scholarly journals Foetal and Neonatal Outcome in Pregnant Women with COVID-19

2020 ◽  
Vol 40 (3) ◽  
pp. 143-156
Author(s):  
Rupesh Shrestha ◽  
Srijana Basnet ◽  
Laxman Shrestha

Introduction: The pandemic caused by coronavirus disease 2019 has adversely affected the health of all individuals including pregnant women. The susceptibility of pregnant women and their foetuses to severe acute respiratory syndrome coronavirus 2 infection is not clearly known. The objective of this review is to summarise the available evidence on foetal and neonatal outcomes of pregnant women with confirmed coronavirus disease 2019. Methods: The review was conduced by searching the PubMed and MedRxiv databases for studies reporting outcome of pregnancy with confirmed coronavirus disease from December 2019 to April 2020 using combination of terms "pregnancy", "coronavirus disease 2019", "foetal outcome" and "neonatal outcome". Only peer reviewed articles reporting outcome of pregnancy with confirmed coronavirus disease 2019 were included in the review irrespective of language. Ongoing pregnancies, induced abortion, and pregnancies without outcome were excluded from analysis. Variables extracted and analysed included gestational age at delivery, mode of delivery, foetal and neonatal outcome. Results: In total, 21 studies consisting 230 pregnant women including three twin pregnancies were enrolled in the study. Fever and cough were the most common symptoms reported in pregnant women. One hundred and sixty-two (70.4%) pregnant women underwent cesarean section and there were 68 (29.6%) preterm deliveries. Eight babies tested positive out of 161 newborns that were tested for coronavirus infection. Among adverse outcomes reported, there were two miscarriages, two still births and only one neonatal death. Conclusions: Outcome of pregnancy with coronavirus disease 2019 in late trimester appears to be favourable. Occurrence of preterm delivery and cesarean section appear higher among infected pregnant women in comparison to general population. There was no conclusive evidence of vertical transmission.

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Mirijam Hall ◽  
David Endress ◽  
Susanne Hölbfer ◽  
Barbara Maier

AbstractObjectivesTo report clinical data on maternal outcome, mode of delivery and immediate neonatal outcome in women infected with COVID-19.MethodsRetrospective data collection.ResultsA total of 8.6% of the total population of hospitalised SARS-CoV-2 positive pregnant women were admitted to a critical care unit. The premature birth rate for births before 34+0 weeks of gestation among pregnant women who tested positive for SARS-CoV-2 was 7.1%. One newborn (3.6%) tested positive for SARS-CoV-2 two days after birth and showed symptoms.ConclusionsPregnant women with COVID-19 seem to be at higher risk of invasive ventilation, admission to a critical care unit and preterm birth, and should therefore be considered a high-risk-population.


2020 ◽  
Author(s):  
Mahboubeh Shirzad ◽  
Elham Shakibazadeh ◽  
Abbas Rahimi Foroushani ◽  
Mehrandokht Abedini ◽  
Hamid Poursharifi

Abstract Background: Cesarean section is an important surgical procedure to save mothers and/or babies’ lives. Current trends show that the rate of Cesarean section is increasing dramatically over the years. The aims of this study were to compare the effects of "motivational interviewing" and "information, motivation and behavioral skills” model on choosing mode of delivery among pregnant women.Methods: In a four-armed, parallel-design randomized controlled trial, 120 women were randomly assigned to three brief interventions and one control groups. We recruited pregnant women referring to Ebnesina hospital, Tehran- Iran from 2019-2020. The intervention groups included: 1) motivational interviewing; 2) face-to-face information, motivation and behavioural skills model; and 3) information, motivation and behavioural skills model provided using a mobile application. The inclusion criteria were being literate, gestational age 24 to 32 weeks, being able to speak Persian, having no complications in the current pregnancy, having no indications for CS, and having enough time to participate in the study. The most important outcomes of the study included women’s intentions to undergo any mode of delivery, women’s self-efficacy in choosing the mode of delivery, and mode of delivery. Data were analyzed using descriptive statistics (mean, frequency and standard deviation), inferential statistics including independent t-test, paired t-test, Chi-squared and One-way ANOVA tests and logistic regression.Results: Following the interventions, significant differences were found in the mode of delivery (P < 0.05) and women’s self-efficacy and intention (P < 0.05). Women who had used the mobile application had more improvements in the self-efficacy and intention than the face-to-face intervention groups.Conclusions: Our study showed positive significant effects of various types of brief interventions to reduce unnecessary Cesarean section rate among the participant women. Providing the intervention using mobile application showed even better results. Our findings may contribute to a rise in normal vaginal delivery; and these simple, non-expensive, tailored to women, and culture-oriented brief interventions can be considered as appropriate strategies to reduce Cesarean section rate in local, national, and/or regional levels.Trial registration: This study has been registered in Iran Randomized Clinical Trial Center (IRCT20151208025431N7). Registered October 07, 2018.


2021 ◽  
Vol 15 (10) ◽  
pp. 3423-3425
Author(s):  
Amna Najam ◽  
Samreen Fakeer Muhammad ◽  
Samia Saifullah ◽  
Maryam Shoaib ◽  
Maria Anwar

Objective: The aim of this study is to compare the fetal and maternal outcomes in between asymptomatic and symptomatic COVID positive pregnant women. Study Design: Retrospective cohort study Place and Duration: The study was conducted at Gynae and Obs department of Sandeman Provincial Hospital, Quetta for duration of six months from November 2020 to April 2021. Methods: One hundred and ten pregnant women with ages 18-45 years had corona virus disease were presented. Informed written consent was taken from all patients for detailed demographics. COVID -19 was diagnosed by PCR. 55 patients had symptoms of coronavirus were included in group A and 55 patients did not show symptoms were included in group B. Frequency of pre-eclampsia, gestational diabetes mellitus and post-partum haemorrhage were calculated. Maternal adverse outcomes (cesarean section, instrumental delivery, induction of labor and prolong labor, hypertensive disorder) were calculated among both groups. Fetal outcomes perinatal mortality, Low birth weight, Low Apgar score and NICU admission were observed. SPSS 20.0 version was used to analyze all data. Results: Mean age of the patients in group A was 28.47±3.18 years with mean BMI 24.03±5.24 Kg/m2 and in group B mean age was 27.99±4.17 years with mean BMI 24.44±6.41 Kg/m2. Maternal outcomes (cesarean section, instrumental delivery, induction of labor and prolong labor,) in symptomatic group were significantly higher than that of asymptomatic group. Fetal outcomes, perinatal mortality in group A 9 (16.4%) and in group B was 5 (9.1%), low birth weight in group A was among 21 (38.2%) and in group B was 10 (18.2%), low apgar score in group A was 11 (20%) and in group B was 8 (14.4%), 15 (27.3%) in group A went to NICU admission and 3 (5.5%) patient in group II admitted to NICU. Conclusion: In this study we concluded that adverse outcomes among symptomatic COVID pregnant women were higher than that of asymptomatic coronavirus pregnant women in terms maternal and perinatal outcomes. Keywords: Pregnant women, Coronavirus, Symptomatic, Asymptomatic, Adverse Outcomes


Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Mahboubeh Shirzad ◽  
Elham Shakibazadeh ◽  
Abbas Rahimi Foroushani ◽  
Mehrandokht Abedini ◽  
Hamid Poursharifi ◽  
...  

Abstract Background Cesarean section is an important surgical procedure, when normal vaginal delivery imposes a risk to mother and/or baby. The World Health Organization states the ideal rate for Cesarean section to be between 10 and 15% of all births. In recent decades, the rate has been increased dramatically worldwide. This paper explains the protocol of a randomized controlled trial that aims to compare the effect of “motivational interviewing” and “information, motivation, and behavioral skills” counseling interventions on choosing mode of delivery in pregnant women. Methods A four-armed, parallel-design randomized controlled trial will be conducted on pregnant women. One hundred and twenty women will be randomly assigned to four groups including three intervention groups and one control group. The intervention groups included the following: (1) motivational interviewing; (2) face-to-face information, motivation, and behavioral skills model; and (3) information, motivation, and behavioral skills model provided using a mobile application. The inclusion criteria include being literate, being in gestational age from 24 to 32 weeks, being able to speak Persian, having no complications in the current pregnancy, having no indications for Cesarean section, and having enough time to participate in the intervention. The primary outcome of the study is the mode of delivery. The secondary outcomes are women’s intention to undergo Cesarean section and women’s self-efficacy. Discussion The interventions of this protocol have been programmed to reduce unnecessary Cesarean sections. Findings may contribute to a rise in normal vaginal delivery, and the effective intervention may be extended for use in national Cesarean section plans. Trial registration Iran Randomized Clinical Trial Center IRCT20151208025431N7. Registered on December 07, 2018.


2020 ◽  
Vol 80 (10) ◽  
pp. 1033-1040
Author(s):  
Anne Dathan-Stumpf ◽  
Katharina Winkel ◽  
Holger Stepan

Abstract Objective The appropriate delivery mode for twins is discussed controversially in the literature. The aim of this study was to investigate delivery modes and short-term neonatal outcomes of twin pregnancies delivered in University Hospital Leipzig. Material and Methods A total of 274 twin pregnancies (32.0 to 39.4 weeks of gestation) delivered between 2015 and 2017 were analyzed retrospectively with regard to the planned and final delivery mode as well as neonatal outcomes. The inclusion and exclusion criteria for vaginal delivery were comparable to those of the Twin Birth Study. Results The spontaneous birth rate for births planned as vaginal deliveries was 78.5%; the rate of secondary cesarean section was 19.4%. The final total cesarean rate was 58.8%, and the rate of vaginal deliveries was 41.2%. Vertex or non-vertex position of the second twin had no significant effect on neonatal outcome or mean delivery interval between the birth of the first and second twin. Chorionicity, neonatal weight and gender had no significant impact on delivery mode. However, successful vaginal delivery was associated with higher gestational age and both fetuses in vertex position. The combined neonatal outcome for both twins was significantly worse if they were delivered by cesarean section compared to spontaneous birth. In addition, the leading twin in monochorionic/diamniotic (MC/DA) pregnancies was intubated more frequently after cesarean delivery and had significantly lower Apgar scores. Conclusion Vaginal delivery in twin pregnancies is a practicable and safe option in specific defined conditions and when the appropriate infrastructure and clinical experience is available.


Author(s):  
Parag M. Hangekar ◽  
Anand Karale ◽  
Neelesh Risbud

Background: Preterm birth is defined as birth between the age of viability and 37 completed weeks of gestation. The aim of this study is to evaluate the safety and efficacy of nifedipine, a calcium channel blocker, as a tocolytic in prolonging duration of pregnancy in case of preterm labor.Methods: This is a retrospective analytical study conducted in Department of Obstetrics and Gynaecology, SKNMC and GH, Pune, India conducted over a period of one year from June 2014 to May 2015. All uncomplicated, singleton preterm labor cases were given Cap. Nifedipine as tocolytic and Inj. Betamethasone for enhancing fetal lung maturity. Maternal parameters studied were Gravida and Parity, previous history of preterm labor, gestational age at delivery, mode of delivery, side effects. Neonatal parameters studied were weight at birth, APGAR score at birth, complications at birth, NICU admissions, mortality.Results: Out of total 4478 deliveries from June 2014 to May 2015, 252 women with preterm labor were treated with nifedipine. 214 out of 252 delivered at term with overall success rate of 84.92%. Out of remaining 38 cases, 36 cases delivered as preterm normal deliveries and 2 required Caesarean section. No major side effects observed in mothers receiving nifedipine. As regards neonatal outcome, 12 babies required NICU admission and mortality was of 2.Conclusions: Nifedipine is safe and effective in prolonging preterm labor and has minimal maternal and neonatal side effects. It eliminates the need for intensive maternal monitoring as required in case of betamimetics.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Zhifen Hua ◽  
Fadwa El Oualja

Abstract Background The delivery mode for pregnant women with uteruses scarred by prior caesarean section (CS) is a controversial issue, even though the CS rate has risen in the past 20 years. We performed this retrospective study to identify the factors associated with preference for CS or vaginal birth after CS (VBAC). Methods Pregnant women (n = 679) with scarred uteruses from Moulay Ali Cherif Provincial Hospital, Rashidiya, Morocco, were enrolled. Gestational age, comorbidity, fetal position, gravidity and parity, abnormal amniotic fluid, macrosomia, placenta previa or abruptio, abnormal fetal presentation, premature rupture of fetal membrane with labor failure, poor progression in delivery, and fetal outcomes were recorded. Results Out of 679 pregnant women ≥28 gestational weeks, 351 (51.69%) had a preference for CS. Pregnant women showed preference for CS if they were older (95% CI 1.010–1.097), had higher gestational age (95% CI 1.024–1.286), and a shorter period had passed since the last CS (95% CI 0.842–0.992). Prior gravidity (95% CI 0.638–1.166), parity (95% CI 0.453–1.235), vaginal delivery history (95% CI 0.717–1.818), and birth weight (95% CI 1.000–1.001) did not influence CS preference. In comparison with fetal preference, maternal preference was the prior indicator for CS. Correlation analysis showed that pregnant women with longer intervals since the last CS and history of gravidity, parity, and vaginal delivery showed good progress in the first and second stages of vaginal delivery. Conclusions We concluded that maternal and gestational age and interval since the last CS promoted CS preference among pregnant women with scarred uteruses.


2021 ◽  
Author(s):  
zijun li ◽  
Xin Zhou ◽  
Yaqin Zheng ◽  
Min Liu ◽  
Xiaoying Fu ◽  
...  

Abstract Background Currently, FM is a sole subjective index which depends on self-assessment of pregnant women, and it can objectively reflect the well being of intrauterine fetus. It has been the focus of obstetricians' research and attention how to quantify fetal movement (FM) and change it into a relatively objective evaluation index. We sought to predict and evaluate the well being of intrauterine fetal with umbilical cord around the neck (UCAN) by performance of daily fetal movement counting chart (DFMC). Methods To retrospectively select 100-case pregnant women who met the enrolled requirements, and whether the fetal was intrauterine safety or not was predicted by analysis of the DFMC before delivery. According to the different perinatal outcomes after delivery, 100-cases pregnant women were divided into intrauterine safety (IUS) group (44 cases) and intrauterine unsafe (IUNS) group (56 cases). And the independent risk factors of fetal intrauterine safety, including maternal age, gestational week, umbilical artery systolic blood flow to diastolic blood flow ratio (S/D), amniotic fluid index (AFI), modified Fischer score of non stress test (NST), DFMC and mode of delivery were analyzed by multi-factors Binary Logistic Regression. Results Only FM and mode of delivery were independent risk factors affecting fetal safety intrauterine (all p value < 0.05). There was no remarkable difference between DFMC prediction and clinical retrospective evaluation of fetal safety in natural delivery and forceps delivery (all P value > 0.05), except in cesarean section (p < 0.05). The sensitivity, specificity and Yuden index of DFMC for predicting the intrauterine safety in natural vaginal delivery were 86.5%, 90.0% and 0.77 respectively, and in cesarean section were 66.7%, 94.6% and 0.61, respectively. Abnormal DFMC may account for the highest proportion of emergency cesarean section (87.5%, 35/40). Conclusions DFMC can effectively predict and evaluate the well being of intrauterine fetus with UCAN. At the same time, it can also provide limited clinical proofs for pregnant women with UCAN to choose model of delivery.


2020 ◽  
Author(s):  
Mahboubeh Shirzad ◽  
Elham Shakibazadeh ◽  
Abbas Rahimi Foroushani ◽  
Mehrandokht Abedini ◽  
Hamid Poursharifi ◽  
...  

Abstract Background: Caesarean Section is an important surgical procedure, when normal vaginal delivery imposes a risk to mother and/or baby. The World Health Organization states the ideal rate for Cesarean section to be between 10% and 15% of all births. In recent decades, the rate has been increased dramatically worldwide. This paper explains the protocol of a randomized controlled trial that aims to compare the effect of "motivational interviewing" and "information, motivation, and behavioral skills” counselling interventions on choosing mode of delivery in pregnant women.Methods: A four-armed, parallel-design randomized controlled trial will be conducted on pregnant women. One hundred and twenty women will be randomly assigned to four groups including three intervention groups and one control group. The intervention groups included: 1) motivational interviewing; 2) face-to-face information, motivation, and behavioral skills model; and 3) information, motivation, and behavioral skills model provided using a mobile application. The inclusion criteria include being literate, gestational age from 24 to 32 weeks, being able to speak Persian, having no complications in the current pregnancy, having no indications for Cesarean section, and having enough time to participate in the intervention. The primary outcome of the study is the mode of delivery. The secondary outcomes are women’s intention to undergo Cesarean section, and women’s self-efficacy.Discussion: The interventions of this protocol have been programmed to reduce unnecessary Cesarean sections. Findings may contribute to a rise in normal vaginal delivery; and the effective intervention may be extended for use in national Cesarean section plans.Trial registration: This study has been registered in Iran Randomized Clinical Trial Center (IRCT20151208025431N7). Registered December 07, 2018.


2020 ◽  
Author(s):  
Manyu Li ◽  
Jie Yin

Abstract Background: To detect the maternal and neonatal outcomes of late pregnant patients complicated with sepsis shock.Methods: The medical records of all late pregnant patients (>=28 weeks) complicated with septic shock from January 2011 through November 2018 in Peking Union Medical College Hospital were retrospectively reviewed. Pertinent literature was identified by searching PubMed and EMBASE.Results: A total 9 patients with an average age of 26.11±6.9 years were included in this study. And the mean gestational age at diagnosis of septic shock was 33 weeks plus 1 day. 87.5% of patients accepted emergency delivery, in which cesarean section was the main delivery mode. 7 patients underwent emergency delivery (including 3 cases of fetal death) and 3 cases of live births (including 1 case of mild neonatal asphyxia). The total maternal mortality rate was 33.3%, and neonatal death rate was 55.6%. Only 1 patient continued pregnancy after disease recovery. 15 published case reports were reviewed. The reported maternal and perinatal death rates were 20% and 46.7% respectively. 2 patients could continue pregnancy after treatment. Group A streptococcus was considered as the main pathogenic bacteria.Conclusions: Late pregnancy complicated with septic shock was associated with high maternal and fetal mortality. Emergency delivery was advised in most of patients. And cesarean section was the main mode of delivery.


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