scholarly journals SARS-CoV-2 Infection in Pregnancy: Clinical Signs, Placental Pathology, and Neonatal Outcome—Implications for Clinical Care

2021 ◽  
Vol 8 ◽  
Author(s):  
Sascia Moresi ◽  
Marco Dell'Aquila ◽  
Silvia Salvi ◽  
Roberta Rullo ◽  
Stefano Fruci ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Neonatal Outcome ◽  
Clinical Care ◽  
Neointimal Hyperplasia ◽  
Clinical Signs ◽  
Test Results ◽  
Placental Pathology ◽  
Risk Of Infection ◽  
Fibrin Deposition ◽  
Histopathologic Findings

Introduction: The current COVID-19 pandemic has been associated with high rates of mortality and significant morbidity. Both the risk of infection for pregnant women and the risk of vertical transmission have been evaluated, and the presence of the SARS-CoV-2 virus has been demonstrated both in the placenta and in the amniochorionic membranes. However, the actual effects of this pathogen on pregnancy and on placental morphology are still unclear.Objective: To describe histopathologic findings in the placentas of women with SARS-CoV-2 infection during pregnancy and their correlation with clinical signs and perinatal outcome.Methods: Placental tissues from pregnant women with SARS-CoV-2 infection delivering between March 2020 and February 2021 were analyzed.Results: One hundred six placentas from women with SARS-CoV-2 infection during pregnancy who delivered in Fondazione Policlinico A. Gemelli were examined. Most of them were asymptomatic. All neonates had available test results for SARS-CoV-2 and only one resulted positive. Placental tissues mainly showed signs of maternal vascular malperfusion and of placenta injury in terms of syncytial node increase (96.2%), villar agglutination (77.3%), neointimal hyperplasia (76.4%), excessive fibrin deposition (43.3%), and chorangiosis (35.8%). No significant differences in the frequency of the histopathological lesions were observed according to maternal symptoms.Conclusion: Looking to placental tissues from SARS-CoV-2 positive women at the screening performed close to delivery, placental injuries could be detected without any correlation with fetal and neonatal outcomes. We hypothesize that short latency between SARS-CoV-2 infection and delivery is the main reason for these observations.

scholarly journals Hyperadrenocorticism Caused by a Pituitary Ganglioglioma in a Dog

2019 ◽  
Vol 56 (4) ◽  
pp. 609-613 ◽  
Author(s):  
Hirokazu Ishino ◽  
Susumu Takekoshi ◽  
Takahiro Teshima ◽  
Kazuyuki Uchida ◽  
Iwao Sakonju ◽  
...  
Keyword(s):  
Benign Tumor ◽  
Elevated Serum ◽  
Clinical Signs ◽  
Careful Analysis ◽  
Test Results ◽  
First Case ◽  
Contrast Enhanced ◽  
Resected Tumor ◽  
Adenoma Tissue ◽  
Histopathologic Findings

An 11-year-old castrated male Chihuahua dog was presented with complaints of polyuria, polydipsia, abdominal enlargement, and alopecia. Hyperadrenocorticism was diagnosed on the basis of clinical signs, blood tests, adrenocorticotropin-stimulation test results, and an elevated serum adrenocorticotropin concentration. Contrast-enhanced magnetic resonance imaging showed that the pituitary gland was enlarged, compatible with a pituitary macroadenoma. Pituitary-dependent hyperadrenocorticism was suspected, and transsphenoidal hypophysectomy was thus performed for complete resection of the tumor. After surgery, the serum adrenocorticotropin concentration normalized and the hyperadrenocorticism resolved. Histological and immunocytochemical analyses revealed a benign tumor composed of mature neuronal cells and glial cells, suggestive of a ganglioglioma with immunolabeling for adrenocorticotropin. Careful analysis of the resected tumor revealed no pituitary adenoma tissue. The clinical and histopathologic findings indicated that the ganglioglioma was directly responsible for the hyperadrenocorticism. This is the first case of hyperadrenocorticism caused by a ganglioglioma in a dog.

scholarly journals Evaluation of Serological Indicators for Toxoplasma, Rubella Virus and Cytomegalovirus Infections in Pregnant Women Applied to Our Hospital

2020 ◽  
Author(s):  
Fatih Çubuk ◽  
Mürşit Hasbek ◽  
Ayşe Hümeyra Taşkın Kafa ◽  
Cem Çelik
Keyword(s):  
Pregnant Women ◽  
Rubella Virus ◽  
Serological Test ◽  
Clinical Signs ◽  
Epidemiological Data ◽  
High Avidity ◽  
Infectious Agents ◽  
Test Results ◽  
Microbiology Laboratory ◽  
Cytomegalovirus Infections

Objective: Toxoplasma gondii, rubella virus and cytomegalovirus (CMV) are important infectious agents that can be transmitted vertically from mother to baby, and can cause clinical signs in the fetus and the newborn. In our study, it was aimed to determine the distribution of antibodies against T. gondii, Rubella and CMV in pregnant women applied to our hospital. Method: In our study, the serological test results of the blood samples of pregnant women used in the diagnosis of T. gondii, Rubella and CMV infections in Microbiology Laboratory of Sivas Cumhuriyet University Faculty of Medicine, were retrospectively analyzed in a two-year period between 2018 and 2019. Results: The positivity rates were determined to be 26.7% for T. gondii IgG, 87.9% for Rubella virus IgG and 99% for CMV IgG. While IgM test positivities for the same pathogens were 1.3%, 0.3%, and 0.7%, respectively. Low avidity results were encountered in 4 patients (22.2%) for T. gondii, whereas the results of all examined tests for Rubella and CMV were found to have high avidity. Conclusion: Regional epidemiological data are important to determine routine screening approach or infectious agents that will be more important for the newborn. We think that we will contribute to the literature with our study based on regional data.

Threat of premature birth: psycho-social aspects

2016 ◽  
pp. 86-89
Author(s):  
S. Zhuk ◽  
◽  
O. Schurevska ◽  
Keyword(s):  
Pregnant Women ◽  
Physical Functioning ◽  
Premature Birth ◽  
Defense Mechanisms ◽  
Subjective Evaluation ◽  
Clinical Signs ◽  
Subjective Assessment ◽  
Psychological Status ◽  
Stress Load ◽  
Mandatory Participation

The objective: to study the psychological characteristics of women’s status in one of the most common complications of pregnancy - the threat of termination of pregnancy, depending on the level of stress load. Patients and methods. We have studied the psychological status (the Holmes-Rahe level of psychosocial stress, the Spielberg-Hanin level of anxiety, V.I.Dobryakov’s related to a pregnancy test, diagnosis of psychological defense mechanisms, assessment of quality of life) 60 pregnant women with threat of premature birth in the third trimester of pregnancy. Surveyed women were divided into 2 groups: group 1 included 30 pregnant women – forced migrant of Donetsk and Lugansk area and 2 group – 30 pregnant women who resided in Kiev. Results. At the same clinical picture of the threat of premature birth we detected discrepancy between the subjective assessment of their condition in women – forced migrants: a high level of situational and personal anxiety, decrease in physical (physical functioning, role-physical functioning) and psychological (social functioning, role emotional functioning) health, doubtful and pathological subtypes of gestational dominant. This creates prerequisites for complications of pregnancy, childbirth and postpartum future period and requires the participation of psychologists in the work with this category of patients. Conclusion. So, revealed a discrepancy between the objective clinical signs similar obstetric pathology (on the example of threatened abortion) in pregnant women with different levels of stress load and their subjective evaluation of their condition that affects their psychological status. This should be reflected in individually tailored therapy and be mainstreamed into the work of obstetricians and gynecologists with these patients, and requires mandatory participation of psychologists in the work with this category of patients. Key words: pregnancy, the threat of premature birth, stress, psychological status.

scholarly journals Impact of SARS-CoV-2 on the clinical outcomes and placental pathology of pregnant women and their infants: A Systematic Review

Heliyon ◽  
2021 ◽  
pp. e06393
Author(s):  
Irina Oltean ◽  
Jason Tran ◽  
Sarah Lawrence ◽  
Brittany Ann Ruschkowski ◽  
Na Zeng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pregnant Women ◽  
Clinical Outcomes ◽  
Placental Pathology

scholarly journals Haemostatic and thrombo-embolic complications in pregnant women with COVID-19: a systematic review and critical analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Juliette Servante ◽  
Gill Swallow ◽  
Jim G. Thornton ◽  
Bethan Myers ◽  
Sandhya Munireddy ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Pregnant Women ◽  
Clinical Evidence ◽  
Case Reports ◽  
Standard Form ◽  
Test Results ◽  
Maternal Deaths ◽  
High Clinical Suspicion ◽  
Increased Risk ◽  
Definition Of

Abstract Background As pregnancy is a physiological prothrombotic state, pregnant women may be at increased risk of developing coagulopathic and/or thromboembolic complications associated with COVID-19. Methods Two biomedical databases were searched between September 2019 and June 2020 for case reports and series of pregnant women with a diagnosis of COVID-19 based either on a positive swab or high clinical suspicion where no swab had been performed. Additional registry cases known to the authors were included. Steps were taken to minimise duplicate patients. Information on coagulopathy based on abnormal coagulation test results or clinical evidence of disseminated intravascular coagulation (DIC), and on arterial or venous thrombosis, were extracted using a standard form. If available, detailed laboratory results and information on maternal outcomes were analysed. Results One thousand sixty-three women met the inclusion criteria, of which three (0.28, 95% CI 0.0 to 0.6) had arterial and/or venous thrombosis, seven (0.66, 95% CI 0.17 to 1.1) had DIC, and a further three (0.28, 95% CI 0.0 to 0.6) had coagulopathy without meeting the definition of DIC. Five hundred and thirty-seven women (56%) had been reported as having given birth and 426 (40%) as having an ongoing pregnancy. There were 17 (1.6, 95% CI 0.85 to 2.3) maternal deaths in which DIC was reported as a factor in two. Conclusions Our data suggests that coagulopathy and thromboembolism are both increased in pregnancies affected by COVID-19. Detection of the former may be useful in the identification of women at risk of deterioration.

scholarly journals Low Maternal Immunoglobulin G Avidity and Single Parity as Adverse Implications of Human Cytomegalovirus Vertical Transmission in Pregnant Women with Immunoglobulin M Positivity

Viruses ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 866
Author(s):  
Masatoki Kaneko ◽  
Junsuke Muraoka ◽  
Kazumi Kusumoto ◽  
Toshio Minematsu
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Vertical Transmission ◽  
Human Cytomegalovirus ◽  
Multiple Logistic Regression Analysis ◽  
Clinical Signs ◽  
Immunoglobulin M ◽  
Igg Antibody ◽  
Neurological Sequelae ◽  
Previous Pregnancy

Human cytomegalovirus (CMV) is the leading cause of neurological sequelae in infants. Understanding the risk factors of primary CMV infection is crucial in establishing preventive strategies. Thus, we conducted a retrospective cohort study to identify risk factors of vertical transmission among pregnant women with immunoglobulin (Ig) M positivity. The study included 456 pregnant women with IgM positivity. Information on age, parity, occupation, clinical signs, IgM levels, and IgG avidity index (AI) was collected. The women were divided into infected and non-infected groups. The two groups showed significant differences in IgM level, IgG AI, number of women with low IgG AI, clinical signs, and number of pregnant women with single parity. In the multiple logistic regression analysis, pregnant women with single parity and low IgG AI were independent predictors. Among 40 women who tested negative for IgG antibody in their previous pregnancy, 20 showed low IgG AI in their current pregnancy. Among the 20 women, 4 had vertical transmission. These results provide better understanding of the risk factors of vertical transmission in pregnant women with IgM positivity.

scholarly journals Spine Examination during COVID-19 Pandemic via Video Consultation

2021 ◽  
Author(s):  
Tom Jansen ◽  
Martin Gathen ◽  
Amadeo Touet ◽  
Hans Goost ◽  
Dieter Christian Wirtz ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Range Of Motion ◽  
Test Results ◽  
Risk Of Infection ◽  
Face To Face ◽  
Reliable Tool ◽  
Provocation Tests ◽  
Active Range Of Motion ◽  
Video Consultation ◽  
Good Agreement

Abstract Introduction During the current COVID-19 pandemic video consultations are increasingly common in order to minimize the risk of infection for staff and patients. The aim of this study was to evaluate the feasibility of a spine examination via video. Methods A total of 43 patients were recruited. Each participant underwent a video-based (VB) and a conventional face-to-face (FTF) spine examination. Pain intensity, active range of motion, inspection, a neurophysiologic basic exam and provocations tests were evaluated using video-based and face-to-face methods. Results The intra-rater reliability (IRR) was measured between both examinations. Good to very good IRR values were obtained in inspection (Kappa between 0,752 und 0,944), active range of motion and basic neurophysiological examination (Kappa between 0,659 und 0,969). Only moderate matches were found in specific provocation tests (Kappa between 0,407 und 0,938). A video-based spine examination is a reliable tool for measuring pain intensity, active range of motion and a basic neurophysiologic exam. Conclusion A basic spine examination during a video consultation is possible. A good agreement of the test results between video-based and face-to-face examination could be found.

scholarly journals Maternal Resources, Pregnancy Concerns, and Biological Factors Associated to Birth Weight and Psychological Health

2021 ◽  
Vol 10 (4) ◽  
pp. 695 ◽  
Author(s):  
David Ramiro-Cortijo ◽  
María de la Calle ◽  
Andrea Gila-Díaz ◽  
Bernardo Moreno-Jiménez ◽  
Maria A. Martin-Cabrejas ◽  
...  
Keyword(s):  
Life Satisfaction ◽  
Birth Weight ◽  
Pregnant Women ◽  
Maternal Depression ◽  
Psychological Health ◽  
Neonatal Outcome ◽  
P Value ◽  
Linear Regression Models ◽  
Psychological Outcome ◽  
Biological Variables

Cognitive maternal adaptation during pregnancy may influence biological variables, maternal psychological, and neonatal health. We hypothesized that pregnant women with numerous general resources and less negative emotions would have a better coping with a positive influence on neonatal birth weight and maternal psychological health. The study included 131 healthy pregnant women. A blood sample was obtained in the first trimester to assess biological variables (polyphenols, hematological and biochemical parameters). Psychological variables (negative affect, anxiety, optimism, resilience, family–work conflicts, pregnancy concerns, general resources, and life satisfaction) were evaluated at several time points along gestation, and birth weight was recorded. Hierarchical linear regression models were used to associate the above parameters with maternal psychological outcome at the end of gestation (depression, resilience, and optimism) and neonatal outcome (birth weight). Maternal depression was associated with leukocytes (β = 0.08 ± 0.03, p-value = 0.003), cholesterol (β = 0.01 ± 0.002, p-value = 0.026), and pregnancy concerns (β = 0.31 ± 0.09, p-value = 0.001). Maternal resilience was associated with leukocytes (β = −0.14 ± 0.09, p-value = 0.010) and life satisfaction (β = 0.82 ± 0.08, p-value = 0.001), and maternal optimism was associated with polyphenol levels (β = 0.002 ± 0.001, p-value = 0.018) and life satisfaction (β = 0.49 ± 0.04, p-value = 0.001). Birth weight was associated with maternal resilience (β = 370.2 ± 97.0, p-value = 0.001), red blood cells (β = 480.3 ± 144.4, p-value = 0.001), and life satisfaction (β = 423.3 ± 32.6, p-value = 0.001). We found associations between maternal psychological, blood variables, and birth weight and maternal depression. This study reveals the relevance of psychological health during pregnancy for maternal and neonatal outcome, and it emphasizes the need to consider it in preventive policies in the obstetric field.

Extensive Perivillous Fibrin and Intervillous Histiocytosis in a SARS-CoV-2 Infected Placenta From an Uninfected Newborn: A Case Report Including Immunohistochemical Profiling

2021 ◽  
pp. 109352662110251
Author(s):  
James Roberts ◽  
Jeanette D Cheng ◽  
Elizabeth Moore ◽  
Carla Ransom ◽  
Minhui Ma ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Report ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Immunohistochemical Staining ◽  
Placental Pathology ◽  
Fibrin Deposition ◽  
Placental Infection ◽  
Fetal Infection

Placental infection by SARS-CoV-2 with various pathologic alterations reported. Inflammatory findings, such as extensive perivillous fibrin deposition and intervillous histiocytosis, have been postulated as risk factors for fetal infection by SARS-CoV-2. We describe the placental findings in a case of a 31-year-old mother with SARS-CoV-2 infection who delivered a preterm female neonate who tested negative for SAR-CoV2 infection. Placental examination demonstrated a small for gestational age placenta with extensive intervillous histiocytosis, syncytiotrophoblast karyorrhexis, and diffuse intervillous fibrin deposition. Immunohistochemical staining demonstrated infection of the syncytiotrophoblasts by SARS-CoV-2 inversely related to the presence of intervillous histiocytes and fibrin deposition. Our case demonstrates that despite extensive placental pathology, no fetal transmission of SARS-CoV-2 occurred, as well as postulates a relationship between placental infection, inflammation, and fibrin deposition.

SARS-CoV-2 in pregnancy: maternal and perinatal outcome data of 34 pregnant women hospitalised between May and October 2020

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Mirijam Hall ◽  
David Endress ◽  
Susanne Hölbfer ◽  
Barbara Maier
Keyword(s):  
Critical Care ◽  
Pregnant Women ◽  
Critical Care Unit ◽  
Birth Rate ◽  
Total Population ◽  
Neonatal Outcome ◽  
Mode Of Delivery ◽  
Outcome Data ◽  
High Risk Population ◽  
Retrospective Data Collection

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.

Sign in / Sign up

Export Citation Format

Share Document