scholarly journals Association Between COVID-19 Pregnant Women Symptoms Severity and Placental Morphologic Features

2021 ◽  
Vol 12 ◽  
Author(s):  
Patricia Zadorosnei Rebutini ◽  
Aline Cristina Zanchettin ◽  
Emanuele Therezinha Schueda Stonoga ◽  
Daniele Margarita Marani Prá ◽  
André Luiz Parmegiani de Oliveira ◽  
...  

Since the beginning of the pandemic, few papers describe the placenta’s morphological and morphometrical features in SARS-CoV-2–positive pregnant women. Alterations, such as low placental weight, accelerated villous maturation, decidual vasculopathy, infarcts, thrombosis of fetal placental vessels, and chronic histiocytic intervillositis (CHI), have been described.ObjectiveTo analyze clinical data and the placental morphological and morphometric changes of pregnant women infected with SARS-CoV-2 (COVID-19 group) in comparison with the placentas of non-infected pregnant women, matched for maternal age and comorbidities, besides gestational age of delivery (Control group).MethodThe patients in the COVID-19 and the Control group were matched for maternal age, gestational age, and comorbidities. The morphological analysis of placentas was performed using Amsterdam Placental Workshop Group Consensus Statement. The quantitative morphometric evaluation included perimeter diameter and number of tertiary villi, number of sprouts and knots, evaluation of deposition of villous fibrin, and deposition of intra-villous collagen I and III by Sirius Red. Additionally, Hofbauer cells (HC) were counted within villi by immunohistochemistry with CD68 marker.ResultsCompared to controls, symptomatic women in the COVID-19 group were more likely to have at least one comorbidity, to evolve to preterm labor and infant death, and to have positive SARS-CoV-2 RNA testing in their concepts. Compared to controls, placentas in the COVID-19 group were more likely to show features of maternal and fetal vascular malperfusion. In the COVID-19 group, placentas of symptomatic women were more likely to show CHI. No significant results were found after morphometric analysis.ConclusionPregnant women with symptomatic SARS-CoV-2 infection, particularly with the severe course, are more likely to exhibit an adverse fetal outcome, with slightly more frequent histopathologic findings of maternal and fetal vascular malperfusion, and CHI. The morphometric changes found in the placentas of the COVID-19 group do not seem to be different from those observed in the Control group, as far as maternal age, gestational age, and comorbidities are paired. Only the deposition of villous fibrin could be more accentuated in the COVID-19 group (p = 0.08 borderline). The number of HC/villous evaluated with CD68 immunohistochemistry did not show a difference between both groups.

2015 ◽  
Vol 8 (7) ◽  
pp. 235 ◽  
Author(s):  
Negin Rezavand ◽  
Firooze Veisi ◽  
Mrayam Zangane ◽  
Roghaye Amini ◽  
Afshin Almasi

<p>Asymptomatic bacteriuria is one of the most common and important bacterial infections during pregnancy and can result in progressive infections and endanger maternal as well as fetal health. In this study, we assessed the relationship between asymptomatic bacteriuria and pre-eclampsia. In this case-control study, pregnant women who presented to Imam Reza Hospital in Kermanshah in 2013-14 were studied. The minimum sample size was calculated as 125 pregnant women in each group with a total of 250 subjects. There were 125 women with pre-eclampsia and 125 women without pre-eclampsia (control group). Matching was done for age, gestational age, and parity between case and control groups. Matching was verified by a P value of 0.061 for maternal age and gestational age and 0.77 for parity. The statistical analyses were done by applying the chi-squared test and determining odds ratio (OR) for having bacteriuria in univariate logistic regression as well as multivariate regression with adjusting the effect of maternal age, gestational age, and parity. Pyuria and bacteriuria were significantly more common in pre-eclampsia group than in control group. The results showed that a significant association existed between asymptomatic bacteriuria and pre-eclampsia. The rate of asymptomatic bacteriuria was 6.8 times higher in women with pre-eclampsia compared to those without pre-eclampsia. Further studies are required for better clarification of association between asymptomatic bacteriuria and pre-eclampsia.</p>


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Dong Wang ◽  
Caixia Liu ◽  
Xinyu Liu ◽  
Ying Zhang ◽  
Yu Wang

Abstract Background Due to metabolic changes in the second trimester and the increasing number of pregnant women with obesity and advanced maternal age, the incidence of gestational diabetes mellitus (GDM) remains high. This study aimed to evaluate the effects of GDM on fetal cardiac morphology and function, and to determine whether these changes increase with increasing estimated fetal weight (EFW). Methods Fifty-eight women with GDM (GDM group) and 58 women with a healthy pregnancy (control group) were included in this prospective observational cohort study. Each group included subgroups of 31 pregnant women with a gestational age between 24+0 weeks and 27+6 weeks as well as 27 pregnant women with a gestational age between 28+0 weeks and 40+0 weeks. For all fetuses, a cine of 2–3 s in the four-chamber view was obtained, and online speckle-tracking analysis was performed using the GE Automatic Fetal Heart Assessment Tool (fetal HQ; General Electric Healthcare Ultrasound, Zipf, Austria) to measure the global sphericity index (GSI), global longitudinal strain (GLS), fractional area change (FAC), 24-segment sphericity index (SI), and 24-segment end-diastolic diameter of the left ventricle (LV) and right ventricle (RV). Data were analyzed using the independent t-test and Wilcoxon rank-sum test, as applicable. Results The GDM group (mean HbA1c value was 5.3 ± 0.57 mmol/L) showed a lower GSI value than the control group (1.21 vs. 1.27, P = 0.000), which indicated a rounder shape of the heart. In addition, fetuses in the GDM group demonstrated significant impairment in cardiac function compared to those in the control group (LV-GLS: -18.26% vs. -22.70%, RV-GLS: -18.52% vs. -22.74%, LV-FAC: 35.30% vs. 42.36%, RV-FAC: 30.89% vs. 36.80%; P = 0.000 for all). Subgroup analyses according to gestational age (24+0–27+6 weeks and 28+0–40+0 weeks) showed that the statistical differences were retained between the GDM and control groups in each subgroup. Conclusions Fetuses of women with GDM present with signs of biventricular systolic dysfunction according to deformation analysis using fetal HQ. Additionally, the heart had a rounder shape in the GDM group than in the control group. This study showed that fetal HQ can be used to assess fetal cardiac morphology and function easily and quickly, and the effects of GDM on fetal cardiac morphology and function appeared from the second trimester. Thus, whether earlier and stricter clinical intervention was necessary remained to be further studied. Furthermore, future studies will need to supplement the effects of blood glucose levels on GLS, FAC, GSI, and 24-segment SI. Additionally, the long-term follow-up after birth should also be improved to observe the influence of changes in the indicators on the prognosis.


2021 ◽  
Vol 8 ◽  
pp. 2333794X2199915
Author(s):  
Haymanot Mezmur ◽  
Nega Assefa ◽  
Tadesse Alemayehu

Background: According to the World Health Organization, teenage pregnancies are high-risk due to increased risks of fetal and infant morbidity and mortality. This study compares adverse fetal outcomes between teen and adult pregnant women from rural Eastern Ethiopia. Methods: Institutional-based cross-sectional study was conducted among women visiting maternity units from surrounding rural areas. A total of 481 teenagers (13-19 years old) and 481 adults (20-34 years old) women with a singleton pregnancy were included in the study. Two hospitals and 3 health centers were selected in Eastern Hararghe Zone, Eastern Ethiopia. Comparative analysis was carried out using the log-binomial regression model to identify factors associated with adverse fetal outcomes in both categories. The results are reported in adjusted prevalence ratios with 95% confidence intervals. Results: High proportion of adverse fetal outcome was observed among teenage women than adult (34.9% vs 21%). Statistically significant difference ( P < .05) in the proportion of low birth weight (21.1% vs 9.3%), preterm birth (18.7% vs 10.6%), APGAR score at 5th minute (9.3% vs 4%) were found in teenagers compared to adult women. Antenatal care attendance (APR = 0.44; 95% CI: 0.23, 0.86); eclampsia (APR = 1.96; 95% CI: 1.26, 3.06); pre-eclampsia (APR = 1.73; 95% CI: 1.12, 2.67); and wealth index (rich) (APR = 0.55; 95% CI: 0.32, 0.94) were significantly associated with adverse fetal outcomes among the teenage women. Whereas intimate partner violence (APR = 2.22; 95% CI: 1.26, 3.90); preeclampsia (APR = 3.05; 95% CI: 1.61, 5.69); antepartum hemorrhage (APR = 2.77; 95% CI: 1.73, 4.46); and hyperemesis gravderm (APR = 1.75; 95% CI: 1.09, 2.79) were significantly associated with adverse fatal outcomes among the adult women. Conclusion: teenage pregnancy is associated with a high rate of adverse fetal outcomes. Early identification and treatment of problems during antenatal follow-up should be the mainstay to avert the massive adverse fetal effects.


2021 ◽  
Vol 15 (5) ◽  
pp. 1774-1779
Author(s):  
Sanaz Nehbandani ◽  
Hajar Salehi ◽  
Khadije Rezaie Keikhaie ◽  
Hossein Rashki Ghalenow ◽  
Fatemeh Mirzaie ◽  
...  

Introduction & Objective: Nausea and vomiting during pregnancy is one of the most common gastrointestinal disorders that more than 85% of pregnant women experience. However, controlling and treating this complication is still one of the most important issues in antenatal care. Therefore, the aim of this study was to investigate the effect of ear acupressure at Shen Men point on relieving nausea, vomiting and retching during pregnancy. Materials and Methods: In this quasi-experimental study, 100 pregnant women with a gestational age of less than 16 weeks attending the health clinics of Zabol city during 2019-2020 were studied in two control and intervention groups (n = 50 in each group). The samples in the intervention group were trained to apply pressure on their ears’ Shen Men point with the thumb for three minutes three times a day (morning, noon, and night), for a duration of one month. At the end of second and fourth weeks, the data were collected using the Rhodes index form and then, were analyzed by SPSS software version 22. Results: According to the results, there was no significant difference between the two groups in terms of age, gestational age, occupation and education. The difference in the mean scores of nausea, vomiting and retching was not statistically significant between the control and intervention groups before the study. But four weeks after the study, a significant difference was observed in the mean scores of vomiting, nausea and retching between the two groups, so that the mean scores of vomiting, nausea and retching were significantly lower in the intervention group than in the control group. Conclusion: The ear acupressure medicine at the Shen men point can be used as a non-invasive, safe and inexpensive method to relieve nausea, vomiting and retching during pregnancy. Keywords: Acupressure medicine, Shen Men, Vomiting, Pregnancy, Nausea, Retching, Rhodosis


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Cuiqin Huang ◽  
Wei Han ◽  
Yajing Fan

Abstract Background We aimed to analyze the correlation between increased fetal movements in the third trimester and neonatal outcomes. Methods We enrolled pregnant women (n = 219) who reported increased/excessive fetal movements in the third trimester in our hospital. A control group of healthy women (n = 278) who had undergone regular childbirth and delivery in our hospital during the same period and did not report abnormal fetal movements were also recruited. All pregnant women underwent fetal non-stress test. We analyzed the neonatal weight, appearance, pulse, grimace, activity, and respiration score, degrees of amniotic fluid contamination, amniotic fluid volume, conditions of umbilical cord around the neck and cord length, and incidence of small for gestational age. In addition, the incidence of preterm delivery, cesarean section rate, postpartum hemorrhage, and other postpartum complications were also analyzed. We then analyzed the correlation between increased/excessive fetal activity and neonatal outcomes. Results Women with complaints of increased/excessive fetal movements exhibited increased fetal movements mainly around 31 and 39 weeks of gestation. Several pregnancy variables, including number of previous delivery, gestational age (less than 34 weeks and more than 37 weeks) and vaginal birth rate, were associated with increased/excessive fetal movements. In addition, women who reported increased/excessive fetal movements had higher odds of large for gestational age (LGA), particularly those with gestational age over 37 weeks. Conclusion Increased/excessive fetal movements may be used to predict adverse neonatal outcome such as LGA.


2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Farideh Akhlaghi ◽  
Seyyed Majid Bagheri ◽  
Omid Rajabi

In this paper, we studied the relation between the micronutrient and gestational diabetes. Therefore, we measured micronutrient concentration including Ni, Al, Cr, Mg, Fe, Zn, Cu, and Se in serum of women with gestational diabetes between 24 and 28 weeks of gestational age (study group) who had inclusion criteria and comparison with micronutrient levels in normal pregnant women with same gestational age (control group). Results showed that there was no significant difference between the serum micronutrient level (Ni, Al, Cr, Mg, Zn, Cu, Se) in study and control groups except serum level of iron which in serum of gestational diabetic women was lower than normal pregnant women and difference was significant.


2021 ◽  
Vol 42 ◽  
Author(s):  
Priscila Costa ◽  
Paula Rosenberg de Andrade ◽  
Bruna Arends Roschel Tomaz ◽  
Samara Macedo Cordeiro ◽  
Danielle Castro Jansen ◽  
...  

ABSTRACT Objective: To verify if participation in educational workshops about bonding with the fetus influences the adoption of practices of interaction with the baby by pregnant women. Method: Randomized clinical trial conducted in a health clinic. The experimental group participated in educational workshops designed for the pregnant couple and the control group received usual care. The practices of interaction with the fetus were evaluated before and after the intervention. Results: 19 pregnant women participated in the study. There was a positive correlation between higher gestational age and the interaction with the fetus (p = 0.016), and between younger mothers and the practice of touching or poking the baby (p = 0.019). There was an increase in the interaction with the fetus in the control and experimental groups (p= 0.024). Conclusion: Educational workshops are strategies for sharing knowledge about fetuses' sensory skills and to foster bonding and child development since pregnancy.


2021 ◽  
Vol 28 (12) ◽  
pp. 1763-1767
Author(s):  
Fouzia Perveen ◽  
Lubna Ali ◽  
Afshan Hasan

Objective: To find out the frequency of subclinical hypothyroidism (SCH) in our pregnant population during 1st Trimester and the mean TSH level in first trimester of pregnancy. Study Design: Cross Sectional Descriptive study. Setting: Dow University Hospital and Dr Ruth KM Pfau CHK. Period: June 2015 to May 2016. Material & Methods: All Pregnant women with <14 weeks gestation were screened for Serum TSH level. Data were recorded after informed consent and institutional ethical approval. Variables recorded were age, parity, gestational age and serum TSH level. Data were analyzed on SPSS version 16. Mean and SD were calculated for quantitative variables ie. Age, parity, gestational age, serum TSH level and serum free T4 level. Mean TSH level according to age group, parity and gestational age groups were determined by applying ANOVA test. Correlation of Serum TSH level with the maternal age, parity and gestational age groups were also assessed by Pearson Correlation test. Significant P-value was taken as <0.05. Results: The frequency of SCH found was 19.35% by taking cut off limit of <2.5 IU/L and 3.55% by taking cut off limit of <4.5 IU/L among total of 310 pregnant women. Mean TSH level was 1.84±1.36 IU/L. The mean maternal age was 27.22 ± 4.43 yrs. while median parity was 1. Mean gestational age of these patients were 9.41 ± 2.748 weeks and out of these 160 (51.61%) were between 4-9 weeks and 150(48.38%) between 10-14 weeks. Majority (74%) of these women belonged to lower middle socioeconomic class. Mean TSH level coorelation between different age groups, parity groups and gestational age groups were found to be insignificant. Conclusion: The prevalence of SCH is not so high and mean TSH level in our population was 1.84 IU/L. But to establish reference range for Pakistani population, further studies in population of different backgrounds and geographical distribution needs to be evaluated.


2020 ◽  
Vol 12 (02) ◽  
pp. 217
Author(s):  
Sri Handayani ◽  
Praise Milie

ABSTRAKLatar Belakang. Upaya pemerintah dalam rangka pencegahan preeklampsia saat ini mendapatkan tantangan baru dengan adanya Pandemi Covid-19. Upaya pemerintah untuk mencegah peningkatan kasus Covid 19 adalah dengan kebijakan protokol kesehatan. Bidan sebagai ujung tombak pelayanan kesehatan harus memiliki inovasi tepat guna dalam memberikan Pendidikan kesehatan sehingga informasi akan lebih efisien dan efektif diberikan. Tujuan.Untuk mengetahui apakah ada pengaruh umur, pendidikan, pekerjaan, paritas dan umur kehamilan pada ibu hamil setelah diberikan pendidikan kesehatan melalui whatsapp group terhadap pengetahuan dan sikap ibu hamil dalam deteksi dini preeklampsia pada masa pandemi covid-19 di RSUD Simo. Metode Penelitian. Jenis penelitian ini adalah Quasi Experiment dengan desain one group pre test-post test design. Populasi pada penelitian ini adalah ibu hamil dengan usia kehamilan < 37 minggu yang terdiagnosa pre eklamsi dan memiliki nomor telepon yang terdaftar Whatsapp di Poliklinik kandungan RSUD Simo Boyolali periode 15 Agustus s/d 2 Sepetember 2020 sebanyak 45 orang. Sampel sebanyak 41 orang. Teknik sampling simple random sampling. Uji statistic bivariate denga Wilcoxon dan Multivariate dengan Regresi. Hasil. Umur ibu berpengaruh terhadap perubahan pengetahuan dengan p value 0,001. Pendidikan ibu tidak berpengaruh terhadap pengetahuan dengan p value 0,082. Pekerjaan ibu berpengaruh terhadap pengetahuan dengan p value 0,024. Paritas ibu tidak berpengaruh terhadap pengetahuan dengan p value 0,089 dan umur kehamilan ibu tidak berpengaruh terhadap pengetahuan dengan p value 0,073. Sedangkan umur ibu berpengaruh terhadap sikap dengan p value 0,001. Pendidikan ibu berpengaruh terhadap sikap dengan p value 0,010. Pekerjaan ibu tidak berpengaruh terhadap sikap dengan p value 0,100. Paritas berpengaruh terhadap sikap dengan p value 0,027 serta umur kehamilan tidak berpengaruh terhadap sikap dengan p value 0,052. Kata kunci : umur, Pendidikan, pekerjaan, paritas, umur kehamilan, Pendidikan kesehatan, whatsapp, pengetahuan, sikap, deteksi dini pre eklamsi  THE INFLUENCE OF HEALTH EDUCATION THROUGH WHATSAPP GROUPS ON THE KNOWLEDGE AND ATTITUDES OF PREGNANT WOMENT IN EARLY DETECTION OF PREECLAMSIA DURING THE COVID 19 PANDEMICABSTRACTBackground. The government's efforts to prevent preeclampsia are currently facing new challenges with the Covid-19 Pandemic. The government's effort to prevent an increase in Covid 19 cases is with a health protocol policy. Midwives as the spearhead of health services must have effective innovations in providing health education so that information will be more efficient and effective. Destination. To find out whether there is an effect of age, education, occupation, parity and gestational age in pregnant women after being given health education through WhatsApp group on the knowledge and attitudes of pregnant women in early detection of preeclampsia during the Covid-19 pandemic at Simo Hospital. Research methods. This type of research is a Quasi Experiment with one group pre-test-post-test design. The population in this study were pregnant women with gestational age <37 weeks who were diagnosed with pre-eclampsia and had a telephone number registered with Whatsapp at the Gynecology Polyclinic at Simo Boyolali Hospital for the period 15 August to 2 September 2020 as many as 45 people. A sample of 41 people.Simple random sampling technique.Bivariate statistical test with Wilcoxon and Multivariate with Regression. Result. Maternal age affects the change in knowledge with p value 0.001. Mother's education has no effect on knowledge with p value 0.082. Mother's job affects knowledge with p value 0.024. Maternal parity has no effect on knowledge with p value 0.089 and maternal gestational age has no effect on knowledge with p value 0.073. Meanwhile, maternal age has an effect on attitudes with p value 0.001. Maternal education has an effect on physical behavior with p value 0.010. Mother's job did not affect attitudes with p value 0.100. Parity affects attitudes with p value 0,027 and gestational age does not affect attitudes with p value 0,052. Keywords: age, education, occupation, parity, gestational age, health education, whatsapp, knowledge, attitudes, early detection of pre eclampsia


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