scholarly journals Third trimester pregnancy and cesarean delivery of a patient with COVID-19: a case report

2020 ◽  
Author(s):  
Maribel Rodríguez González ◽  
Martha L. Villarreal Morales ◽  
Aracelis Nieves Rodríguez ◽  
Edwin Soto Tapia ◽  
William Ramírez Cacho ◽  
...  

Abstract Background: Limited data is available about the clinical features, management and neonatal outcomes of pregnant women COVID-19 positive. Case: At 37 WGA, a 34-year-old woman G3C1A1 of Puerto Rican origin presented to her follow-up perinatologist visit with flu-like symptoms and COVID-19 contact exposure history. After confirmation of COVID-19 infection and findings on chest radiography, she was successfully treated with ceftriaxone, azithromycin, hydroxychloroquine sulfate, and supportive measures. She had an uncomplicated cesarean delivery with no evidence of vertical transmission. The infant’s physical examination was unremarkable, without any clinical indication of infection.Conclusion: We describe the favorable clinical outcome of a delivery in a woman with COVID-19 in Puerto Rico. It highlights the importance of the rapid clinical management and the hospital coordinated response for the care of a COVID-19 positive pregnant patient at a point where there are no evidence-based or established guidelines. Universal screening for COVID-19 in pregnant women who are admitted for delivery should be considered as part of the hospitals COVID-19’s protocols to improve the staff and patient’s protection.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ruibin Deng ◽  
Xian Tang ◽  
Jiaxiu Liu ◽  
Yuwen Gao ◽  
Xiaoni Zhong

Abstract Background A high rate of cesarean delivery has become a cause of global concern. Although the rate of cesarean delivery has declined over recent years, it remains at a high level largely because of cesarean delivery on maternal request (CDMR). Unnecessary cesarean delivery has limited significance in benefiting maternal and infant physical health; in some ways, it might pose potential risks instead. With the implementation of the “Two-child Policy” in China, an increasing number of women plan to have a second child. Accordingly, how to handle the CDMR rate in China remains an important issue. Methods Data were collected from a longitudinal follow-up study conducted in Chongqing, China, from 2018 to 2019. A structured questionnaire was administered to subjects for data collection. Basic information, including demographic characteristics, living habits, medical history, and follow-up data of pregnant women, as well as their families and society, was collected. Additionally, delivery outcomes were recorded. Logistic regression was performed to analyze the factors influencing CDMR. Results The rate of cesarean delivery in Chongqing, China was 36.01 %, and the CDMR rate was 8.42 %. Maternal request (23.38 %), fetal distress (22.73 %), and pregnancy complications (9.96 %) were the top three indications for cesarean delivery. Logistic regression analysis showed that older age (OR = 4.292, 95 % CI: 1.984–9.283) and being a primiparous woman (OR = 6.792, 95 % CI: 3.230-14.281) were risk factors for CDMR. In addition, CDMR was also associated with factors such as the tendency to choose cesarean delivery during late pregnancy (OR = 5.525, 95 % CI: 2.116–14.431), frequent contact with mothers who had undergone vaginal deliveries (OR = 0.547, 95 % CI: 0.311–0.961), and the recommendation of cesarean delivery by doctors (OR = 4.071, 95 % CI: 1.007–16.455). Conclusions “Maternal request” has become the primary indication for cesarean delivery. The occurrence of CDMR is related to both the personal factors of women during pregnancy and others. Medical institutions and obstetricians should continue popularizing delivery knowledge among pregnant women, enhancing their own professional knowledge about delivery, adhering to the standard indications for cesarean delivery, and providing pregnant women with adequate opportunities for attempting vaginal delivery.


2021 ◽  
Author(s):  
Yasmeen Anwer ◽  
Fahad Abbasi ◽  
Ariba Dar ◽  
Abdullah Hafeez ◽  
Assad Hafeez ◽  
...  

Abstract BackgroundEvidence for Better Lives Study (EBLS) is an endeavour to establish a global birth cohort with participants from resource poor settings across the globe. It aims to investigate mediators and moderators of child development and wellbeing; it envisages informing policy and practice change to promote child health and wellbeing globally. Pakistan is one of the resource poor settings taking part in this global birth cohort; we report the feasibility of establishing such a birth cohort in Pakistan.MethodFrom March 2019 to July 2019, 153 third trimester pregnant women were identified, using community health worker registers, and approached for baseline demographics and a number of maternal wellbeing, mental health, support related information and stress related biomarkers in a peri-urban area of Islamabad Capital Territory. From October 2019 to December 2019, we re-contacted and followed 121 between 8-24 weeks postnatal period. All interviews were done after consent and data was collected electronically. Results150 (98%) third trimester pregnant women consented and were interviewed, 111 (74%) provided bio-samples and 121 (80.6%) were followed up postnatally. Their mean age and years of schooling was 27.29 (5.18) and 7.77 (4.79) respectively. Majority (82.3%) of the participants were housewives. Nearly a tenth were first time mothers while 63% of women reported current pregnancy to have been unplanned. Overall wellbeing and mental health were reported to be poor (WHO-5 mean scores 49.41 (32.20) & PHQ-9 mean scores 8.23 (7.0)). About 22% of women reported four or more adverse childhood experiences; 12.2% reported intimate partner violence during their current pregnancy. During the postnatal follow up visits, 58% of the women reported breastfeeding their infants. ConclusionThe study demonstrated Pakistan site could identify, approach, interview and follow up women and children postnatally, with a high response rates for both the follow up visits and bio-samples. Thus, a larger scale pregnancy birth cohort study in Pakistan is feasible to conduct.


1995 ◽  
Vol 133 (1) ◽  
pp. 71-74 ◽  
Author(s):  
Elio Roti ◽  
Luigi Bartalena ◽  
Roberta Minelli ◽  
Mario Salvi ◽  
Eliana Gardini ◽  
...  

Roti E, Bartalena L, Minelli R, Salvi M, Gardini E, Pistolesi A, Martino E, Braverman LE. Circadian thyrotropin variations are preserved in normal pregnant women. Eur J Endocrinol 1995;133:71–4. ISSN 0804–4643 Serum thyrotropin (TSH) concentration circadian rhythm is abolished in many endocrine and nonendocrine diseases. In the present study we have measured serum TSH concentration over 24 h every 2 h in second and third trimester pregnant women. During the 24-h period, serum free thyroxine and free triiodothyronine concentrations did not change significantly. In contrast, serum TSH concentrations demonstrated significant circadian variations both in the second and third trimester pregnant women (p<0.02 and p <0.005, respectively). In summary, second and third trimester pregnancy is associated with a normal circadian TSH rhythm. Elio Roti, Centro per lo Studio, Prevenzione, Diagnosi e Cura delle Tireopatie, University of Parma, via Gramsci 14, 1-43100 Parma, Italy


1970 ◽  
Vol 1 ◽  
pp. 1-4 ◽  
Author(s):  
F Husain ◽  
SA Latif ◽  
MM Uddin

Study was carried out in the department of physiology, Mymensingh Medical College, Mymensingh, Bangladesh during the period of July 2006 to June 2007 to investigate the effect of pregnancy on serum total cholesterol. The serum concentrations of total cholesterol was measured in 100 cases of 2nd and 3rd trimester of pregnancy and in a control group of 100 cases of non pregnant women which was matched on reproductive age. Data were analyzed by computer with SPSS program using unpaired student‘t’ test. The results showed that the pregnant women had significantly higher concentrations of serum total cholesterol. Higher concentration of total cholesterol was more common in pregnant than control and reaching maximum at 3rd trimester of pregnancy. This may be a purely physiological response to pregnancy or it may be indicative of pathology in some women. These results deserve a follow up study to investigative whether the hypercholesterolemia persists after parturition. Key Words: Total cholesterol, pregnancy, parturition, hypercholesterolemia J Bangladesh Soc Physiol. 2006 Dec;(1):1-4.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ya Chen ◽  
Yun Fang Yan ◽  
Ying Zhang ◽  
Xianming Carroll ◽  
Hui Rong Li ◽  
...  

Abstract Background Spontaneous formation of urinoma is a rare condition, especially for pregnant women. We report a patient in the third trimester of pregnancy with a spontaneous renal rupture who then develops a urinoma from urine leaking into the perinephric space. Case presentation A 23-year-old primagravida was diagnosed with a spontaneous renal rupture and acute left loin pain accompanied by hematuria when she was 35 weeks pregnant. A sub-capsular perinephric cyst then developed to a size of 319 × 175 × 253 mm, and because of discomfort to the patient, we performed Cesarean section. After a healthy male newborn was delivered, fluid was suctioned from a large perirenal cyst that had an estimated size of 300 × 200 × 300 mm. A percutaneous nephrostomy tube was left in the cyst until CT showed no remaining fluid. In the six-month follow-up, the patient showed no perirenal extravasation according to an ultrasound scan, and the urine analysis and renal function tests were normal. Conclusion Close follow-up should be recommended for the patient who has renal rupture after conservative therapy, especially for pregnant woman. CT or MRI should be considered in addition to utilizing ultrasound in the management of pregnant women who present with urinomas. Percutaneous nephrostomy is suggested as an appropriate treatment for large urinomas.


2021 ◽  
Vol 17 ◽  
Author(s):  
Fatemeh Azarkish ◽  
Roksana Janghorban

Background: Pregnant women are a vulnerable group in viral outbreaks, especially in the COVID-19 pandemic. Objective: The aim of this review was to identify maternal and neonatal outcomes in available articles on pregnancies affected by COVID-19. Methods: The articles that had assessed outcomes of pregnancy and perinatal of women with COVID-19 between Oct 2019 and Aug 2020 without language limitation were considered. We searched databases, selected relevant studies and extracted data regarding maternal and neonatal outcomes from each article. Results: Data of 11078 pregnant women with COVID-19 of 23 countries were assessed from 77 articles between December 8, 2019 and Aug 18, 2020. Most pregnant women reported in their third trimester, out of which 6229 (56.22%) cases were symptomatic at the time of admission. Common onset symptoms, abnormal laboratory findings, and chest computed tomography pattern were cough (40.88%), lymphocytopenia (43.38%), and multiple ground-glass opacities (4.42%), respectively. 51.37% of all deliveries were done through cesarean section. 158 maternal mortality and 4.2 % ICU admission were reported. Vertical transmission was not reported, but its possibility was suggested in thirty-two neonates. Ten neonatal deaths, thirteen stillbirths, and nineteen abortions were reported. 60% of newborns were not breastfed. Conclusion: This review showed fewer adverse maternal and neonatal outcomes in pregnant women with COVID-19 in comparison with previous coronavirus outbreak infection in pregnancy. Limited data are available regarding the possibility of virus transmission in utero, during vaginal childbirth and breastfeeding. The effect of COVID-19 on the first and second trimesters and ongoing pregnancy outcomes in infected mothers is still questionable.


1970 ◽  
Vol 2 (2) ◽  
pp. 16-19
Author(s):  
Veena Agrawal ◽  
Sonal Kulshresta

Objectives: To determine the incidence and rate of persistence of placenta praevia diagnosed as low lying placenta in d" 20 weeks' gestation using sonography (USG) and to establish its' co-relation with pregnancy outcome. Methods: Randomized 230 pregnant women studied by USG at d" 20weeks gestation. Among them 42 were recruited for study as they were having low lying placenta. These cases were rescanned at e" 28 weeks. Results: In 230 cases, the incidence of low lying placenta at d" 20weeks was18.26% (42/230); 90.5% had lateral, 2.4% had marginal and 7.1% had total placenta praevia. A total of 26 (61.9%) cases, had threatened abortion and two patients aborted. On longitudinal follow-up, 80% of remaining 40 cases had normally situated placenta at rescan. However those with total placenta praevia at d" 20weeks persisted as such with 100% persistence while only 10.5% with lateral low lying placenta persisted. APH was presentation in 3(7.1%), all of them undergoing cesarean sections for placenta praevia. Conclusion: Ultrasonography at < 20 weeks gestation showing low lying placenta has been useful in predicting placenta praevia at third trimester. Total placenta at this gestation has invariably persisted as placenta previa at third trimester. Key words: Placenta, Low lying Placenta, Placenta Praevia, APH  doi:10.3126/njog.v2i2.1449 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 16 - 19


Anemia ◽  
2020 ◽  
Vol 2020 ◽  
pp. 1-10 ◽  
Author(s):  
Bahredin Abdella ◽  
Mohammed Ibrahim ◽  
Iyasu Tadesse ◽  
Kalkidan Hassen ◽  
Mekonnin Tesfa

Background. Anemia in pregnancy is defined as a hemoglobin (Hb) concentration of less than 11 grams (gm)/deciliter (dl) in venous blood. Globally, it affects 1.62 billion people. In developing countries, anemia is a major cause of maternal and child morbidity and mortality. Globally, anemia contributes to 20% of all maternal deaths. Nearly 50% of the world’s population is estimated to be infected with Helicobacter pylori (HP). High prevalence of HP among pregnant women was also reported in developing countries than developed ones. The association between HP infection and occurrence of anemia is not well known in Ethiopia. Therefore, the aim of this study was to determine the association between anemia and Helicobacter pylori infection among pregnant women attending antenatal care follow-up in Kulito Health Center, Halaba Zone, South Ethiopia. Methods. Institution-based cross-sectional study was employed. Systematic random sampling procedure was employed to select 236 pregnant women who attended antenatal care at Kulito Health Center. An interviewer-administered questionnaire supplemented by laboratory tests was used to obtain the data. The collected data were analyzed by using SPSS version 20.0. Results. The prevalence of anemia among antenatal care attendant pregnant women of Kulito Health Center was 27.5% with 36 (15.2%) of mild, 29 (12.3%) of moderate, and no severe cases of anemia. The overall prevalence of HP infection among study participants was found to be 129 (54.7%) (95% CI: 47.9–61.4). Factors significantly associated with anemia were presence of HP infection (AOR = 3.064, 95% CI: 1.336 7.027), low interpregnancy gap (AOR = 2.863, 95% CI: 1.245–6.582), being on the third trimester (AOR = 6.457; 95% CI: 1.276–32.729), and mid-upper arm circumference (MUAC) level <21 cm (AOR = 2.595, 95% CI: 1.044–6.450). Conclusion. This study revealed that anemia and HP infection were highly prevalent among pregnant women attending the antenatal follow-up clinic in Kulito Health Center. HP infection, low interpregnancy gap, being on the third trimester, and MUAC less than 21 cm were the independent factors associated with anemia. Recommendation. Pregnant women should be aware that anemia is a problem that can be prevented by early prevention and treatment of HP infection and undernutrition, using family planning to widen the interpregnancy gap. Further experimental studies are warranted to determine the cause and effect of the association between anemia and HP infection.


2021 ◽  
Author(s):  
Rajesh Kumar Mishra ◽  
Sangeet Kumar ◽  
Sushin Mohapatra

Abstract The ongoing pandemic of COVID-19 disease has adverse effects on both pregnant women and their fetuses. However the literature about the effects of this disease on placenta and its clinical implication is limited. Here we report two cases of severe oligohydramnios detected in asymptomatic patients with covid infection. In both of our patients, severe oligohydramnios was detected during routine antenatal check up in third trimester of pregnancy. Both the patients underwent cesarean delivery and delivered healthy neonates. The onset of oligohydramnios was noticed to be very fast and not associated with severity of symptoms of Covid-19 infection. It is recommended for increase in number of ultrasound examination in pregnant women positive for covid-19 infection in view of our findings.


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