor ◽  
Induced Labor ◽  
Factors Associated ◽  
Labor Duration ◽  
Total Labor

Background: Perinatal asphyxia is a significant contributing factor for neonatal morbidity and mortality. The aim of this study was to investigate the clinical factors associated with umbilical artery pH variability and fetal acidosis at birth.Methods: This is a single center cross-sectional study in a public regional hospital in southeastern Spain from January to December 2019. The reference population was 1.655 newborns, final sample of 312 experimental units with validated values of umbilical cord blood pH.Results: Factors such as gestational age at term (X̄at-term: 7.26 ± 0.08-X̄no-at−term: 7.31 ± 0.05, p: 0.00), primiparity (X̄primiparity: 7.24 ± 0.078-X̄multiparity: 7.27 ± 0.08, p: 0.01), induced labor (X̄induced: 7.24 ± 0.07-X̄spontaneous: 7.26 ± 0.081, p: 0.02), vaginal delivery (X̄vaginal:7.25 ± 0.08-X̄cesarean:7.27 ± 0.07, p: 0.01), and prolonged dilation duration (X̄AboveAverage: 7.22 ± 0.07-X̄BelowAverage: 7.27 ± 0.08, p: 0.00), expulsion duration (X̄AboveAverage: 7.23 ± 0.07-X̄BelowAverage: 7.26 ± 0.08, p: 0.01), and total labor duration (X̄AboveAverage: 7.23 ± 0.07-X̄BelowAverage: 7.27 ± 0.08, p: 0.00) are associated with a decrease in umbilical artery pH at birth. However, only three factors are associated with acidosis pH (<7.20) of the umbilical artery at birth: the induction of labor [OR: 1.74 (95% CI: 0.98–3.10); p: 0.04], vaginal delivery [OR: 2.09 (95% CI: 0.95–4.61); p: 0.04], and total duration of labor [OR: 2.06 (95% CI: 1.18–3.57); p: 0.01].Conclusions: Although several factors may affect the variability of umbilical artery pH at birth by decreasing their mean values (gestational age, primiparity, induced labor, vaginal delivery and prolonged: dilation duration, expulsion duration and total labor duration), only induction of labor, vaginal delivery and total duration of labor are associated with an acidosis (<7.20) of same.

Factors Predicting Successful Vaginal Delivery Following Induction of Labor in Term Pregnancy v1

2021 ◽  
Author(s):  
Wirada Hansahiranwadee ◽  
Threebhorn Kamlungkuea ◽  
Jittima Manonai Bartlett
Keyword(s):  
Prediction Model ◽  
Vaginal Delivery ◽  
Gestational Age ◽  
Labor Induction ◽  
Induction Of Labor ◽  
Fetal Weight ◽  
Term Pregnancy ◽  
Individual Probability ◽  
History Of ◽  
Estimated Fetal Weight

Objective This study was proposed to evaluatefactors predicting successful vaginal delivery following labor induction and develop induction prediction model in term pregnancy among Thai pregnant women. Method We conducted a retrospective cohort study using electronic medical recordsof 23,833 deliveries from April 2010 - July 2021 at tertiary-level hospital in Bangkok, Thailand. Univariate regression was performed to identify association of individual parameters to successful vaginal delivery. Multiple logistic regression analysis of all possible variables from univariate analysis was performed to develop prediction model with statistically significant of p value < 0.05. Results Of thetotal 809 labor-induced pregnancies, the vaginal delivery rate was 56.6%. Among predicting variables, history of previous vaginal delivery (aOR 5.75, 95%CI3.701-8.961), maternal delivery BMI < 25 kg/m2 (aOR 2.010, 95%CI1.303-3.286), estimated fetal weight < 3500 g (aOR 2.193, 95%CI1.246-3.860), and gestational age ≤ 39 weeks (aOR 1.501, 95%CI1.038-2.173) significantly increased the probability of successful vaginal delivery following labor induction. The final prediction model has been internally validated. Model calibration and discrimination were satisfactory with Hosmer-Lemeshow test P= 0.21 and with AUC of 0.732 (95% CI 0.692-0.772). Conclusions This study determined the pragmatic predictors for successful vaginal delivery following labor induction comprised of history of previous vaginal delivery, maternal delivery BMI < 25 kg/m2, estimated fetal weight < 3500 g, and gestational age ≤ 39 weeks. The final induction prediction model was well-performing internally validated prediction model to estimate individual probability when undergoing induction of labor. Despite of restricted population, the predicting factors and model could be useful for further prospective study and clinical practice to improve induction outcomes.

scholarly journals Vaginal delivery in women with COVID-19: report of two cases

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Dongmei Cao ◽  
Miaomiao Chen ◽  
Min Peng ◽  
Heng Yin ◽  
Guoqiang Sun
Keyword(s):  
Pregnant Woman ◽  
Vaginal Delivery ◽  
Vertical Transmission ◽  
Gestational Age ◽  
Late Pregnancy ◽  
Neonatal Infection ◽  
Chest Ct ◽  
Nasopharyngeal Swab ◽  
Telephone Interviews ◽  
Abnormal Chest

Abstract Background During the ongoing global outbreak of COVID-19, pregnant women who are susceptible to COVID-19 should be highly concerned. The issue of vertical transmission and the possibility of neonatal infection is a major concern. Case presentation Case 1: A 35-year-old pregnant woman with a gestational age of 37 weeks and 6 days was admitted to our hospital at the point of giving birth. Except for the abnormalities in her chest CT image, she was asymptomatic. She had an uncomplicated spontaneous vaginal delivery, and her infant was discharged home for isolation. Because of the positive result of the maternal swabs for SARS-CoV-2 obtained on the 2nd day after sampling, we transferred the mother to the designated hospital and followed up with her by telephone interviews. Luckily, it was confirmed on February 23 that the newborn did not develop any COVID-19 symptoms after observation for 14 days after birth. Case 2: Another pregnant woman, with a gestational age of 38 weeks and 2 days, was also admitted to our hospital because of spontaneous labor with cervical dilation of 5 cm. Since she had the typical manifestations of COVID-19, including cough, lymphopenia, and abnormal chest CT images, she was highly suspected of having COVID-19. Based on the experience from case 1, we helped the mother deliver a healthy baby by vaginal delivery. On the 2nd day after delivery, the maternal nasopharyngeal swab result was positive, while the infant’s result was negative. Conclusion There is still insufficient evidence supporting maternal-fetal vertical transmission for COVID-19-infected mothers in late pregnancy, and vaginal delivery may not increase the possibility of neonatal infection.

Comparative assessment of informational content of the equations of F.P. Hadlock and the computer program of V.N. Demidov in determination of term of gestation and fetal weight in the III trimester of gestation

2017 ◽  
Author(s):  
E.A. Derkach , O.I. Guseva
Keyword(s):  
Computer Program ◽  
High Precision ◽  
Gestational Age ◽  
Computer Programs ◽  
Comparative Assessment ◽  
Fetal Weight ◽  
Informational Content ◽  
Third Trimester ◽  
The Third

Objectives: to compare the accuracy of equations F.P. Hadlock and computer programs by V.N. Demidov in determining gestational age and fetal weight in the third trimester of gestation. Materials: 328 patients in terms 36–42 weeks of gestation are examined. Ultrasonography was performed in 0–5 days prior to childbirth. Results: it is established that the average mistake in determination of term of pregnancy when using the equation of F.P. Hadlock made 12,5 days, the computer program of V.N. Demidov – 4,4 days (distinction 2,8 times). The mistake within 4 days, when using the equation of F.P. Hadlock has met on average in 23,1 % of observations, the computer program of V.N. Demidov — 65,9 % (difference in 2,9 times). The mistake more than 10 days, took place respectively in 51,7 and 8,2 % (distinction by 6,3 times). At a comparative assessment of size of a mistake in determination of fetal mass it is established that when using the equation of F.P. Hadlock it has averaged 281,0 g, at application of the computer program of V.N. Demidov — 182,5 g (distinction of 54 %). The small mistake in the mass of a fetus which isn't exceeding 200 g at application of the equation of F.P. Hadlock has met in 48,1 % of cases and the computer program of V.N. Demidov — 64,0 % (distinction of 33,1 %). The mistake exceeding 500 g has been stated in 18 % (F.P. Hadlock) and 4,3 % (V.N. Demidov) respectively (distinction 4,2 times). Conclusions: the computer program of V.N. Demidov has high precision in determination of term of a gestation and mass of a fetus in the III pregnancy.

The sFlt-1 to PlGF Ratio in Pregnant Women with Rheumatoid Arthritis: Impact of Disease Activity and Sulfasalazine Use

Rheumatology ◽  
2021 ◽  
Author(s):  
Rugina I Neuman ◽  
Hieronymus T W Smeele ◽  
A H Jan Danser ◽  
Radboud J E M Dolhain ◽  
Willy Visser
Keyword(s):  
Rheumatoid Arthritis ◽  
Cohort Study ◽  
Disease Activity ◽  
Pregnant Women ◽  
Gestational Age ◽  
Third Trimester ◽  
Low Disease Activity ◽  
The Third ◽  
Observational Prospective Cohort Study ◽  
Plgf Ratio

Abstract Objectives An elevated sFlt-1/PlGF-ratio has been validated as a significant predictor of preeclampsia, but has not been established in women with rheumatoid arthritis (RA). We explored whether the sFlt-1/PlGF-ratio could be altered due to disease activity in RA, and could be applied in this population to predict preeclampsia. Since sulfasalazine has been suggested to improve the angiogenic imbalance in preeclampsia, we also aimed to examine whether sulfasalazine could affect sFlt-1 or PlGF levels. Methods Making use of a nationwide, observational, prospective cohort study on pregnant women with RA, sFlt-1 and PlGF were measured in the third trimester. A total of 221 women, aged 21–42 years, were included, with a median gestational age of 30 + 3 weeks. Results No differences in sFlt-1 or PlGF were observed between women with high, intermediate or low disease activity (p= 0.07 and p= 0.41), whereas sFlt-1 and PlGF did not correlate with DAS28-CRP score (r=-0.01 and r=-0.05, respectively). Four (2%) women with a sFlt-1/PlGF-ratio ≤38 developed preeclampsia in comparison to three (43%) women with a ratio &gt; 38, corresponding to a negative predictive value of 98.1%. Sulfasalazine users (n = 57) did not show altered levels of sFlt-1 or PlGF in comparison to non-sulfasalazine users (n = 164, p= 0.91 and p= 0.11). Conclusion Our study shows that in pregnant women with RA, the sFlt-1/PlGF-ratio is not altered due to disease activity and a cut-off ≤38 can be used to exclude preeclampsia. Additionally, sulfasalazine use did not affect sFlt-1 or PlGF levels in this population.

Predicting Perinatal Outcome from Prenatal Ultrasound Characteristics in Pregnancies Complicated by Gastroschisis

2015 ◽  
Vol 39 (4) ◽  
pp. 279-286 ◽  
Author(s):  
Gabriella Martillotti ◽  
Isabelle Boucoiran ◽  
Amélie Damphousse ◽  
Andrée Grignon ◽  
Eric Dubé ◽  
...  
Keyword(s):  
Gestational Age ◽  
Predictive Value ◽  
Intrauterine Growth Restriction ◽  
Adverse Outcome ◽  
Prenatal Ultrasound ◽  
Intestinal Lumen ◽  
Third Trimester ◽  
Mesenteric Circulation ◽  
Intrauterine Growth ◽  
Bowel Dilatation

Introduction: The objective of the study was to establish the predictive value of prenatal ultrasound markers for complex gastroschisis (GS) in the first 10 days of life. Material and Methods: In this retrospective cohort study over 11 years (2000-2011) of 117 GS cases, the following prenatal ultrasound signs were analyzed at the last second- and third-trimester ultrasounds: intrauterine growth restriction, intra-abdominal bowel dilatation (IABD) adjusted for gestational age, extra-abdominal bowel dilatation (EABD) ≥25 mm, stomach dilatation, stomach herniation, perturbed mesenteric circulation, absence of bowel lumen and echogenic dilated bowel loops (EDBL). Results: Among 114 live births, 16 newborns had complex GS (14.0%). Death was seen in 16 cases (13.7%): 3 intrauterine fetal deaths, 9 complex GS and 4 simple GS. Second-trimester markers had limited predictive value. Third-trimester IABD, EABD, EDBL, absence of intestinal lumen and perturbed mesenteric circulation were statistically associated with complex GS and death. IABD was able to predict complex GS with a sensitivity of 50%, a specificity of 91%, a positive predictive value of 47% and a negative predictive value of 92%. Discussion: Third-trimester IABD adjusted for gestational age appears to be the prenatal ultrasound marker most strongly associated with adverse outcome in GS.

scholarly journals Expectant Management Leading to Successful Vaginal Delivery following Intrauterine Fetal Death in a Woman with an Incarcerated Uterus

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Masafumi Yamamoto ◽  
Mio Takami ◽  
Ryosuke Shindo ◽  
Michi Kasai ◽  
Shigeru Aoki
Keyword(s):  
Vaginal Delivery ◽  
Fetal Death ◽  
Expectant Management ◽  
Intrauterine Fetal Death ◽  
Third Trimester ◽  
Spontaneous Reduction

Expectant management leads to successful vaginal delivery following intrauterine fetal death in a woman with an incarcerated uterus. Management of intrauterine fetal death in the second or third trimester of pregnancy in women with an incarcerated uterus is challenging. We report a case of successful vaginal delivery following intrauterine fetal death by expectant management in a woman with an incarcerated uterus. In cases of intrauterine fetal death in women with an incarcerated uterus, vaginal delivery may be possible if the incarceration is successfully reduced. If the reduction is impossible, expectant management can reduce uterine retroversion, thereby leading to spontaneous reduction of the incarcerated uterus. Thereafter, vaginal delivery may be possible.

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