scholarly journals COVID-19 during pregnancy. Analytical inspection

2021 ◽  
pp. 74-80
Author(s):  
G.I. Ischenko ◽  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Complications ◽  
Vascular Dysfunction ◽  
Clinical Manifestations ◽  
Morbidity And Mortality ◽  
Pharmacologic Therapy ◽  
Target Cells ◽  
Pathophysiological Mechanism ◽  
Pregnancy And Lactation ◽  
High Level

The cause of the current pandemic was the rapid spread of the coronavirus SARS-CoV-2 and the development of respiratory syndrome with significant morbidity and mortality. Pregnant women have the higher risk of morbidity and mortality than non-pregnant women. Pregnancy is the vulnerable condition that may contribute to a higher risk of infection due to the change in physiology during gestation. Physiologic, metabolic, and vascular changes in normal and high-risk pregnancies may affect risks for severe acute respiratory syndrome SARS-CoV-2 infection. The pathogenesis of COVID-19 during pregnancy explains the functioning of the renin-angiotensin-aldosterone system. SARS-CoV-2 uses angiotensin-converting enzyme-2 receptors to enter target cells. Its regulation during pregnancy may increase the risk of respiratory syndrome with COVID-19. The virus, by binding to receptors, causes decreasing its regulation and can lead to increasing angiotensin II, relative to angiotensin 1, 7, which is manifested by vasoconstriction and vascular dysfunction in preeclampsia. Coronavirus disease and preeclampsia have partially the same pathophysiological mechanism, which includes endothelial dysfunction and coagulation disorders. There is systemic inflammation or microcirculation disorders, which is characterized by vasoconstriction and ischemia, hypercoagulation. Thus, abnormalities that are characteristic of COVID-19 infection are similar to those that occur with preeclampsia during pregnancy. In addition, the known pathological mechanism of COVID-19 is an excessive anti-inflammatory response called the cytokine storm. The immune response is sufficiently altered during pregnancy, which can significantly alter the laboratory and clinical manifestations of COVID-19 during pregnancy. Therefore, the combination of these conditions can potentially lead to vascular damage. Currently, there are very limited data on the course, clinic and consequences of infection during pregnancy. This literature review combines various high-level studies that indicate higher rates of preeclampsia and other complications associated with pregnancy and SARS-CoV-2 infection. Studies to date have reported higher risks of pregnancy complications, including preterm birth and preeclampsia, as well as higher rates of cesarean delivery. For the fetus were recorded isolated cases of stillbirth, which was less than <1%. Accordingly, this signals needs to increase attention to the course of infection during pregnancy, and the optimal treatment of COVID-19, as well as prevention strategies during pregnancy. Pharmacologic therapy is limited to medications with proven safety during pregnancy and lactation. No conflict of interest was declared by the authors. Key words: COVID-19, pregnancy, newborns, pregnancy complications.

Severe Acute Respiratory Syndrome by COVID-19 in pregnant and postpartum women

2021 ◽  
Vol 21 (suppl 2) ◽  
pp. 461-469
Author(s):  
Ana Paula Nogueira Godoi ◽  
Gilcelia Correia Santos Bernardes ◽  
Nivea Aparecida de Almeida ◽  
Saulo Nascimento de Melo ◽  
Vinícius Silva Belo ◽  
...  
Keyword(s):  
Heart Disease ◽  
Severe Acute Respiratory Syndrome ◽  
Pregnant Women ◽  
Descriptive Analysis ◽  
Ventilatory Support ◽  
Clinical Manifestations ◽  
Morbidity And Mortality ◽  
Epidemiological Surveillance ◽  
Postpartum Women ◽  
Risk Of Death

Abstract Objectives: to evaluate the morbidity and mortality profile and factors associated with death due to severe acute respiratory syndrome (SARS) by COVID-19 in pregnant and postpartum women. Methods: this is a quantitative and retrospective research that analyzed the SIVEP-gripe Database (Influenza Epidemiological Surveillance Information System), from 01/01/2020 to 04/01/2021. All pregnant women and postpartum women diagnosed with SARS caused by COVID-19 in the State of Minas Gerais were included. After the descriptive analysis of the hospitalizations profile, the association between different exposure variables and the occurrence of death was evaluated. Results: of the 227 records obtained, 94.3% required hospitalization. Among hospitalizations in the Intensive Care Unit, 29.8% used invasive ventilatory support. Fifteen deaths were recorded. The most frequent clinical manifestations were: cough and fever; the predominant comorbidities were cardiovascular disease and diabetes mellitus. The variables “ICU stay”, “use of ventilatory support” and “heart disease” were associated with the occurrence of deaths. Conclusions: hospitalization was necessary for most pregnant women with SARS and the presence of previous heart disease increased the risk of death. Knowing the SARS morbidity and mortality profile is important in the definition of public health strategies aimed at reducing the impacts of COVID-19 during pregnancy and the puerperium.

scholarly journals PERBEDAAN TINGKAT PENGETAHUAN IBU HAMIL PRIMIGRAVIDA YANG MELAKUKAN KUNJUNGAN ANTENATAL PADA DOKTER SPESIALIS OBGYN DENGAN BIDAN DI KOTA PADANG

2019 ◽  
Vol 3 (2) ◽  
pp. 104-111
Author(s):  
Susanti Apriani ◽  
Syahredi Syaiful Adnani ◽  
Hafni Bachtiar
Keyword(s):  
Mortality Rate ◽  
Health Services ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Health Survey ◽  
Pregnancy Complications ◽  
Cross Sectional ◽  
Level Of Knowledge ◽  
High Level ◽  
The City

The maternal mortality rate in Indonesia Demographic and Health Survey (IDHS) 2012, increased sig- nificantly to 359 per 100,000 births hidup.1 Obtained in Household Health Survey (Survey) 2001 mater- nal mortality rate can be lowered only by basic health services such as antenatal. Based on a UNICEF report, only about 45% were informed about the signs of pregnancy complications. This research was conducted to determine the cross sectional differences in the level of knowledge of pregnant women who had antenatal care at obstetricians and midwives in the city of Padang. Primigravida pregnant women who visit antenatal care at obstetricians and midwives in Padang City, amounting to 73.8% have a high level of knowledge. There were no differences in the level of knowledge of pregnant women who had antenatal care at obstetrician (p> 0.05)Keywords: Antenatal, Midwives, Obstetrician, knowledge

Evaluation of the results of planned open surgical interventions in primary chronic vein disease in pregnant women

2020 ◽  
pp. 51-56
Author(s):  
V.М. Аntonyuk-Kysil ◽  
◽  
І.Y. Dziubanovskyi ◽  
V.М. Yenikeeva ◽  
S.І. Lichner ◽  
...  
Keyword(s):  
Pregnant Woman ◽  
Pregnant Women ◽  
Postoperative Period ◽  
Postpartum Period ◽  
Clinical Manifestations ◽  
Lower Extremities ◽  
Vascular Surgeon ◽  
Surgical Interventions ◽  
Perinatal Center ◽  
Vein Disease

The objective: to evaluate the results of planned open surgical interventions (POSI) in pregnant women with primary symptomatic chronic vein disease (PSCVD). Materials and methods. The study included 457 pregnant women operated on a routine basis with PSCVD. The patients underwent ultrasound duplex angioscanning (USDA) of the veins of the lower extremities, inguinal canals, and iliac veins. The severity of the clinical manifestations of PSCVD was evaluated on a VCSS scale. With the help of the circadian visual-analog scale, the dynamics after the operative pain were studied. The effect of POSI on uterine tone and cardiac function of the fetus was investigated using cardiotocography. When forming the results for POSI, data from USDA, the severity of clinical and cosmetic manifestations of PCVD, the need for active prevention of thrombophlebetic, thromboembolic and hemorrhagic complications, minimization of surgical childbirth were taken into account. The results of treatment were studied in 2 groups of patients. Patients of the first group were treated with conservative therapy, the second group – POSI. Parametric indicators, which were presented as mean and standard error M(SD), were used for statistical data processing of the study, and their reliability was estimated using Student’s t-test. The species was determined to be significant at p<0.05. Results. 495 POSI were performed at 28-38 weeks gestation in an obstetric hospital (perinatal center), by a vascular surgeon from the staff of the center, who was familiarized with the peculiarities of working with this contingent of patients. Surgery was performed under local anesthesia in 346 (75.49%) pregnant women at one extremity, in 111 (24.51%) – at two in one session. According to the results of the study, it was noted that in the first group 33.7% of patients had a positive clinical result due to the reduction of pain syndrome, while 67.5% of patients had an increase and spread of varicose transformation in the area of saphenous and/or non-saphenous veins with spread of pathological venous reflux in the distal direction. 78% of patients had the need to administer prophylactic doses of low molecular weight heparins, both during pregnancy and in postpartum period. Out of 126 pregnant women with pronounced varicose veins of the external genital organs and perineum in 36 (28.6%) deliveries were performed by caesarean section. In 9 (3%) patients there was an acute thrombophlebitis of the subcutaneous veins of the lower extremities, which required 5 pregnant women to undergo urgent surgery when the inflammatory process had spread to the middle and above along the femoral vein of the large subcutaneous vein. Pregnant women of the second group with PSCVD on the basis of obstetric hospital (perinatal center) POSI were performed in the organization, which laid the ideology of the FTS program, strictly individual indications for intervention in the optimal terms of pregnancy, multidisciplinary management of patients, due to this in 93% of operated patients regression of clinical manifestations of the disease was noted, whch contributed to the correct and safe delivery of pregnancy with 100% absence of preterm birth, abnormalities in fetal development, pregnancy course, negative impact on obstetric and somatic condition of the pregnant woman. No hemorrhagic, thrombophlebic, thromboembolic complications were noted. Patients in the postoperative period did not require medical support, as during the period of pregnancy, during delivery and in the postpartum period. There were no indications for surgical delivery. 2.4% of patients experienced complications of post-operative wounds in the form of cheese, which had no effect on pregnancy and was eliminated before delivery. In the postoperative period, if necessary, it was recommended to use elastic compression class garments 1–2. Conclusion. POSI made at PSCVD in optimal terms of pregnancy in a specialized obstetric hospital by a vascular surgeon in strictly individual indications is safe, both for the fetus and the pregnant woman. It is promising to further study the results of POSI in pregnant women with PSCVD to introduce it into the arsenal of treatment of this pathology. Key words: FTS ideology, planned open surgical interventions in pregnant women.

Hodgkin Disease and Pregnancy - A Case Report

2014 ◽  
Vol 68 (2) ◽  
pp. 104-106
Author(s):  
Aleksandra Pivkova Veljanovska ◽  
Sonja Genadieva Stavrik ◽  
Zlate Stojanoski ◽  
Lazar Cadievski ◽  
Adela Stefanija ◽  
...  
Keyword(s):  
Case Report ◽  
Pregnant Women ◽  
Hodgkin Disease ◽  
Morbidity And Mortality ◽  
Chemotherapy Treatment ◽  
Related Factors ◽  
Hematological Disorder

Abstract The article presents a case with diagnosed Hodgkin disease (HD) during pregnancy. The aim of this case study was to present diagnostic possibilities in determining HD stage during pregnancy and therapeutic dilemmas. The incidence of HD during pregnancy is 3.2% of all cases with this malignant hematological disorder. The treatment of this disease during pregnancy depends on disease-related factors, pregnancy-related factors, as well as possible implications for fetal morbidity and mortality. The need of analysis of the nature of the disease during pregnancy indicates examination of a larger series of pregnant women with HD and the drawn conclusions affect the decision whether chemotherapy treatment should start immediately or it should be postponed for after delivery.

Maternal-Fetal Management in Trombophilia Related and Placenta-Mediated Pregnancy Complications

2018 ◽  
Vol 69 (9) ◽  
pp. 2396-2401
Author(s):  
Costin Berceanu ◽  
Elena Loredana Ciurea ◽  
Monica Mihaela Cirstoiu ◽  
Sabina Berceanu ◽  
Anca Maria Ofiteru ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Complications ◽  
Case Control Study ◽  
Case Control ◽  
Placental Insufficiency ◽  
Management Options ◽  
Specific Therapy ◽  
Pregnancy Morbidity ◽  
The Impact ◽  
Control Study

It is widely accepted that thrombophilia in pregnancy greatly increases the risk of venous thromboembolism. Pregnancy complications arise, at least partly, from placental insufficiency. Any change in the functioning of the gestational transient biological system, such as inherited or acquired thrombophilia, might lead to placental insufficiency. In this research we included 64 pregnant women with trombophilia and 70 cases non-trombophilic pregnant women, with or without PMPC, over a two-year period. The purpose of this multicenter case-control study is to analyze the maternal-fetal management options in obstetric thrombophilia, the impact of this pathology on the placental structure and possible correlations with placenta-mediated pregnancy complications. Maternal-fetal management in obstetric thrombophilia means preconceptional or early diagnosis, prevention of pregnancy morbidity, specific therapy as quickly as possible and fetal systematic surveilance to identify the possible occurrence of placenta-mediated pregnancy complications.

scholarly journals Opposite correlation of 25-hydroxy-vitamin D- and 1,25-dihydroxy-vitamin D-metabolites with gestational age, bone- and lipid-biomarkers in pregnant women

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Oleg Tsuprykov ◽  
Saban Elitok ◽  
Claudia Buse ◽  
Chang Chu ◽  
Bernhard Karl Krämer ◽  
...  
Keyword(s):  
Vitamin D ◽  
Alkaline Phosphatase ◽  
Pregnant Women ◽  
Clinical Chemistry ◽  
Water Soluble ◽  
Target Cells ◽  
Vitamin D Metabolites ◽  
Specific Alkaline Phosphatase ◽  
Bone Specific Alkaline Phosphatase ◽  
Group B

Abstract25-Hydroxyvitamin D (25OHD) and 1,25-dihydroxyvitamin D (1,25(OH)2D) need to be bound to carrier proteins to be transported to their target cells. The majority of either 25OHD or 1,25(OH)2D is bound to vitamin D-binding protein (DBP), a smaller fraction is bound to albumin and only very small amounts of 25OHD or 1,25(OH)2D are free. Albumin-bound 25OHD or 1,25(OH)2D is relatively easily available after dissociation from albumin. Thus, the sum of free and albumin-bound forms is called bioavailable 25OHD and bioavailable 1,25(OH)2D. Total 25OHD and 1,25(OH)2D are defined as the sum of free, albumin-bound and DBP-bound 25OHD and 1,25(OH)2D, respectively. This cross-sectional study in 427 pregnant women compared the correlation of the six vitamin D compounds with biomarkers of bone health, lipid metabolism, kidney function, endocrine parameters, and group B water-soluble vitamins. Among the 25OHD metabolites analysed, total 1,25(OH)2D showed clearly the best correlation with calcium, bone-specific alkaline phosphatase, adiponectin, LDL, HDL, urea, thyroxine, and group B water-soluble vitamins. When comparing the three 25OHD metabolites, both free 25OHD and bioavailable 25OHD showed overall good correlations with calcium, bone-specific alkaline phosphatase, adiponectin, LDL, HDL, urea, thyroxine, triiodothyronine, and group B water-soluble vitamins, The correlations of 1,25(OH)2D and 25OHD metabolites went always in opposite directions. Only PTH correlates always inversely with all six vitamin D compounds. In conclusion, free 25(OH)D and bioavailable 25(OH)D are more precise determinants of the vitamin D status than total 25(OH)D in normal pregnancy, whereas total 1,25(OH)2D is superior to free and bioavailable 1,25(OH)2D. Except for PTH, correlations of 25(OH)D and 1,25(OH)2D metabolites with typical clinical chemistry readouts go in opposite directions.

scholarly journals 31. Influenza Vaccination During Pregnancy: A Descriptive Cross-sectional Survey of the Knowledge, Beliefs, and Attitudes of Mexican Gynecologists and Family Physicians

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S39-S39
Author(s):  
Erika Z Lopatynsky-Reyes ◽  
Sue Ann Costa-Clemens ◽  
Enrique Chacon-Cruz ◽  
Michael Greenberg
Keyword(s):  
Influenza Vaccination ◽  
Pregnant Women ◽  
Latin American ◽  
Vaccine Coverage ◽  
Family Physicians ◽  
Morbidity And Mortality ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Beliefs And Attitudes ◽  
In Pregnancy

Abstract Background Influenza in pregnancy is associated with elevated morbidity and mortality. Influenza vaccines are both safe and effective in pregnancy, supporting routine use in this population. Even though influenza vaccination in Mexico is recommended for pregnant women, there are no publications of influenza vaccine coverage in pregnancy. This is the first Latin American survey done only in physicians aiming to assess the knowledge, beliefs, and attitudes that Mexican Obstetrics-Gynecologists (OBG) and Family Physicians (FP) have towards influenza and influenza immunization during pregnancy. Methods A cross-sectional survey was conducted, both paper-based and online. The questionnaire was composed of 35 questions, which addressed general knowledge of influenza, recommendations for vaccination during pregnancy, and beliefs and attitudes concerning the acceptability of the vaccine in pregnant women. Results A total of 206 completed surveys were available, 98 (47.6%) from OBG, 108 (52.4%) from FP. Regarding current practicing medical institutions, 76 (37%), 69 (34%), 31 (14.5%), 30 (14.5%) reported working for the Mexican Institute of Social Security, Private Sector, Secretariat of Health, or a combination of all respectively, representing an estimated 2,472 daily pregnancy consultations. About a quarter (26.2%) reported not having a notion that influenza is more severe among pregnant women. More than half (51.5%) ignored the potential side effects of influenza infection on the fetus. The majority (56.8%) did not know when vaccination during pregnancy should occur. Pregnancy as a risk factor for developing influenza complications was known only in 48.1%. Also, 46.1 % believed that vaccination only confers protection to the mother, but not to the fetus. Nevertheless, 96.1% considered that immunization against influenza during pregnancy is a safe and effective preventive intervention. A results’ summary is shown in Figure-1. Conclusion Based on this survey, current knowledge of OBG and FP for influenza morbidity and mortality during pregnancy, and the importance of influenza vaccination in pregnant women, is poor. Mandatory recommendations to educate medical providers regarding influenza vaccination during pregnancy in Mexico are necessary, even as imperative for CME credits. Disclosures All Authors: No reported disclosures

scholarly journals Clinical Features and Maternal-fetal Results of Pregnant Women in COVID-19 Times

2021 ◽  
Vol 43 (05) ◽  
pp. 384-394
Author(s):  
Ana Paula Nogueira Godoi ◽  
Gilcelia Correia Santos Bernardes ◽  
Leilismara Sousa Nogueira ◽  
Patrícia Nessralla Alpoim ◽  
Melina de Barros Pinheiro
Keyword(s):  
Pregnant Women ◽  
Vertical Transmission ◽  
Postpartum Period ◽  
Scientific Literature ◽  
Respiratory Infections ◽  
Clinical Manifestations ◽  
Fetal Distress ◽  
Medical Subject Headings ◽  
Substantial Evidence ◽  
The Subject

Abstract Objective Coronavirus disease 2019 (COVID-19) is a disease caused by a newly discovered coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which usually leads to non-specific respiratory symptoms. Although pregnant women are considered at risk for respiratory infections by other viruses, such as SARS and Middle East respiratory syndrome (MERS), little is known about their vulnerability to SARS-CoV-2. Therefore, this study aims to identify and present the main studies on the topic, including the postpartum period. Methods In this narrative review, articles were searched in various databases, organizations, and health entities using keywords compatible with medical subject headings (MeSH), such as: COVID-19, pregnancy, vertical transmission, coronavirus 2019, and SARS-CoV-2. Results The review of the scientific literature on the subject revealed that pregnant women with COVID-19 did not present clinical manifestations significantly different from those of non-pregnant women; however, there are contraindicated therapies. Regarding fetuses, studies were identified that reported that infection by SARS-CoV-2 in pregnant women can cause fetal distress, breathing difficulties and premature birth, but there is no substantial evidence of vertical transmission. Conclusion Due to the lack of adequate information and the limitations of the analyzed studies, it is necessary to provide detailed clinical data on pregnant women infected with SARS-CoV-2 and on the maternal-fetal repercussions caused by this infection. Thus, this review may contribute to expand the knowledge of professionals working in the area as well as to guide more advanced studies on the risk related to pregnant women and their newborns. Meanwhile, monitoring of confirmed or suspected pregnant women with COVID-19 is essential, including in the postpartum period.

scholarly journals Intestinal parasitic infections and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zelalem Animaw ◽  
Addisu Melese ◽  
Habtamu Demelash ◽  
Girma Seyoum ◽  
Abiy Abebe
Keyword(s):  
Pregnant Women ◽  
Associated Factors ◽  
Intestinal Parasites ◽  
Meta Analysis ◽  
Morbidity And Mortality ◽  
Cochrane Library ◽  
Stool Examination ◽  
Parasitic Infections ◽  
Intestinal Parasitic Infections ◽  
Pooled Prevalence

Abstract Background Intestinal parasitic infections (IPIs) are public health problems widely distributed in the world and cause significant morbidity and mortality; many of which occur among women of reproductive age. IPIs caused by helminthes and protozoan parasites are common among pregnant women. Data on the national pooled prevalence of intestinal parasites and associated factors during pregnancy is not documented well in Ethiopia. This review aims at summarizing evidences on the burden of IPIs and associated factors among pregnant women in Ethiopia. Methods Published and unpublished studies were thoroughly searched at MEDLINE/PubMed, EMBASE, Google Scholar, CINAHL, Cochrane library and Science Direct. In addition, repositories of Addis Ababa, Gondar and Jimma Universities were searched. Eligible studies were selected following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline. The pooled prevalence of intestinal parasites and summary odds ratios (ORs) were determined with 95 % confidence intervals (CI). Sub-groups analyses were done based on study region, types of parasites, methods of stool examination and study setting. The statistical analyses were performed using STATA version 14.0 software. Results Among 168 retrieved studies, 31 studies with a total population of 12,118 pregnant women were included. The estimated pooled prevalence of IPIs among pregnant women in Ethiopia was 27.32 % (95 % CI: 20.61, 33.87 %). In the subgroup analysis, Oromia and Amhara regions had the highest prevalence with a 29.78 % (95 % CI: 15.97, 43.60) and 29.63 % (95 % CI: 15.37, 43.89); respectively. In addition, studies conducted in the community showed higher prevalence than institution based studies (49.93 % Vs 24.84 %; respectively). The most prevalent type of intestinal parasite identified were Hookworm followed by Ascaris lumbricoides with a pooled prevalence of 11.2 and 10.34 %, respectively. In our analysis; residence, being bare footed, lack of hand washing habit and eating uncooked/raw vegetables were significantly associated with IPIs among pregnant women in Ethiopia. Conclusions Prevalence of IPIs during pregnancy is relatively high in Ethiopia. Poor hygienic practices were identified as risk factors. Based on our finding, targeted preventive measures shall be considered so as to prevent morbidity and mortality due to IPIs.

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