scholarly journals Evaluation of clinico-epidemiological factors and outcome of COVID-19 disease in perinatal period

2021 ◽  
Vol 10 (4) ◽  
pp. 1515
Author(s):  
Suchita V. Dabhadkar ◽  
Vaishali S. Taralekar ◽  
Mahima R. A. ◽  
Salil D. Barsode ◽  
Pooja S. Kale
Keyword(s):  
Pregnant Women ◽  
Health Care Workers ◽  
Perinatal Period ◽  
Vulnerable Groups ◽  
Substantial Impact ◽  
Care Workers ◽  
Increased Risk ◽  
Study Participants ◽  
Infective Etiology ◽  
Disease Community

Background: The coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It is well accepted that pregnant women are at increased risk of infections, morbidity from known respiratory viruses like H1N1, varicella, influenza. COVID-19, a virus from the same family poses a greater and influential risk to the health of our mothers and their babies. Raised concerns of pregnant women, being physiologically immunocompromised with associated comorbidities like hypertension, diabetes, heart disease, anemia is very challenging for the obstetrician to conquer.Methods: We tested 405 pregnant women for PCR SARS CoV-2 during the pandemic out of which 59 pregnant women turned out to be positive, and were included in the study analysis. These women had singleton live pregnancy beyond 37 weeks and opted for in patient management. Study participants did not have any known obstetric complications.Results: 81% of women were delivered by cesearean section, indication being premature rupture of membranes and anhydramnios in 45 % of women reflecting the infective etiology of the disease. 60% women were asymptomatic, yet positive for the disease. Community spread was seen in 75% of the women. No ICU admissions were recorded.Conclusions: The substantial impact on the vulnerable groups like pregnancy has necessitated need for further studies and research and to build more service models as frontline obstetric COVID health care workers. 

scholarly journals Pragmatic approach to provide uninterrupted obstetric services amidst SARS COV-2 pandemic

2020 ◽  
Vol 6 (6) ◽  
pp. 143-146
Author(s):  
Brinderjeet Kaur
Keyword(s):  
Pregnant Women ◽  
Health Care Workers ◽  
Support Staff ◽  
Vulnerable Groups ◽  
Gear Up ◽  
The Novel ◽  
Perinatal Morbidity ◽  
Staff Support ◽  
Care Workers ◽  
Obstetric Services

The novel severe acute respiratory syndrome corona virus 2 (SARS COV-2) has taken our civilization by surprise. Eachpassing day emanate new set of issues, necessitating changes in its management. Its significance & impact on pregnant woman, pregnancy outcome has been detrimental as COVID-19 has been associated with maternal and perinatal morbidity and mortality in this set of vulnerable groups–pregnant women. The recommendations by ICMR need to be appreciated and efforts should be made at each level to simplify the assessment of COVID-19. We at a tertiary private setup followed methodology for triage and assessment for pregnant women ever since lock down measures was levied. The present paper discusses in brief the approach that was followed at our institute that helped us to provide services without fail during the crisis hour as well as minimizing the risk of infection to our doctors, resident doctors, nursing staff, support staff and health care workers in the team. This could provide valuable inputs to other institutes facing dearth of skilled man power as we all need to gear up for coming months as the pandemic is ongoing with no flattening of curve in near sight.

scholarly journals The Danish implementation study on response to pregnancy complications, MAMAACT

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Villadsen ◽  
H Johnsen ◽  
T D Rasmussen ◽  
J Sørensen ◽  
U Christensen ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Complications ◽  
Smart Phone ◽  
Target Group ◽  
Warning Signs ◽  
Perinatal Health ◽  
Vulnerable Groups ◽  
Contributing Factors ◽  
Increased Risk ◽  
Ward Level

Abstract Differential incidence and severity of pregnancy complications are likely important contributing factors to the increased risk of poor pregnancy outcomes among ethnic minority women in Europe. To address this issue, the MAMAACT trial has been developed based on a thorough mixed methods needs assessment and co-creation process, feasibility tested, now implemented in a nationwide complex intervention. The overall aim of the Danish MAMAACT trial is to reduce ethnic and social disparity in stillbirth and newborns' health by improved management of pregnancy complications. The overall target group is all pregnant women, and the specific target group is women of non-Western origin. The hypothesis of MAMAACT is that improved communication between pregnant women and midwives regarding body symptoms that need prompt reaction will improve perinatal health among these vulnerable groups. The intervention consists of postgraduate training of midwives in intercultural communication and a smart phone application and a leaflet, both in six different languages. The app and leaflet target the women and explain the most serious warning signs of pregnancy complications and how to respond to them. MAMAACT is implemented and evaluated in a randomized controlled cluster trial and 10 maternity wards consist the intervention groups, while nine maternity wards are the control groups. The evaluation is a mixed method evaluation focusing on understanding the mechanisms of change, how context at both maternity ward level as well as in the everyday life of women affects the implementation, and finally if effects on health literacy of the women and perinatal health of the children can be documented.

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

Level of physical activity and its correlates among health care workers in Ethiopia, 2019

2019 ◽  
Author(s):  
Tigist Demssew Adane ◽  
Birhan Gebresillassie Gebregiorgis ◽  
Elda Mekonnen Nigussie ◽  
Abate Dargie Wubetu
Keyword(s):  
Physical Activity ◽  
Health Care ◽  
Health Care Providers ◽  
Health Care Workers ◽  
Health Professionals ◽  
Associated Factors ◽  
P Value ◽  
Care Providers ◽  
Care Workers ◽  
Study Participants

Abstract Background These days, engaging at sufficient regular physical activity strongly recommended for good health and physical functioning. Physical activity can increase the self-confidence of the health professionals and they would become fit for daily activities with patients. Knowing the level of physical activity can help health care professionals to plan for physical activity programs. This study aimed to measure the level of physical activity and associated factors among adult health professionals at Tirunesh Beijing general hospital.Objective The aim of this study was to assess the level of physical activity and associated factors among health care workers in Ethiopia, 2019.Methods Institution based cross-sectional study conducted level of physical activity and associated factors among health care workers in Ethiopia, 2019. Two hundred nighty seven adult health professionals were participated, which was a 97.4% response rate. The global physical activity questionnaire used to measure the level of physical activity. Descriptive statistics and binary logistic regression analyses was done to affirm the variables characteristics. A predictor variable with a p-value of less than 0.2 exported to multivariate analysis. During multivariate analysis, statistical significance declared at a p-value of < 0.05.Results In general, the majority of the study participants, 89.2% (95% CI: 85.9-92.6) were achieved recommended levels of physical activity. Regarding the intensity of the physical activity, the overall mean time score was 518.4 mints per week or 2352.6 MET/week. For moderate-intensity physical activity, 83.5% of the study participants were physically active, (≥150 minutes/week). In the case of vigorous activity, about 32.7% of the study participants were physically active and engaged in vigorous physical activity (≥75 minutes /week). The study participants, who had self-motivation for physical activity, had a BMI of less than 25 kg/m2 and aged < 40 years were physically active.Conclusions Health care providers’ habit of physical activity improved as compared with the previous studies. However, the current level of physical activity of health professionals is not adequate. Health care providers’ age, body mass index and self-motivation attribute to physical activity. The level of physical activity can increase by enhancing staff motivation towards physical activity.

scholarly journals Factors for late initiation of antenatal care in Dar es Salaam, Tanzania: A qualitative study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Saidi Mgata ◽  
Stephen Oswald Maluka
Keyword(s):  
Health Care ◽  
Antenatal Care ◽  
Health System ◽  
Pregnant Women ◽  
Health Care Workers ◽  
Cultural Beliefs ◽  
Dar Es Salaam ◽  
World Health ◽  
Health Providers ◽  
Care Workers

Abstract Background Antenatal care (ANC) provided by a trained health care provider is important for monitoring pregnancy thereby reducing potential risks for the mother and child during pregnancy and delivery. The World Health Organization (WHO) recommends at least four ANC visits to all pregnant women. While the proportion of women who attend at least one ANC in low-income countries is high, most pregnant women start their first ANC attendance very late. In Tanzania only 24% of pregnant women start their first ANC attendance before the fourth month of pregnancy. While factors for the utilization of antenatal care in general have been widely studied, there is paucity of studies on the factors affecting timing of the first ANC attendance. This study aimed to understand individual, community, and health system factors that lead to the delay in seeking ANC services among pregnant women in Ilala Municipal in Dar es Salaam region, Tanzania. Methods A qualitative exploratory study, using in-depth interviews with 20 pregnant women and five health care workers was conducted in three different health facilities in Dar es Salaam Tanzania. Thematic analysis approach was used to analyse the data. Results Individual perceptions of antenatal care, past experience with pregnancy, fear of pregnancy disclosure, and socio-cultural beliefs were the key individual and social factors for late ANC attendance. Shortage of trained health care workers, lack of spouse’s escort and health providers’ disrespect to pregnant women were the main health system barriers to early ANC attendance. Conclusions This study concludes that community members should be sensitized about the importance of early ANC attendance. Additionally, while spouse’s escort policy is important for promoting PMTCT, the interpretation of the policy should not solely be left to the health providers. District and regional health officials should provide correct interpretation of this policy.

scholarly journals The Real Impact of the Coronavirus Disease 2019 (covid-19) on the Pregnancy Outcome

2020 ◽  
Vol 42 (05) ◽  
pp. 303-304
Author(s):  
Ana Katherine Gonçalves
Keyword(s):  
Pregnant Women ◽  
Health Care Workers ◽  
Influenza Pandemic ◽  
The Elderly ◽  
H1n1 Influenza ◽  
Clinical Impact ◽  
Additional Information ◽  
Intrauterine Transmission ◽  
Care Workers ◽  
2009 H1n1

AbstractThe COVID-19 outbreak is increasing around the world in the number of cases, deaths, and affected countries. Currently, the knowledge regarding the clinical impact of COVID-19 on maternal, fetal, and placental aspects of pregnancy is minimal. Although the elderly and men were the most affected population, in previous situations, such as the 2009 H1N1 influenza pandemic and the Ebola epidemic, pregnant women were more likely to develop complications than nonpregnant women. There are unanswered questions specific to pregnant women, such as whether pregnant women are more severely affected and whether intrauterine transmission occurs. Additional information is needed to inform key decisions, such as whether pregnant health care workers should receive special consideration, whether to separate infected mothers and their newborns, and whether it is safe for infected women to breastfeed.

scholarly journals Using BCG vaccine to enhance non-specific protection of health care workers during the COVID-19 pandemic: A structured summary of a study protocol for a randomised controlled trial in Denmark

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Anne Marie Rosendahl Madsen ◽  
Frederik Schaltz-Buchholzer ◽  
Thomas Benfield ◽  
Morten Bjerregaard-Andersen ◽  
Lars Skov Dalgaard ◽  
...  
Keyword(s):  
Health Care ◽  
Randomised Controlled Trial ◽  
Health Care Workers ◽  
Cumulative Incidence ◽  
Controlled Trial ◽  
Bcg Vaccine ◽  
Care Workers ◽  
Full Protocol ◽  
Randomised Controlled ◽  
Study Participants

Abstract Objectives: The Bacille Calmette-Guérin (BCG) vaccine against tuberculosis is associated with non- specific protective effects against other infections, and significant reductions in all-cause morbidity and mortality have been reported. We aim to test whether BCG vaccination may reduce susceptibility to and/or the severity of COVID-19 and other infectious diseases in health care workers (HCW) and thus prevent work absenteeism. The primary objective is to reduce absenteeism due to illness among HCW during the COVID-19 pandemic. The secondary objectives are to reduce the number of HCW that are infected with SARS-CoV-2, and to reduce the number of hospital admissions among HCW during the COVID-19 pandemic. Hypothesis: BCG vaccination of HCW will reduce absenteeism by 20% over a period of 6 months. Trial design: Placebo-controlled, single-blinded, randomised controlled trial, recruiting study participants at several geographic locations. The BCG vaccine is used in this study on a different indication than the one it has been approved for by the Danish Medicines Agency, therefore this is classified as a phase III study. Participants: The trial will recruit 1,500 HCW at Danish hospitals. To be eligible for participation, a subject must meet the following criteria: Adult (≥18 years); Hospital personnel working at a participating hospital for more than 22 hours per week. A potential subject who meets any of the following criteria will be excluded from participation in this study: Known allergy to components of the BCG vaccine or serious adverse events to prior BCG administration Known prior active or latent infection with Mycobacterium tuberculosis (M. tuberculosis) or other mycobacterial species Previous confirmed COVID-19 Fever (>38 C) within the past 24 hours Suspicion of active viral or bacterial infection Pregnancy Breastfeeding Vaccination with other live attenuated vaccine within the last 4 weeks Severely immunocompromised subjects. This exclusion category comprises: a) subjects with known infection by the human immunodeficiency virus (HIV-1) b) subjects with solid organ transplantation c) subjects with bone marrow transplantation d) subjects under chemotherapy e) subjects with primary immunodeficiency f) subjects under treatment with any anti-cytokine therapy within the last year g) subjects under treatment with oral or intravenous steroids defined as daily doses of 10 mg prednisone or equivalent for longer than 3 months h) Active solid or non-solid malignancy or lymphoma within the prior two years Direct involvement in the design or the execution of the BCG-DENMARK-COVID trial Intervention and comparator: Participants will be randomised to BCG vaccine (BCG-Denmark, AJ Vaccines, Copenhagen, Denmark) or placebo (saline). An adult dose of 0.1 ml of resuspended BCG vaccine (intervention) or 0.1 ml of sterile 0.9% NaCl solution (control) is administered intradermally in the upper deltoid area of the right arm. All participants will receive one injection at inclusion, and no further treatment of study participants will take place. Main outcomes: Main study endpoint: Days of unplanned absenteeism due to illness within 180 days of randomisation. Secondary study endpoints: The cumulative incidence of documented COVID-19 and the cumulative incidence of hospital admission for any reason within 180 days of randomisation. Randomisation: Randomisation will be done centrally using the REDCap tool with stratification by hospital, sex and age groups (+/- 45 years of age) in random blocks of 4 and 6. The allocation ratio is 1:1. Blinding (masking): Participants will be blinded to treatment. The participant will be asked to leave the room while the allocated treatment is prepared. Once ready for injection, vaccine and placebo will look similar, and the participant will not be able to tell the difference. The physicians administering the treatment are not blinded. Numbers to be randomised (sample size): Sample size: N=1,500. The 1,500 participants will be randomised 1:1 to BCG or placebo with 750 participants in each group. Trial Status: Current protocol version 5.1, from July 6, 2020. Recruitment of study participants started on May 18, 2020 and we anticipate having finished recruiting by the end of December 2020. Trial registration: The trial was registered with EudraCT on April 16, 2020, EudraCT number: 2020-001888-90, and with ClinicalTrials.gov on May 1, 2020, registration number NCT04373291. Full protocol: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol. Keywords: COVID-19, Randomised controlled trial, Protocol, BCG vaccine, NSEs/Non-specific effects of vaccines, Heterologous effects of vaccines, Health care workers, Pandemic, Immune training.

scholarly journals Ebola viral disease and pregnancy

2015 ◽  
Vol 8 (3) ◽  
pp. 108-113 ◽  
Author(s):  
Benjamin O Black ◽  
Séverine Caluwaerts ◽  
Jay Achar
Keyword(s):  
Pregnant Women ◽  
Health Care Workers ◽  
Management Strategies ◽  
Medical Personnel ◽  
Viral Disease ◽  
Review Article ◽  
Infected Woman ◽  
Care Workers ◽  
The Impact ◽  
Broad Overview

Ebola viral disease’s interaction with pregnancy is poorly understood and remains a particular challenge for medical and para-medical personnel responding to an outbreak. This review article is written with the benefit of hindsight and experience from the largest recorded Ebola outbreak in history. We have provided a broad overview of the issues that arise for pregnant women and for the professionals treating them during an Ebola outbreak. The discussion focuses on the specifics of Ebola infection in pregnancy and possible management strategies, including the delivery of an infected woman. We have also discussed the wider challenges posed to pregnant women and their carers during an epidemic, including the identification of suspected Ebola-infected pregnant women and the impact of the disease on pre-existing health services. This paper outlines current practices in the field, as well as highlighting the gaps in our knowledge and the paramount need to protect the health-care workers directly involved in the management of pregnant women.

scholarly journals Perceptions, Uses of, and Interests in Complementary Health Care Approaches in Depressed Pregnant Women

2016 ◽  
Vol 22 (1) ◽  
pp. 81-95 ◽  
Author(s):  
Jennifer Matthews ◽  
Jennifer L. Huberty ◽  
Jenn A. Leiferman ◽  
Darya McClain ◽  
Linda K. Larkey
Keyword(s):  
Mental Health ◽  
Pregnant Women ◽  
Lifestyle Behaviors ◽  
Health And Wellness ◽  
Physical And Mental Health ◽  
Unhealthy Lifestyle ◽  
Complementary Health Approaches ◽  
Increased Risk ◽  
Women’S Perceptions ◽  
Study Participants

Depression affects up to 23% of pregnant women and is associated with adverse physical/mental health outcomes for both the mother and baby. Depressed pregnant women may be more likely to engage in unhealthy lifestyle behaviors that contribute to an increased risk for chronic disease. Little is known regarding depressed pregnant women’s perceptions, uses of, and interests in complementary health approaches. Study participants (mean age 28.7 ± 6.8; n = 1032) included pregnant women ≥8 weeks gestation who responded to a survey assessing physical and mental health and wellness practices. Of those completing the survey, depressed pregnant women (n = 272) had significantly higher levels of anxiety ( P < .001) and stress ( P < .001) and had poorer sleep quality ( P < .001), mindfulness ( P < .001), and social support ( P < .001) compared to nondepressed pregnant women (n = 760). A majority (84%) of depressed pregnant women would consider using a complementary health approach for weight and/or stress management during pregnancy, and more than 50% were interested in yoga.

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