scholarly journals Management and Prevention of COVID-19 in Pregnancy and Pandemic Obstetric Care: A Review of Current Practices

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 467
Author(s):  
Argyro Pountoukidou ◽  
Maria Potamiti-Komi ◽  
Vrisiis Sarri ◽  
Michail Papapanou ◽  
Eleni Routsi ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Obstetric Care ◽  
Neonatal Infection ◽  
Personal Hygiene ◽  
Delivery Mode ◽  
Uncomplicated Pregnancy ◽  
Third Stage ◽  
Guidelines And Recommendations ◽  
Two Stages ◽  
Adequate Oxygenation

Constant accumulation of data results in continuous updates of guidelines and recommendations on the proper management of pregnant women with COVID-19. This study aims to summarize the up-to-date information about the prevention and management of suspected/confirmed SARS-CoV-2 infection in obstetric patients and obstetric care during prenatal, intrapartum, and postpartum periods. We conducted a comprehensive literature search in PubMed for relevant English-written full-text reviews. We also included relevant guidelines and recommendations. In women with a low risk for infection and uncomplicated pregnancy, elective and non-urgent appointments should be postponed or completed through telehealth. Vaccination should be discussed and distance and personal hygiene preventive measures should be recommended. Routine ultrasound examinations should be adjusted in order to minimize exposure to the virus. Standardized criteria should evaluate the need for admission. Women with moderate/high-risk for infection should be isolated and tested with RT-PCR. The mode and timing of delivery should follow routine obstetric indications. In case of infection, glucocorticoids are recommended in critically ill pregnant women, after individualized evaluation. During labor and concomitant infection, the duration of the first two stages should be reduced as possible to decrease aerosolization, while minimization of hemorrhage is essential during the third stage. Close maternal monitoring and adequate oxygenation when necessary always remain a prerequisite. Discharge should be considered on the first or second day postpartum, also depending on delivery mode. Breastfeeding with protective equipment is recommended, as its benefits outweigh the risks of neonatal infection. Recommendations are currently based on limited available data. More original studies on infected pregnant women are needed to establish totally evidence-based protocols of care for these patients.

Optimisation of tactics of conducting pregnancy and labours at women after auxiliary reproductive technologies

2016 ◽  
pp. 160-164
Author(s):  
D.N. Maslo ◽  
Keyword(s):  
Pregnant Women ◽  
Resistance Index ◽  
First Trimester ◽  
Reproductive Technologies ◽  
Premature Delivery ◽  
Control Group ◽  
Uterine Arteries ◽  
Placental Dysfunction ◽  
Placental Blood ◽  
Two Stages

The objective: frequency decrease perinatal pathologies at women after ART on the basis of studying clinical-ehografical, endocrinological, biochemical, dopplerometrical, cardiotokografical and morphological researches, and also improvement of algorithm of diagnostic and treatment-and-prophylactic actions. Patients and methods. The work basis is made spent by us from 2012 on 2015 by complex inspection of 300 pregnant women from which 250 were after ART and 50 – firstlabours which pragnency without ART, and also their newborns. For the decision of an object in view of research spent to two stages. At 1 stage spent prosperctive research which included 150 pregnant women: з them 100 women pregnancy at which has come out ART (1 group) and 50 healthy women (control group). At 2 stage spent prospective randomization in which result of patients after ART have divided on two equal groups by therapy principle: 2 basic group - 75 pregnant women after ART at which used the algorithm improved by us; 3 group of comparison - 75 pregnant women after ART which have been spent on the standard treatment-and-prophylactic actions. Results. The results suggest that women after using ART is a high frequency of reproductive losses in the first trimester (10.0%), 3.0% of spontaneous abortion from 16 to 22 weeks, and 3.0% "early" premature delivery (22 to 28 weeks of pregnancy). The frequency of violations of the functional state of placenta in women after using IVF is 63.0%, which is the main cause of high levels of perinatal losses (40.0 ‰), and delivery by cesarean section (96.0%). Placental dysfunction in women after using ART characterized by retrohorialnyh hematoma (21.0%); size mismatch fruit (30.0%) and hypertonicity of the uterus (73.0%) against changes in fruit-placental blood flow - increased resistance index in umbilical artery and increased vascular resistance in the uterine arteries. Endocrinological and biochemical changes in placental dysfunction in women after using IVF starting from 28 weeks of pregnancy and are in significant reduction in progesterone, placental b1-microglobulin, B2-microglobulin of fertility and trophic в-glycoprotein. Conclusion. The received results: use of the algorithm of diagnostic and treatment-and-prophylactic actions improved by us allows to lower frequency of spontaneous interruption of pregnancy till 22 weeks – from 13.0% to 5.7%; «early» premature birth – from 3.0% to 1.0%; placentary dysfunction from 63.0% to 40.6%; cesarean sections – from 96.0% to 56.5%, and also perinatal losses – from 40.0‰ to 16.2‰. Key words: pregnancy, childbirth, auxiliary reproductive technologies.

The Origins of the Village Revisited: From Nuclear to Extended Households

2002 ◽  
Vol 67 (3) ◽  
pp. 417-433 ◽  
Author(s):  
Kent V. Flannery
Keyword(s):  
Nuclear Family ◽  
Extended Family ◽  
Near East ◽  
Shared Storage ◽  
Nuclear Families ◽  
Second Stage ◽  
Third Stage ◽  
Two Stages ◽  
Extended Households ◽  
The Village

In Mesoamerica and the Near East, the emergence of the village seems to have involved two stages. In the first stage, individuals were distributed through a series of small circular-to-oval structures, accompanied by communal or “shared” storage features. In the second stage, nuclear families occupied substantial rectangular houses with private storage rooms. Over the last 30 years a wealth of data from the Near East, Egypt, the Trans-Caucasus, India, Africa, and the Southwest U.S. have enriched our understanding of this phenomenon. And in Mesoamerica and the Near East, evidence suggests that nuclear family households eventually gave way to a third stage, one featuring extended family households whose greater labor force made possible extensive multifaceted economies.

Order-disorder phenomena in α -brass - III. Influence of plastic deformation

1960 ◽  
Vol 257 (1290) ◽  
pp. 363-385 ◽  
Keyword(s):  
Plastic Deformation ◽  
Cold Work ◽  
Stored Energy ◽  
High Concentration ◽  
Complex Behaviour ◽  
Second Stage ◽  
Third Stage ◽  
Anneal Hardening ◽  
Two Stages ◽  
Degree Of Order

The evolution of stored energy during heating for specimens of deformed α-brass is quite different from that previously observed for pure metals; the stored energy is much larger and at least three stages of evolution exist. These have been studied for deformation in torsion and tension and the results correlated with measurements of electrical resistivity, density and hardness. The large release of energy in the first two stages is attributed mainly to the return of order destroyed by plastic deformation; the degree of disorder after heavy cold work is much greater than after quenching (part II). However, slight deformation (10% tension) increases the degree of order slightly. The first stage of energy release, below 120 °C, is probably due to rapid reordering assisted by vacancies created during deformation. The second stage represents the bulk of the reordering and some recovery involving rearrangement and annihilation of dislocations. The deformed specimens are probably strain-aged and thus recovery is accompanied by the dispersal of atmospheres of zinc which increases resistivity and decreases density, to some extent counteracting the effects of recovery. The balance of these three processes in stage 2 causes complex behaviour, the magnitude and even the sign of some changes in properties varies with the deformation. Reordering is complete before the beginning of the third stage of further recovery and recrystallization, in which dispersal of atmospheres is again important. Comparison of measurements of energy, resistivity and density suggests that the high concentration of stacking faults contributes to the resistivity. Anneal hardening is observed for the higher deformations and the maximum hardness coincides with the maximum degree of order.

scholarly journals Barreras en la atención de la morbilidad materna en Yaxkukul, Yucatán, México

2019 ◽  
pp. 28-37
Author(s):  
Elsa RODRÍGUEZ-ANGULO ◽  
Marita SOLÍS-RIVERO ◽  
Ricardo OJEDA-RODRÍGUEZ ◽  
Guadalupe ANDUEZA-PECH
Keyword(s):  
Pregnant Women ◽  
Rural Health ◽  
Obstetric Care ◽  
Cross Sectional ◽  
Obstetric Emergency ◽  
A Value ◽  
Rural Health Center ◽  
Quality Of Obstetric Care ◽  
Three Delays

Objectives. Identify the barriers that cause delays in the route of obstetric care in pregnant women of Yaxkukul, Yucatán, from January 2016 to May 2018. Methodology. Observational, descriptive, cross-sectional and retrospective study. Pregnant women who attended prenatal control at the rural health center of Yaxkukul were interviewed and reviewed their clinical record. Sociodemographic characteristics, prenatal control were studied and the critical route of obstetric care was described, under the model of the three delays. Percentages, measures of central tendency and dispersion were calculated; as well as square chi to look for association between delays and maternal morbidity. A 95% confidence level and a value of p <0.05 were used. Contribution. The present study contributes to the prevention of maternal and perinatal mortality. Knowing the barriers that cause delays in care can identify deficiencies in the obstetric emergency protocol established in rural health units, to improve the quality of obstetric care.

scholarly journals Profile of D-dimer in Uncomplicated Pregnancy

2019 ◽  
pp. 283-287
Author(s):  
Rahajuningsih Dharma ◽  
Mercy T. Panjaitan ◽  
Kanadi Sumapradja ◽  
Rianto Setiabudy
Keyword(s):  
Pregnant Women ◽  
Clinical Pathology ◽  
Cross Sectional Study ◽  
Control Group ◽  
Sectional Study ◽  
Cross Sectional ◽  
Uncomplicated Pregnancy ◽  
D Dimer

Abstract Objective: To obtain the profile of D-dimer in uncomplicated pregnancy. Methods: A cross sectional study was done on 90 uncomplicated pregnant women consisted of 30 women in each trimester and 30 healthy, nonpregnant women as control group from July to August 2012. D-dimer level was measured by particle enhanced immunoturbidimetry method using Innovance D-dimer and Sysmex CA 1500 in the Department of Clinical Pathology, Dr. Cipto Mangunkusumo Hospital, Jakarta. Results: All women in the control group showed normal D-dimer level (<0.,5 mg/L FEU). The median and range of D-dimer level in the 1st trimester, 2nd trimester, and 3rd trimester were 0.42 mg/L FEU and 0.1-1.07 mg/L FEU, 0.97 mg/L FEU and  0.6-3.34 mg/L FEU, and 1.56 mg/L FEU and  0.69-3.75 mg/L FEU, respectively.  Increased D-dimer level was found in 27% of pregnant women in 1st trimester, 87% in 2nd trimester, and 100% in 3rd trimester. Conclusion: Increased D-dimer level was found in  27% of pregnant women in 1st trimester, 87% in 2nd trimester, and  100% in 3rd trimester. The range of D-dimer level in the 1st trimester was 0.1-1.07 mg/L FEU, in the 2nd trimester was 0.6-3.34 mg/L FEU, and in the 3rd trimester was 0.69-3.75 mg/L FEU. Keywords: D-dimer, trimester, uncomplicated pregnancy   Abstrak Tujuan : Untuk mendapatkan profil  D-dimer pada kehamilan tanpa komplikasi. Metode : Penelitian potong lintang dilakukan pada 90 perempuan hamil tanpa komplikasi yang terdiri atas 30 perempuan pada tiap trimester dan 30 perempuan sehat yang tidak hamil, sebagai kelompok kontrol dari bulan Juli sampai Agustus 2012. Kadar D-dimer diukur dengan cara particle enhanced immunoturbidimetry  menggunakan reagen InnovanceÒ D-dimer dan koagulometer SysmexÒ CA 1500 di  Deparemen Patologi Klinik, Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo, Jakarta. Hasil: Seluruh perempuan dalam kelompok kontrol mempunyai kadar D-dimer dalam batas normal (<0.,5 mg/L FEU). Median (rentang) kadar D-dimer  pada trimester pertama, kedua, dan ketiga berturut-turut  0.42 mg/L FEU  (0.1-1.07 mg/L FEU), 0.97 mg/L FEU (0.6-3.34 mg/L FEU), dan 1.56 mg/L FEU   (0.69-3.75 mg/L FEU).  Peningkatan kadar D-dimer ditemukan pada 27% perempuan hamil trimester pertama, 87%  trimester kedua, dan pada 100%  trimester ketiga.   Kesimpulan: Peningkatan kadar  D-dimer ditemukan pada  27% perempuan hamil trimester pertama,  87% trimester kedua dan   100% pada trimester ketiga.  Rentang kadar D-dimer level pada trimester pertama adalah 0.1-1.07 mg/L FEU, pada trimester kedua  0.6-3.34 mg/L FEU, dan pada trimester ketiga  0.69-3.75 mg/L FEU. Kata kunci: D-dimer, kehamilan tanpa komplikasi, trimester

scholarly journals Состояние гемодинамики у беременных с ожирением

2015 ◽  
Author(s):  
М. М Матлубов ◽  
А. А. Семенихин ◽  
С. А Рузибаев ◽  
Н. И Закирова ◽  
О. В Ким
Keyword(s):  
Adverse Effect ◽  
Body Mass Index ◽  
Pregnant Women ◽  
Cardiovascular System ◽  
Functional State ◽  
Control Group ◽  
Hemodynamic Status ◽  
Uncomplicated Pregnancy ◽  
Normal Body Weight ◽  
Survey Results

СОСТОЯНИЕ ГЕМОДИНАМИКИ У БЕРЕМЕННЫХ С ОЖИРЕНИЕМ - В данной статье представлены изменения состояния гемодинамики у беременных с ожирением при неосложнённой беременности. В исследование включены результаты комплексного обследования 84 беременных в возрасте от 23 до 28 лет с ожирением различной степени выраженности при сроках гестации 36-38 недель. В контрольную группу вошла 21 беременная аналогичного возраста и срока гестации с нормальной массой тела. У всех наблюдаемых пациентов беременность согласно консультациям акушер-гинекологов была признана неосложнённой. Степень ожирения оценивали по индексу массы тела. Проведённое исследование показало, что избыточный вес тела по мере её прогрессирования оказывает крайне неблагоприятное влияние на гемодинамику и функциональное состояние сердечно-сосудистой системы в целом, снижает коронарные резервы. Наиболее выраженные нарушения функционального состояния сердечно-сосудистой системы имеют место при ожирении II и III степеней.<br />СТАН ГЕМОДИНАМІКИ У ВАГІТНИХ З ОЖИРІННЯМ - Уданій статті представлено зміни стану гемодинаміки у вагітних з ожирінням при неускладненій вагітності. У дослідження включені результати комплексного обстеження 84 вагітних у віці від 23 до 28 років з ожирінням різного ступеня вираження при термінах гестації 36-38 тижнів. У контрольну групу ввійшла 21 вагітна аналогічного віку та терміну гестації з нормальною масою тіла. У всіх спостережуваних пацієнтів вагітність згідно з консультаціями акушер-гінекологів була визнана неусклад- неною. Ступінь ожиріння оцінювали за індексом маси тіла. Проведене дослідження показало, що надлишкова маса тіла в міру її прогресування украй несприятливо впливає на гемо- динаміку і функціональний стан серцево-судинної системи в цілому, знижує коронарні резерви. Найбільш виражені порушення функціонального стану серцево-судинної системи мають місце при ожирінні II і III ступенів.<br />HEMODYNAMIC STATUS OF PREGNANT WOMEN WITH OBESITY - In this article are represented the changes in hemodynamic status of pregnant women with obesity in uncomplicated pregnancy. In the study was included the full survey results of 84 pregnant women aged between 23 and 28 years with obesity of varying severity at 36-38 weeks gestation. The control group included 21 pregnant women of similar age and gestational age with normal body weight. All observed patients, pregnancy according obstetrical consultation was recognized uncomplicated. The degree of obesity was assessed by body mass index. Researchers conducted showed that overweight as its progression has a very adverse effect on hemodynamics and functional state of the cardiovascular system as a whole, reduces coronary reserve. The most pronounced violation of the functional state of the cardiovascular system occurs in obesity 2nd and 3rd degree.<br />Ключевые слова: беременность, ожирение, гемодинамика.<br />Ключові слова: вагітність, ожиріння, гемодинаміка

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