scholarly journals Samba II PCR testing for COVID-19 in pregnant women: a retrospective cohort study and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ruiling Xu ◽  
Tara Alicia Pauley ◽  
Hannah Missfelder-Lobos ◽  
Richard John Haddon ◽  
Ravindra Kumar Gupta ◽  
...  
Keyword(s):  
Cohort Study ◽  
Literature Review ◽  
Pregnant Women ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Turnaround Time ◽  
Maternity Unit ◽  
Asymptomatic Carriage ◽  
Positive Rate ◽  
The Impact

Abstract Background Asymptomatic carriage of COVID-19 in pregnant women has been reported and could lead to outbreaks in maternity units. We sought to ascertain the impact of rapid isothernal nucleic acid based testing for COVID-19 in an unselected cohort of pregnant women attending our maternity unit. We also assessed the correlation between community prevalence and asymptomatic carriage. Methods Data for the retrospective cohort study were collected from a large UK tertiary maternity unit over a 4-week period using computerised hospital records. Literature searches were performed across multiple repositories. COVID-19 prevalence was extracted from online repositories. Results Nasopharyngeal and oropharyngeal swabs were obtained from 457/465 (98%) women during the study period. The median turnaround time for results was 5.3 h (interquartile range (IQR) 2.6–8.9 h), with 92% of the results returned within 24 h. In our cohort, only one woman tested positive, giving a screen positive rate of 0.22% (1/457; 95% CI: 0.04–1.23%). One woman who tested negative developed a fever postnatally following discharge but was lost to follow-up. From our literature review, we did not find any correlation between asymptomatic carriage in pregnant women and the reported regional prevalence of COVID-19. Conclusions Testing using the SAMBA-II machine was acceptable to the vast majority of pregnant women requiring admission and had a low turnaround time. Asymptomatic carriage is low, but not correlated to community prevalence rates. Screening pregnant women on admission will remain an important component in order to minimise nosocomial infection.

scholarly journals Samba II PCR testing for COVID-19 in an unselected cohort of pregnant women in the UK

2020 ◽  
Author(s):  
Ruiling Xu ◽  
Tara Alicia Pauley ◽  
Hannah Missfelder-Lobos ◽  
Richard John Haddon ◽  
Ravindra Kumar Gupta ◽  
...  
Keyword(s):  
Literature Review ◽  
Pregnant Women ◽  
Cohort Analysis ◽  
Tertiary Hospital ◽  
Turnaround Time ◽  
Maternity Unit ◽  
Asymptomatic Carriage ◽  
The Uk ◽  
The Impact ◽  
Unselected Cohort

Abstract OBJECTIVE: Asymptomatic carriage of COVID-19 in pregnant women has been reported and could lead to outbreaks in maternity units. We sought to ascertain the impact of rapid isothernal nucleic acid based testing for COVID-19 in an unselected cohort of pregnant women attending our maternity unit. We also assessed the correlation between community prevalence and asymptomatic carriage.DESIGN: Retrospective cohort analysis and literature reviewSETTING: Tertiary hospital in Cambridge, UKPOPULATION: Pregnant women (with gestation age between 12-42 weeks) admitted to a single maternity unit over a 4-week period (07/05/2020-06/06/2020) METHODS: Data were collected using computerised hospital records. Literature searches were performed across multiple repositories. COVID-19 prevalence was extracted from online repositories.RESULTS: NP and OP swabs were obtained from 457/465 women during the study period (98%). The median turnaround time for results was 5.3 hours (interquartile range (IQR) 2.6-8.9 hours). 92% of results were returned within 24 hours. In our cohort, only one woman tested positive, giving a screen positive rate of 0.22% (1/457; 95% confidence interval: 0.04-1.23%). One woman who tested negative developed a fever postnatally following discharge but was lost to follow-up. From our literature review, we did not find any correlation between asymptomatic carriage in pregnant women and the reported regional prevalence of COVID-19. CONCLUSIONS: Testing using the SAMBA-II machine was acceptable to the vast majority of pregnant women requiring admission and had a low turnaround time. Asymptomatic carriage is low, but not correlated to community prevalence rates. Screening pregnant women on admission will remain an important component in order to minimise nosocomial infection.

scholarly journals The impact of levothyroxine exposure on delivery outcome in hypothyroid pregnant women (PETAL study): A five-year retrospective cohort study

2021 ◽  
pp. 1753495X2110641
Author(s):  
Diana Oprea ◽  
Nadine Sauvé ◽  
Jean-Charles Pasquier
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Caesarean Delivery ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Singleton Pregnancy ◽  
Delivery Outcome ◽  
The Impact

Background Hypothyroidism affects 3% of pregnant women, and to date, no studies have addressed the impact levothyroxine-treated hypothyroidism on delivery outcome. Methods This retrospective cohort study was conducted among 750 women with a singleton pregnancy who gave birth between 2015 and 2019. Delivery modes were compared between 250 hypothyroid women exposed to levothyroxine and 500 euthyroid control women. The aim of this study was to determine the impact of levothyroxine exposure on delivery outcome. Results Multiple logistic regression showed no significant association between exposure to levothyroxine and the overall rate of caesarean delivery (aOR 1.1; 95% CI 0.8 to 1.6). Mean TSH concentrations were significantly higher throughout the pregnancy in hypothyroid women despite levothyroxine treatment. Maternal and neonatal outcomes in both groups were not different. Conclusion Hypothyroidism treated with levothyroxine during pregnancy according to local guidelines is not a significant risk factor for caesarean delivery.

scholarly journals Impact of treatment for bacterial vaginosis on prematurity among Brazilian pregnant women: a retrospective cohort study

2005 ◽  
Vol 123 (3) ◽  
pp. 108-112 ◽  
Author(s):  
Rodrigo Pauperio Soares de Camargo ◽  
José Antonio Simões ◽  
José Guilherme Cecatti ◽  
Valéria Moraes Nader Alves ◽  
Sebastian Faro
Keyword(s):  
Cohort Study ◽  
Bacterial Vaginosis ◽  
Pregnant Women ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Low Risk ◽  
Perinatal Complications ◽  
Prenatal Care Visit ◽  
History Of ◽  
The Impact

CONTEXT AND OBJECTIVE: Bacterial vaginosis has been associated with prematurity and other perinatal complications. However, the efficacy of the treatment for preventing such complications has not yet been well established. The objective of this study was to evaluate the impact of treatment for bacterial vaginosis on a low-risk population of Brazilian pregnant women, in order to prevent prematurity and other perinatal complications. DESIGN AND SETTING: Observational retrospective cohort study, at the Obstetric and Gynecology Department, Universidade Estadual de Campinas (Unicamp). METHODS: Vaginal bacterioscopy results from 785 low-risk pregnant women were studied. Three different groups of women were identified: 580 without bacterial vaginosis during pregnancy, 134 with bacterial vaginosis treated using imidazoles (metronidazole, tinidazole, or secnidazole) during pregnancy, and 71 with bacterial vaginosis not treated during pregnancy. The diagnosis of bacterial vaginosis was based on Nugent's criteria, from the vaginal bacterioscopy performed during the first prenatal care visit. RESULTS: The frequency of prematurity was 5.5% among the women without bacterial vaginosis, 22.5% among those with untreated bacterial vaginosis and 3.7% among those with treated bacterial vaginosis. The risk ratios for perinatal complications were significantly higher in the group with untreated bacterial vaginosis: premature rupture of membranes, 7.5 (95% CI: 1.9-34.9); preterm labor, 3.4 (95% CI: 1.4-8.1); preterm birth, 6.0 (95% CI: 1.9-19.7); and low birth weight, 4.2 (95% CI: 1.2-14.3). CONCLUSION: The treatment of bacterial vaginosis significantly reduced the rates of prematurity and other perinatal complications among these low-risk Brazilian pregnant women, regardless of the history of previous preterm delivery.

scholarly journals Delay in the induction of labour process: a retrospective cohort study and computer simulation of maternity unit workload

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e045577
Author(s):  
Katherine Robertson ◽  
Ian Hardingham ◽  
Rhiannon D'Arcy ◽  
Aparna Reddy ◽  
Joe Clacey
Keyword(s):  
Computer Simulation ◽  
Cohort Study ◽  
Simulation Model ◽  
Real World ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Induction Of Labour ◽  
Computer Simulation Model ◽  
Maternity Unit ◽  
The Impact

ObjectivesDelay in the induction of labour (IOL) process is associated with poor patient experience and adverse perinatal outcome. Our objective was to identify factors associated with delay in the IOL process and develop interventions to reduce delay.Design and settingsWe performed a retrospective cohort study of maternity unit workload in a large UK district general hospital. Electronic hospital records were used to quantify delay in the IOL process and linear regression analysis was performed to assess significant associations between delay and potential causative factors. A novel computer maternity unit simulation model, MUMSIM (Maternity Unit Management SIMulation), was developed using real-world data and interventions were tested to identify those associated with a reduction in delay.ParticipantsAll women giving birth at Stoke Mandeville Hospital, Buckinghamshire National Health Service (NHS) Trust in 2018 (n=4932).Primary outcome measureDelay in the IOL process of more than 12 hours.ResultsThe retrospective analysis of real-world maternity unit workload showed 30% of women had IOL and of these, 33% were delayed >12 hours with 20% delayed >24 hours, 10% delayed >48 hours and 1.3% delayed >72 hours. Delay was significantly associated with the total number of labouring women (p=0.008) and the number of booked IOL (p=0.009) but not emergency IOL, spontaneously labouring women or staffing shortfall. The MUMSIM computer simulation predicted that changing from slow release 24-hour prostaglandin to 6-hour prostaglandin for primiparous women would reduce delay by 4% (p<0.0001) and that additional staffing interventions could significantly reduce delay up to 17.9% (p<0.0001).ConclusionsPlanned obstetric workload of booked IOL is associated with delay rather than the unpredictable workload of women in spontaneous labour or emergency IOL. We present a novel maternity unit computer simulation model, MUMSIM, which allows prediction of the impact of interventions to reduce delay.

scholarly journals Risk Factors Associated with Coronavirus Disease 2019 (COVID-19) Symptoms and Potential Vertical Transmission During Pregnancy: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Bibita Peter ◽  
Nicholas Ree ◽  
Karen Ferrer ◽  
Laila Younes ◽  
Barbara Lepe ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
Disease Severity ◽  
Vertical Transmission ◽  
Retrospective Cohort Study ◽  
Pregnancy Outcomes ◽  
Retrospective Cohort ◽  
Public Hospitals ◽  
Growing Body ◽  
The Impact

Abstract Objective: The COVID-19 pandemic is of special concern for pregnant women. A growing body of evidence suggests the virus can have a deleterious impact upon outcomes related to birth and newborn health. There is a paucity of published research demonstrating the factors that influence disease severity among those who are pregnant, while a growing body of evidence demonstrates that vertical transmission occurs. Our study investigated the impact of maternal characteristics upon COVID-19 outcomes, as well as whether disease severity impacted pregnancy outcomes. Methods: We conducted a retrospective cohort study of pregnant women with COVID-19 who were admitted to two public hospitals in our state between April-August, 2020. Pregnancy outcomes and clinical, laboratory, and placental data were collected. Results: Thirty-four pregnant women tested positive for SARS-CoV-2. Among them, 55% (19/34) were symptomatic. Of those who were symptomatic, 68% (13/19) presented with fever and cough. Those with symptoms had a statistically significant higher pregestational mean BMI compared with asymptomatic women (35.7±7.9 vs 26.7±6.9, P=0.004). Screening of biochemical records demonstrated that symptomatic women had lower potassium levels compared with those who were asymptomatic (median: 3.70 mEq/L vs 4.30 mEq/L, P=0.009). High BMI (42.4 kg/m2) and low potassium levels (3.0 mEq/L) were observed in the only case of postpartum mortality among the symptomatic women. We did not observe any influence of maternal COVID-19 severity on placental histopathology/infant health or evidence of vertical transmission, regardless of preterm status or duration of fetal exposure. Conclusion: High pregestational BMI and lower potassium levels were associated with the presence of COVID-19 symptoms among pregnant women.

scholarly journals Asymptomatic carriage of COVID-19 in pregnant women: a retrospective cohort study

2020 ◽  
Author(s):  
Ruiling Xu ◽  
Tara Pauley ◽  
Hannah Missfelder Lobos ◽  
Richard Haddon ◽  
Hsu Chong
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Asymptomatic Carriage

scholarly journals General versus regional anaesthesia for caesarean section indicated for acute foetal distress: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Junette Arlette Mbengono Metogo ◽  
Theophile Njamen Nana ◽  
Brian Ajong Ngongheh ◽  
Emelinda Berinyuy Nyuydzefon ◽  
Christoph Akazong Adjahoung ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
Retrospective Cohort Study ◽  
Medical Records ◽  
Regional Anaesthesia ◽  
Retrospective Cohort ◽  
Statistical Significance ◽  
Neonatal Resuscitation ◽  
Maternal Outcomes ◽  
Foetal Distress

Abstract Background Acute foetal distress (AFD) is a life-threatening foetal condition complicating 2% of all pregnancies and accounting for 8.9% of caesarean sections (CS) especially in developing nations. Despite the severity of the problem, no evidence exists as to the safest anaesthetic technique for the mother and foetus couple undergoing CS for AFD. We aimed to compare general anaesthesia (GA) versus regional (spinal and epidural) anaesthesia in terms of their perioperative maternal and foetal outcomes. Methods We carried out a retrospective cohort study by reviewing the medical records of all women who underwent CS indicated for AFD between 2015 to 2018 at the Douala General Hospital, Cameroon. Medical records of neonates were also reviewed. We sought to investigate the association between GA, and regional anaesthesia administered during CS for AFD and foetal and maternal outcomes. The threshold of statistical significance was set at 0.05. Results We enrolled the medical records of 117 pregnant women who underwent CS indicated for AFD. Their mean age and mean gestational age were 30.5 ± 4.8 years and 40 weeks respectively. Eighty-three (70.9%), 29 (24.8%) and 05 (4.3%) pregnant women underwent CS under SA, GA and EA respectively. Neonates delivered by CS under GA were more likely to have a significantly low APGAR score at both the 1st (RR = 1.93, p = 0.014) and third-minute (RR = 2.52, p = 0.012) and to be resuscitated at birth (RR = 2.15, p = 0.015). Past CS, FHR pattern on CTG didn’t affect these results in multivariate analysis. Adverse maternal outcomes are shown to be higher following SA when compared to GA. Conclusion The study infers an association between CS performed for AFD under GA and foetal morbidity. This, however, failed to translate into a difference in perinatal mortality when comparing GA vs RA. This finding does not discount the role of GA, but we emphasize the need for specific precautions like adequate anticipation for neonatal resuscitation to reduce neonatal complications associated with CS performed for AFD under GA.

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