Pregnancy outcomes in women receiving eculizumab for the management of paroxysmal nocturnal haemoglobinuria

Aims To report pregnancy outcomes and complications in women receiving eculizumab for the management of paroxysmal nocturnal haemoglobinuria. Methods A service evaluation of routinely collected medical records across 49 pregnancies in 21 women. Results Eculizumab was used in 37 pregnancies, 31 of which (83.8%) ended in live birth. Eight infants (25.8%) were born prematurely. Over half (54%) of women required increases in their dose of eculizumab to control their haemolysis. There were no reported cases of maternal thrombosis. Major ante/postpartum bleeding necessitating urgent intervention was reported in 10.8% of pregnancies. There were two cases of intrauterine death and three miscarriages. There were no maternal or neonatal deaths. Three newborns required prolonged hospital stays. Conclusions Eculizumab appears to benefit pregnant women with paroxysmal nocturnal haemoglobinuria and pregnancy outcomes following its use are largely good.

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Pregnancy and Breastfeeding During COVID-19 Pandemic: A Systematic Review of Published Pregnancy Cases

Frontiers in Public Health ◽

10.3389/fpubh.2020.558144 ◽

2020 ◽

Vol 8 ◽

Author(s):

Carina Rodrigues ◽

Inês Baía ◽

Rosa Domingues ◽

Henrique Barros

Keyword(s):

Systematic Review ◽

Adverse Effects ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Web Of Science ◽

Study Quality ◽

Neonatal Deaths ◽

Live Births ◽

Milk Samples ◽

The Impact

Background: The COVID-19 pandemic is an emerging concern regarding the potential adverse effects during pregnancy. This study reviews knowledge on the impact of COVID-19 on pregnancy and describes the outcome of published cases of pregnant women diagnosed with COVID-19.Methods: Searches were conducted in PubMed®, Scopus®, Web of Science®, and MedRxiv® up to 26th June 2020, using PRISMA standards, to identify original published studies describing pregnant women at any gestational age diagnosed COVID-19. There were no date or language restrictions on the search. All identified studies were included irrespective of assumptions on study quality.Results: We identified 161 original studies reporting 3,985 cases of pregnant women with COVID-19 (1,007 discharged while pregnant). The 2,059 published cases with pregnancy outcomes resulted in 42 abortions, 21 stillbirths, and 2,015 live births. Preterm birth occurred in 23% of cases. Around 6% of pregnant women required admission to an intensive care unit and 28 died. There were 10 neonatal deaths. From the 163 cases with amniotic fluid, placenta, and/or cord blood analyzed for the SARS-CoV-2 virus, 10 were positive. Sixty-one newborns were positive for SARS-CoV-2. Four breast milk samples from 92 cases showed evidence of SARS-CoV-2.Conclusion: Emerging evidence suggests that vertical transmission is possible, however, there is still a limited number of reported cases with intrapartum samples. Information, counseling and adequate monitoring are essential to prevent and manage adverse effects of SARS-CoV-2 infection during pregnancy.

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COVID-19 Quarantine is a Risk Factor for Poor Pregnancy Outcomes in GDM Patients: A Retrospective Study

10.21203/rs.3.rs-836921/v1 ◽

2021 ◽

Author(s):

Qin-Yu Cai ◽

Yin Yang ◽

Ling-Ling Ruan ◽

Dang-Dang Wang ◽

Han-Lin Cui ◽

...

Keyword(s):

Pregnant Women ◽

Electronic Medical Records ◽

Pregnancy Outcomes ◽

Medical Records ◽

Control Group ◽

Second Trimester ◽

Public Health Emergencies ◽

Nuchal Cord ◽

Adverse Pregnancy ◽

Glucose Management

Abstract Aims: This study was to evaluate the effects of the home quarantine on pregnancy outcomes of gestational diabetes mellitus (GDM) patients during the COVID-19 outbreak.Methods: Thecomplete electronic medical records of GDM patients with home quarantine history were collected and classified into the home quarantine group from 24 February 2020 to 24 November 2020. The same period of GDM patients without home quarantine historywas included in the control group from 2018 and 2019.Results: A total of 1358 GDM patients were included in the analysis, including 484 in 2018, 468 in 2019, and 406 in 2020. GDM patients with home quarantine in 2020 had higher glycemic levels and worse pregnancy outcomes than 2018 and 2019, including higher cesarean section rate,lower Apgar scores, and higher incidence of macrosomia and nuchal cord. More importantly, the second trimester of home quarantine had brought a broader impactto pregnant women and fetuses.Conclusion: Home quarantine has aggravated the condition of GDM pregnant women and brought more adverse pregnancy outcomes during the COVID-19 outbreak. Therefore, we suggested that governments and hospitals should strengthen lifestyle guidance, glucose management, and antenatal care for GDM patients with home quarantine during public health emergencies.

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THE STATE OF THE HEPATOBILIARY SYSTEM IN PREGNANT WOMEN WHO RECEIVED PROGESTERONE THERAPY

V F Snegirev Archives of Obstetrics and Gynecology ◽

10.18821/2313-8726-2019-6-4-203-208 ◽

2019 ◽

Vol 6 (4) ◽

pp. 203-208

Author(s):

Delyara R. Novruzova ◽

E. A Sosnova ◽

L. V Tumbinskaya ◽

E. V Kirakosyan

Keyword(s):

Pregnant Women ◽

Pregnancy Outcomes ◽

Medical Records ◽

Biochemical Parameters ◽

Obstetrics And Gynecology ◽

Control Groups ◽

Hepatobiliary System ◽

Exogenous Progesterone ◽

A Prospective Study ◽

And Control

Introduction. One of the most common drugs for maintaining pregnancy is exogenous progesterone. With the expansion of the indications for its use during pregnancy, the number of complications associated with it may increase. Material and methods. The article presents the results of a prospective study of medical records of pregnant women, which were observed in the V.F. Snegirev Obstetrics and Gynecology Clinic in 2017 and received exogenous progesterone therapy. Results. The dynamics of changes in the studied biochemical parameters was multidirectional in the main and control groups. According to pregnancy outcomes, statistically significant differences between the groups were not found. Conclusions. Critical abnormalities of the main biochemical parameters in pregnant women of the main group were not detected. Preparations of the gestagen series in appropriate dosages do not significantly affect the main indicators of the hepatobiliary system and pregnancy outcomes, so their use is permissible under the control of laboratory parameters.

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Prenatal Fine Particulate Matter (PM2.5) Exposure and Pregnancy Outcomes—Analysis of Term Pregnancies in Poland

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17165820 ◽

2020 ◽

Vol 17 (16) ◽

pp. 5820

Author(s):

Cezary Wojtyla ◽

Karolina Zielinska ◽

Paulina Wojtyla-Buciora ◽

Grzegorz Panek

Keyword(s):

Air Pollution ◽

Particulate Matter ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Medical Records ◽

Low Birthweight ◽

Fine Particulate Matter ◽

Outcomes Analysis ◽

Fine Particulate ◽

Pm2.5 Exposure

Air pollution is currently one of the greatest threats to global health. Polish cities are among the most heavily polluted in Europe. Due to air pollution 43,100 people die prematurely in Poland every year. However, these data do not take into account the health consequences of air pollution for unborn children. Thus, the aim of this study was to evaluate the effects of the fine particulate matter air pollution (less than 2.5 μm in diameter) on pregnancy outcomes. An analysis of pregnant women and their children was made using a questionnaire survey from a nationwide study conducted in 2017. Questionnaires from 1095 pregnant women and data from their medical records were collected. An analysis of air pollution in Poland was conducted using the air quality database maintained by the Chief Inspectorate for Environmental Protection in Poland. A higher concentration of PM2.5 was associated with a decrease in birth weight and a higher risk of low birthweight (i.e., <2500 g). We also observed lower APGAR scores. Thus, all possible efforts to reduce air pollution are critically needed.

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Covid-19 and pregnancy: the experience of a tertiary maternity hospital

Journal of Perinatal Medicine ◽

10.1515/jpm-2021-0070 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Panagiotis Antsaklis ◽

Konstantinos Tasias ◽

Alexandros Psarris ◽

Marianna Theodora ◽

George Daskalakis ◽

...

Keyword(s):

Pregnant Women ◽

Medical Records ◽

Clinical Status ◽

Maternity Hospital ◽

Neonatal Outcomes ◽

Nasopharyngeal Swab ◽

Rt Pcr ◽

Neonatal Deaths ◽

Maternal And Neonatal Outcomes ◽

Polymerase Chain

Abstract Objectives The aim of our study is to present the effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in pregnancy and evaluate its impact on maternal and neonatal outcomes. Methods We retrospectively reviewed the medical records of all COVID-19 positive pregnant women who were admitted to “Alexandra” maternity hospital from March to December 2020 (n=40). The infection status was determined via real-time polymerase chain reaction (RT-PCR) of nasopharyngeal swab specimen. We documented the demographic features, clinical status, pregnancy characteristics and maternal and fetal outcomes. Results Forty COVID-19 positive pregnant women were admitted to our clinic during the study period. Mean maternal age was 27.6 years. Gestational age (GA) ranged from 10–42 weeks of pregnancy with mean GA calculated at 38+3 weeks. Associated comorbidities included hypertension, hypothyroidism, epilepsy, hepatitis B and asthma. Thirty-five out of 40 women delivered within the study period. Cesarean section was performed in 57.1% of the cases. Most of the cases (87.5%) were asymptomatic while ventilation was required for only one patient. All neonates tested negative for SARS-CoV-2. Neither maternal nor neonatal deaths occurred. Conclusions In alignment to other studies, our data show that the course of coronavirus disease 2019 (COVID-19) during pregnancy in the majority of cases is mild and neonatal outcomes also appear favorable.

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Pregnancy outcomes, Newborn complications and Maternal-Fetal Transmission of SARS-CoV-2 in women with COVID-19: A systematic review of 441 cases

10.1101/2020.04.11.20062356 ◽

2020 ◽

Cited By ~ 10

Author(s):

Rahul K Gajbhiye ◽

Deepak N Modi ◽

Smita D Mahale

Keyword(s):

Systematic Review ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Distress Syndrome ◽

Neonatal Deaths ◽

Hypertensive Disorders ◽

Still Births ◽

Maternal Fetal Transmission

ABSTRACTObjectiveThe aim of this systematic review was to examine the maternal and fetal outcomes in pregnant women with COVID-19 and also assess the incidence of maternal-fetal transmission of SARS CO-V-2 infection.Data sourcesWe searched PUMBED. Medline, Embase, MedRxiv and bioRxiv databases upto 3rd May 2020 utilizing combinations of word variants for “coronavirus” or “COVID-19” or “severe acute respiratory syndrome” or “SARS-COV-2” and “pregnancy”. We also included data from preprint articles.Study eligibility criteriaOriginal case reports and case series on pregnant women with diagnosis of SARS-CoV-2 infection.Study appraisal and synthesis methodsWe included 50 studies reporting the information on 441 pregnant women and 391 neonates. The primary outcome measures were maternal health characteristics and adverse pregnancy outcomes, neonatal outcomes and SARS-CoV-2 infection in neonates was extracted. Treatments given to pregnant women with COVID-19 were also recorded.ResultsOut of 441 women affected by COVID-19 in pregnancy, 387 women have delivered. There are nine maternal deaths reported. In pregnant women with COVID-19, the most common symptoms were fever (56%), cough (43%), myalgia (19%), dyspnea (18%) and diarrhea (6%). Pneumonia was diagnosed by CT scan imaging in 96 % of COVID-19 pregnant women. Pregnancy complications included delivery by cesarean section (80%), preterm labor (26%), fetal distress (8%) and premature rupture of membranes (9%). Six still births (2%) are reported. The most common co-morbidities associated with pregnant women with COVID-19 were hypertensive disorders (10%), diabetes (9%), placental disorders (2%), co-infections (3%), scarred uterus (3%) and hypothyroidism (3%). Amongst the neonates of COVID-19 mothers, preterm birth (25%), respiratory distress syndrome (8%), pneumonia (8%) were reported. There were four neonatal deaths reported. Vertical transmission rate of SARS-CoV-2 is estimated to be 8%.ConclusionIn pregnant women with COVID-19, hypertensive disorders and diabetes are common comorbidities and there is a risk of preterm delivery and maternal death. Amongst the neonates born to mothers with COVID-19, respiratory distress syndrome and pneumonia are common occurrence. There are reports of still births and neonatal deaths. There is an evidence of vertical transmission of SARS-CoV-2 infection in women with COVID-19.

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Pregnancy Outcomes in HIV-Infected Women Receiving Long-Term Isoniazid Prophylaxis for Tuberculosis and Antiretroviral Therapy

Infectious Diseases in Obstetrics and Gynecology ◽

10.1155/2013/195637 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 17

Author(s):

Allan W. Taylor ◽

Barudi Mosimaneotsile ◽

Unami Mathebula ◽

Anikie Mathoma ◽

Ritah Moathlodi ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Adverse Pregnancy Outcome ◽

Antiretroviral Drugs ◽

Neonatal Deaths ◽

Adverse Pregnancy ◽

Record Review ◽

Isoniazid Prophylaxis

Objective. While 6- to 12-month courses of isoniazid for tuberculosis prevention are considered safe in pregnant women, the effects of longer-term isoniazid prophylaxis or isoniazid in combination with antiretroviral therapy (ART) are not established in human-immunodeficiency-virus-(HIV-) infected women who experience pregnancy during the course of therapy.Design.Nested study of pregnancy outcomes among HIV-infected women participating in a placebo-controlled, TB-prevention trial using 36 months daily isoniazid. Pregnancy outcomes were collected by interview and record review.Results. Among 196 pregnant women, 103 (52.6%) were exposed to isoniazid during pregnancy; all were exposed to antiretroviral drugs. Prior to pregnancy they had received a median of 341 days (range 1–1095) of isoniazid. We observed no isoniazid-associated hepatitis or other severe isoniazid-associated adverse events in the 103 women. Pregnancy outcomes were 132 term live births, 42 premature births, 11 stillbirths, 8 low birth weight, 6 spontaneous abortions, 4 neonatal deaths, and 1 congenital abnormality. In a multivariable model, neither isoniazid nor ART exposure during pregnancy was significantly associated with adverse pregnancy outcome (adjusted odds ratios 0.6, 95% CI: 0.3–1.1 and 1.8, 95% CI 0.9–3.6, resp.).Conclusions. Long-term isoniazid prophylaxis was not associated with adverse pregnancy outcomes, such as preterm delivery, even in the context of ART exposure.

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1374-P: Association between Number of Abnormal Glucose Values and Severity of Fasting Plasma Glucose in IADPSG Criteria and Pregnancy Outcomes in Pregnant Women in South India

Diabetes ◽

10.2337/db20-1374-p ◽

2020 ◽

Vol 69 (Supplement 1) ◽

pp. 1374-P

Author(s):

BHAVADHARINI BALAJI ◽

RANJIT MOHAN ANJANA ◽

MOHAN DEEPA ◽

PRADEEPA RAJENDRA ◽

UMA RAM ◽

...

Keyword(s):

Pregnant Women ◽

Plasma Glucose ◽

Fasting Plasma Glucose ◽

Pregnancy Outcomes ◽

South India ◽

Fasting Plasma ◽

Iadpsg Criteria

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A study on the design of a wardrobe, for patients bed-ridden with cancer, applying the knowledge of anonymous design

Impact ◽

10.21820/23987073.2020.7.45 ◽

2020 ◽

Vol 2020 (7) ◽

pp. 45-47

Author(s):

Naoko Fujii

Keyword(s):

Hospital Stay ◽

Nursing Care ◽

Healthcare Professionals ◽

The Other ◽

Human Beings ◽

Prolonged Hospital Stay ◽

Hospital Patients ◽

Hospital Gowns ◽

Hospital Stays ◽

Prolonged Hospital

The majority of human beings will be admitted to hospital at some point over the course of their lives. For the more fortunate among us, these hospital stays will be brief and will barely register as a significant experience. However, for others, being admitted for weeks or months at a time will be necessary in order to combat and recover from whatever it was that made admittance to hospital necessary. While it is easy to think of many reasons why a prolonged hospital stay might be undesirable, one that may escape our attention is the clothes that are worn by patients during their stay. Once a patient has been assigned a bed, they are often given a gown which they put on without thought and then lie down. The gowns that are given to patients are generally designed with healthcare professionals in mind. For example, in Japan pyjamas and yukata (bathrobes) are used as hospital gowns because they have a front opening that is easy to use during treatment and nursing care. In addition, the other gowns can be opened from the ankle to the crotch using the zip. Dr Naoko Fujii has focused her career on designing clothes for hospital patients and believes that there is a way to satisfy the practical needs of a hospital and the care it gives at the same time as satisfying the requirements of patients. She is now focusing her attention on this challenge.

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