CLINICAL CHARACTERISTICS AND FETO-MATERNAL OUTCOMES IN PREGNANT WOMEN WITH COVID -19 INFECTIONS

2021 ◽  
pp. 30-32
Author(s):  
Gulshan Bano ◽  
Anubha Prashad ◽  
Rakhee Soni ◽  
Mohammed Mishal
Keyword(s):  
Pregnant Women ◽  
Cesarean Delivery ◽  
Clinical Features ◽  
Clinical Characteristics ◽  
Maternal Outcomes ◽  
Hypertensive Disorder ◽  
Co Morbidity ◽  
Hypertensive Disorder Of Pregnancy ◽  
The Mean ◽  
In Pregnancy

Background and objectives:-COVID-19 is ongoing pandemic, caused by novel Corona Virus. There is very scarce information is available about clinical features and feto-maternal outcomes of COVID-19 in pregnancy. Therefore, this study was aimed to determine clinical characteristics and feto-maternal outcomes of pregnant women with COVID-19. Methods- In this retrospective study, we included all pregnant women admitted with COVID-19 over three months. Clinical features, laboratory ndings and feto-maternal outcomes were assessed.Results:-The mean age of the patients was 24 years. Hypertensive disorder of pregnancy was most common associated co-morbidity. Majority of patients (81%) were asymptomatic. Lymphocytopenia was seen in 58% of the patients and 47% had elevated levels of CRP. All patients who presented in rst trimester had spontaneous abortion. There is relatively higher rate of preterm birth (21%) and cesarean delivery(43%). All the neonates were tested negative for COVID-19. Conclusion;- There is relatively higher rate of cesarean delivery. Overall feto-maternal outcome was good and there was no evidence of vertical transmission.

Acute Colonic Diverticulitis: Diagnostic Evidence, Demographic and Clinical Features in ree Practice Settings

2014 ◽  
Vol 23 (4) ◽  
pp. 379-386 ◽  
Author(s):  
Rajan Iyer ◽  
George F. Longstreth ◽  
Li-Hao Chu ◽  
Wansu Chen ◽  
Linnette Yen ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Clinical Features ◽  
Clinical Characteristics ◽  
Past History ◽  
Colonic Diverticulitis ◽  
Co Morbidity ◽  
Objective Evidence ◽  
Multiple Variables ◽  
Acute Colonic Diverticulitis

Background & Aims: Diverticulitis is often diagnosed in outpatients, yet little evidence exists on diagnostic evidence and demographic/clinical features in various practice settings. We assessed variation in clinical characteristics and diagnostic evidence in inpatients, outpatients, and emergency department cases and effects of demographic and clinical variables on presentation features.Methods: In a retrospective cohort study of 1749 patients in an integrated health care system, we compared presenting features and computed tomography findings by practice setting and assessed independent effects of demographic and clinical factors on presenting features.Results: Inpatients were older and more often underweight/normal weight and lacked a diverticulitis past history and had more comorbidities than other patients. Outpatients were most often Hispanic/Latino. The classical triad (abdominal pain, fever, leukocytosis) occurred in 78 (38.6%) inpatients, 29 (5.2%) outpatients and 34 (10.7%) emergency department cases. Computed tomography was performed on 196 (94.4%) inpatients, 110 (9.2%) outpatients and 296 (87.6%) emergency department cases and was diagnostic in 153 (78.6%) inpatients, 62 (56.4%) outpatients and 243 (82.1%) emergency department cases. Multiple variables affected presenting features. Notably, female sex had lower odds for the presence of the triad features (odds ratio [95% CI], 0.65 [0.45-0.94], P<0.05) and increased odds of vomiting (1.78 [1.26-2.53], P<0.01). Patients in age group 56 to 65 and 66 or older had decreased odds of fever (0.67 [0.46-0.98], P<0.05) and 0.46 [0.26-0.81], P<0.01), respectively, while ≥1 co-morbidity increased the odds of observing the triad (1.88 [1.26-2.81], P<0.01).Conclusion: There was little objective evidence for physician-diagnosed diverticulitis in most outpatients. Demographic and clinical characteristics vary among settings and independently affect presenting features.Abbreviations: AD: acute colonic diverticulitis; BMI: body mass index; CT: computed tomography; ED: emergency department; IBS: irritable bowel syndrome; ICD-9-CM: International Classification of Diseases, 9th Revision, Clinical Modification; IP: inpatient; KPSC: Kaiser Permanente Southern California; OP: outpatient.

scholarly journals Factors influencing stress, anxiety, and depression among Iranian pregnant women: the role of sexual distress and genital self-image

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Afsaneh Keramat ◽  
Mina Malary ◽  
Mahmood Moosazadeh ◽  
Nastaran Bagherian ◽  
Mohammad-Reza Rajabi-Shakib
Keyword(s):  
Pregnant Women ◽  
Multivariate Linear Regression Analysis ◽  
Depression And Anxiety ◽  
Sexual Distress ◽  
Self Image ◽  
Factors Influencing ◽  
Severity Of Depression ◽  
The Mean ◽  
Distress Scale ◽  
In Pregnancy

Abstract Background Pregnancy is a unique period with the increased likelihood of psychological changes and emotional disturbances such as depression, anxiety, and stress. In this study, we investigated the factors influencing depression, anxiety, and stress in pregnancy and identify their associations with Sexual Distress (SD) and Genital Self-Image (GSI). Methods This was a descriptive, correlational, cross-sectional study performed using the two-stage cluster sampling method between September 2019 and January 2020. Overall, 295 pregnant women completed a demographics and obstetric information checklist, Depression Anxiety and Stress Scale-21 (DASS-21), Female Genital Self-Image Scale (FGSI), and Female Sexual Distress Scale-Revised (FSDS-R). Results Analysis of Variance (ANOVA) showed significant differences in the mean scores of SD between the groups with varying degrees of depression, anxiety, and stress (P <  0.001) and in the mean score of GSI between the groups with varying degrees of depression (P = 0.01) and anxiety (P <  0.001). In multivariate linear regression analysis, higher (worse) depression, anxiety, and stress scores were found in women with more advanced age and higher SD scores; however, these scores were lower (better) in those with increased gestational age. Lower depression and anxiety scores were associated with moderate satisfaction with income, moderate satisfaction with BI in pregnancy, and lower stress and depression scores were linked to planned pregnancy. Higher (better) GSI score was a predictor of lower depression score, complication in a previous pregnancy was a predictor of higher stress score, and finally, fear of fetal abortion and being a housewife were predictors of a higher anxiety score. Conclusion Various factors contribute to the development of antenatal depression, anxiety, and stress. A positive correlation was found between SD and the severity of depression, anxiety, and stress, while a negative correlation was noted between GSI and the severity of depression and anxiety. Therefore, raising awareness regarding SD and GSI through screening and counseling sessions can have beneficial effects for mothers and their fetuses.

Adverse Perinatal Outcomes Associated with Stage 1 Hypertension in Pregnancy: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Elizabeth Norton ◽  
Frances Shofer ◽  
Hannah Schwartz ◽  
Lorraine Dugoff
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort ◽  
Perinatal Outcomes ◽  
Hypertensive Disorder ◽  
Hypertension In Pregnancy ◽  
Increased Risk ◽  
Hypertensive Disorder Of Pregnancy ◽  
Adverse Perinatal Outcomes ◽  
Stage 1 ◽  
In Pregnancy

Objective To determine if women who newly met criteria for stage 1 hypertension in early pregnancy were at increased risk for adverse perinatal outcomes compared with normotensive women. Study Design We conducted a retrospective cohort study of women who had prenatal care at a single institution and subsequently delivered a live infant between December 2017 and August 2019. Women with a singleton gestation who had at least two prenatal visits prior to 20 weeks of gestation were included. We excluded women with known chronic hypertension or other major maternal illness. Two groups were identified: (1) women newly diagnosed with stage 1 hypertension before 20 weeks of gestation (blood pressure [BP] 130–139/80–89 on at least two occasions) and (2) women with no known history of hypertension and normal BP (<130/80 mm Hg) before 20 weeks of gestation. The primary outcome was any hypertensive disorder of pregnancy; secondary outcomes were indicated preterm birth and small for gestational age. Generalized linear models were used to compare risk of adverse outcomes between the groups. Results Of the 1,630 women included in the analysis, 1,443 women were normotensive prior to 20 weeks of gestation and 187 women (11.5%) identified with stage 1 hypertension. Women with stage 1 hypertension were at significantly increased risk for any hypertensive disorder of pregnancy (adjusted risk ratio [aRR]: 1.86, 95% confidence interval [CI]: 1.12–3.04) and indicated preterm birth (aRR: 1.83, 95% CI: 1.12–3.02). Black women and obese women with stage 1 hypertension were at increased for hypertensive disorder of pregnancy compared with white women and nonobese women, respectively (aRR: 1.32, 95% CI: 1.11–1.57; aRR: 1.69, 95% CI: 1.39–2.06). Conclusion These results provide insight about the prevalence of stage 1 hypertension and inform future guidelines for diagnosis and management of hypertension in pregnancy. Future research is needed to assess potential interventions to mitigate risk. Key Points

scholarly journals Interactions between Vitamin D Status, Calcium Intake and Parathyroid Hormone Concentrations in Healthy White-Skinned Pregnant Women at Northern Latitude

Nutrients ◽  
2018 ◽  
Vol 10 (7) ◽  
pp. 916 ◽  
Author(s):  
Andrea Hemmingway ◽  
Karen O’Callaghan ◽  
Áine Hennessy ◽  
George Hull ◽  
Kevin Cashman ◽  
...  
Keyword(s):  
Vitamin D ◽  
Parathyroid Hormone ◽  
Pregnant Women ◽  
Calcium Intake ◽  
Geometric Mean ◽  
Vitamin D Status ◽  
Metabolic System ◽  
Cross Sectional ◽  
The Mean ◽  
In Pregnancy

Adverse effects of low vitamin D status and calcium intakes in pregnancy may be mediated through functional effects on the calcium metabolic system. Little explored in pregnancy, we aimed to examine the relative importance of serum 25-hydroxyvitamin D (25(OH)D) and calcium intake on parathyroid hormone (PTH) concentrations in healthy white-skinned pregnant women. This cross-sectional analysis included 142 participants (14 ± 2 weeks’ gestation) at baseline of a vitamin D intervention trial at 51.9 °N. Serum 25(OH)D, PTH, and albumin-corrected calcium were quantified biochemically. Total vitamin D and calcium intakes (diet and supplements) were estimated using a validated food frequency questionnaire. The mean ± SD vitamin D intake was 10.7 ± 5.2 μg/day. With a mean ± SD serum 25(OH)D of 54.9 ± 22.6 nmol/L, 44% of women were <50 nmol/L and 13% <30 nmol/L. Calcium intakes (mean ± SD) were 1182 ± 488 mg/day and 23% of participants consumed <800 mg/day. The mean ± SD serum albumin-adjusted calcium was 2.2 ± 0.1 mmol/L and geometric mean (95% CI) PTH was 9.2 (8.4, 10.2) pg/mL. PTH was inversely correlated with serum 25(OH)D (r = −0.311, p < 0.001), but not with calcium intake or serum calcium (r = −0.087 and 0.057, respectively, both p > 0.05). Analysis of variance showed that while serum 25(OH)D (dichotomised at 50 nmol/L) had a significant effect on PTH (p = 0.025), calcium intake (<800, 800–1000, ≥1000 mg/day) had no effect (p = 0.822). There was no 25(OH)D-calcium intake interaction effect on PTH (p = 0.941). In this group of white-skinned women with largely sufficient calcium intakes, serum 25(OH)D was important for maintaining normal PTH concentration.

scholarly journals Hypertensive disorders of pregnancy: A five-year review in Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, Nigeria

2020 ◽  
Vol 3 (1) ◽  
pp. 67-72
Author(s):  
Olufemi Adebawojo ◽  
Adebayo Akadri ◽  
John Imaralu
Keyword(s):  
Cesarean Section ◽  
Teaching Hospital ◽  
University Teaching ◽  
Elective Cesarean Section ◽  
Delivery Mode ◽  
Hypertensive Disorder ◽  
Ogun State ◽  
Hypertensive Disorders ◽  
Hypertensive Disorder Of Pregnancy ◽  
The Mean

Objective: To determine the prevalence and outcome of hypertensive disorder of pregnancy in Babcock University Teaching Hospital, Ilishan-Remo, Ogun State Nigeria Method: This was a retrospective descriptive study of all documented cases of hypertensive disorder of pregnancy between the 1st of June 2012 and 31st May, 2017. Information such as age, parity, booking status, level of education, blood pressure at presentation, urinalysis at presentation, gestational age at presentation, and delivery, mode of delivery, baby’s birth weight was extracted from patients’ case files. Result: There were 1,118 deliveries during the study period out of which 55 (4.9%) patients had hypertensive disorders in pregnancy. The mean age was 31.5years ±48.1 and mean parity, 1.2± 1.1.  The mean systolic and diastolic blood pressures were 180.4 ± 1.88mmHg and 105.1± 1.5mmHg, respectively. Thirty-four (75.5%) of the women had preeclampsia/ eclampsia, while 7 (15.5%) had gestational hypertension. Most women were delivered preterm (22 patients, 48.7%).  The majority of them (33, 73.3%) were delivered by cesarean section, out of which 2 (4.4%) were elective cesarean section and 31 patients (68.8%) were emergency cesarean section. The case fatality rate was 1.8%. Conclusion: Pre-eclampsia was the most prevalent t hypertensive disorder of pregnancy.  It was more prevalent among primigravidae patients and the most common complication was preterm delivery. Strengthening antenatal care services will enable early identification of cases. Prompt referral of cases for specialist care will help in reducing the adverse outcomes associated with the condition.

scholarly journals Differences in pregnancy and perinatal outcomes among symptomatic versus asymptomatic COVID-19-infected pregnant women: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Durray Shahwar A. Khan ◽  
La-Raib Hamid ◽  
Anna Ali ◽  
Rehana A. Salam ◽  
Nadeem Zuberi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Pregnant Women ◽  
Low Birthweight ◽  
Meta Analysis ◽  
Perinatal Outcomes ◽  
Respiratory Disorder ◽  
Significant Difference ◽  
The Mean ◽  
In Pregnancy

Abstract Background There is dearth of information on COVID-19’s impact on pregnant women. However, literature reported trends of COVID-19 differ, depending on the presence of clinical features upon presentation. Objective This systematic review aimed to assess differences in risk factors, management, complications, and pregnancy and perinatal outcomes in symptomatic vs. asymptomatic pregnant women with confirmed SARS-CoV-2 infection. Methods A search was run on electronic databases to identify studies reporting COVID-19 in pregnancy. Meta-analysis was performed and odds ratios and mean difference with 95% confidence intervals were calculated using Review Manager 5.4. Review Prospero registration number CRD42020204662. Results We included ten articles reporting data from 3158 pregnancies; with 1900 symptomatic and 1258 asymptomatic pregnant women. There was no significant difference in the mean age, gestational age, and body mass index between the two groups. The meta-analysis suggested that pregnant women who were obese (OR:1.37;95%CI:1.15 to 1.62), hypertensive (OR:2.07;95%CI:1.38 to 3.10) or had a respiratory disorder (OR:1.64;95%CI:1.25 to 2.16), were more likely to be symptomatic when infected with SARS-CoV-2. Pregnant women with Black (OR:1.48;95%CI:1.19 to 1.85) or Asian (OR:1.64;95%CI:1.23 to 2.18) ethnicity were more likely to be symptomatic while those with White ethnicity (OR:0.63;95%CI:0.52 to 0.76) were more likely to be asymptomatic. Cesarean-section delivery (OR:1.40;95%CI:1.17 to 1.67) was more likely amongst symptomatic pregnant women. The mean birthweight(g) (MD:240.51;95%CI:188.42 to 293.51), was significantly lower, while the odds of low birthweight (OR:1.85;95%CI:1.06 to 3.24) and preterm birth (< 37 weeks) (OR:2.10;95%CI:1.04 to 4.23) was higher amongst symptomatic pregnant women. Symptomatic pregnant women had a greater requirement for maternal ICU admission (OR:13.25;95%CI:5.60 to 31.34) and mechanical ventilation (OR:15.56;95%CI:2.96 to 81.70) while their neonates had a higher likelihood for Neonatal Intensive Care Unit admission (OR:1.96;95%CI:1.59 to 2.43). The management strategies in the included studies were poorly discussed, hence could not be analyzed. Conclusion The evidence suggests that the presence of risk factors (co-morbidities and ethnicity) increased the likelihood of pregnant women being symptomatic. Higher odds of complications were also observed amongst symptomatic pregnant women. However, more adequately conducted studies with adjusted analysis and parallel comparison groups are required to reach conclusive findings.

A Population-level Analysis of the Differing Effects of Rheumatoid Arthritis and Spondyloarthritis on Peripartum Outcomes

2019 ◽  
Vol 47 (2) ◽  
pp. 197-203 ◽  
Author(s):  
Stephanie O. Keeling ◽  
Samantha L. Bowker ◽  
Anamaria Savu ◽  
Padma Kaul
Keyword(s):  
Rheumatoid Arthritis ◽  
Pregnant Women ◽  
Population Level ◽  
Nonsteroidal Antiinflammatory Drugs ◽  
Neonatal Outcomes ◽  
Hypertensive Disorder ◽  
Antiinflammatory Drugs ◽  
Hypertensive Disorders ◽  
Maternal And Neonatal Outcomes ◽  
In Pregnancy

Objective.The effects of rheumatoid arthritis (RA) and spondyloarthritis (SpA) on maternal and neonatal outcomes at a population level have not previously been well compared.Methods.A contemporary pregnancy cohort of 312,081 women and corresponding birth events was assembled for the province of Alberta from the random selection of 1 live birth event per woman. We identified 3 groups: (1) no inflammatory arthritis (no IA, n = 308,989), (2) RA (n = 631), and (3) SpA (n = 2461). We compared maternal and neonatal outcomes, comorbid conditions, and medication use among the 3 groups. Multivariable logistic regression models evaluated the independent association between RA and SpA, relative to no IA, and the outcomes of small for gestation age (SGA) and hypertensive disorders during pregnancy.Results.Pregnant women with RA were significantly more likely to have preterm delivery (13.5%), cesarean delivery (33.9%), hypertensive disorders in pregnancy (10.5%), and SGA babies (15.6%), compared to pregnant women with either SpA or no IA. Nonsteroidal antiinflammatory drugs and corticosteroid use were significantly higher in pregnant women with RA compared to the other groups. Women with RA were significantly more likely to have an SGA baby (OR 1.51, 95% CI 1.21–1.88; p < 0.01), and hypertensive disorder in pregnancy (OR 1.51, 95% CI 1.16–1.97; p < 0.01), compared to women with no IA, while no difference was found between women with SpA and those with no IA.Conclusion.Women with RA have a higher risk of worse maternal and neonatal outcomes, whereas the risk of these events is similar between women with and without SpA.

scholarly journals Functional Status of Maternal Thyroid Gland in Eclampsia

2019 ◽  
Vol 31 (1) ◽  
pp. 9-14
Author(s):  
M Hafizur Rahman ◽  
Mahbub Ara Chowdhury ◽  
Shahin Mahmuda
Keyword(s):  
Pregnant Women ◽  
Normal Pregnancy ◽  
Hormonal Changes ◽  
Free Triiodothyronine ◽  
College Hospital ◽  
Medical College ◽  
The Mean ◽  
Maternal Thyroid ◽  
Complicated Pregnancy ◽  
In Pregnancy

Marked changes in maternal thyroid activity occur in pregnancy. During pregnancy bodily hormonal changes and metabolic demands result in complex alteration in the bio-chemical parameters of thyroid activities. Besides these, thyroid enlargement, increased thyroid capability for iodine uptake and increase in basal metabolic rate are evidential though these findings are not usually associated with symptoms of hyperthyroidism in pregnancy. Serum concentration of thyroid hormone thyroxine and triiodothyronine in complicated pregnancy like eclamptic toxemia is another field of controversy. To evaluate the changes in thyroid function in normal pregnancy and eclamptic toxemia, a study was undertaken in Rajshahi Medical College Hospital. We collected serum specimens from non pregnant but married women, normal 3rd trimester pregnant women and patients with eclampsia at 3rd trimester of pregnancy and measured serum concentrations of total and free thyroxine (TT4 & FT4) and total and free triiodothyronine (TT3 & FT3 ) by using RIA. Among the study subjects, 10 women were married but non pregnant, 12 women were in their 3rd trimester of normal pregnancy and 32 patients of eclamptic toxemia with 3rd trimester of pregnancy. In normal pregnancy, FT4 and FT3 levels remained normal while TT4 and TT3 levels were elevated. In patients with toxemia of pregnancy, the mean serum TT3 concentration was significantly lower than that of normal pregnancy and the serum FT3 concentrations were below the normal pregnancy range. The mean serum TT4 and FT4 concentrations in patients with eclampsia were however, significantly higher than those in normal pregnant women. TAJ 2018; 31(1): 9-14

Mindfulness and insomnia at pregnancy

2016 ◽  
Vol 33 (S1) ◽  
pp. s269-s269
Author(s):  
M. Marques ◽  
A.T. Pereira ◽  
E. Bento ◽  
S. Xavier ◽  
J. Azevedo ◽  
...  
Keyword(s):  
Anxiety Disorders ◽  
Pregnant Women ◽  
Mean Value ◽  
Inner Experience ◽  
The Mean ◽  
Competing Interest ◽  
Acting With Awareness ◽  
The Impact ◽  
Insomnia Symptoms ◽  
In Pregnancy

IntroductionThe impact of mindfulness in improving insomnia symptoms is documented in different samples (e.g. anxiety disorders; insomnia samples) and mindfulness based programs for pregnancy refer the association between mindfulness development and the reduction of insomnia symptoms/improvement of sleep.ObjectiveTo explore differences in the Facets Mindfulness Questionnaire-10 (FMQ-10; Azevedo et at. 2015), between sleep groups, in Portuguese pregnant women.MethodsFour hundred and nineteen pregnant women (mean age: 32.51 ± 4.759; weeks of gestation: 17.32 ± 4.803) answered the Facets Mindfulness Questionnaire-10 and the Insomnia Assessment Scale (IAS, Marques et al., 2015). Three sleep groups were created considering all the IAS items: good sleepers (no insomnia symptoms; no associated daily impairment); insomnia symptoms groups (one/more insomnia symptoms; no associated daily impairment; exclusion of other conditions/disorders explaining the symptoms); insomniacs (one/more insomnia symptoms; one/more daily associated impairment; exclusion of other conditions/disorders explaining the symptoms).ResultsThere were significant differences in the total FMQ-10 score, the F1/Nonjudging of inner experience and the F2/acting with awareness, between sleep groups [respectively, F (2.402) = 6,933; P = 0.001; F (2.406) = 10.243; P = 0.001; F (2.406) = 37.431; P = 0.002]. Tukey tests indicated that the mean total FMQ-10 and F1/Nonjudging of inner experience scores of good sleepers and insomnia symptoms group were significantly higher than of the insomniacs. The mean value of F2/acting with awareness in the good sleepers was significantly higher than of the insomniacs.ConclusionsIt seems important to develop mindfulness to improve sleep in pregnancy or reduce the impact of insomnia symptoms (common at pregnancy).Disclosure of interestThe authors have not supplied their declaration of competing interest.

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