scholarly journals Maternal Death Caused by Severe-Critical COVID-19 in Jakarta: Case Series

2021 ◽  
Vol 9 (C) ◽  
pp. 103-108
Author(s):  
Suskhan Djusad ◽  
Alfa Putri Meutia ◽  
Arresta Suastika ◽  
Gita Nurul Hidayah ◽  
Ilham Utama Surya ◽  
...  
Keyword(s):  
Septic Shock ◽  
Pregnant Women ◽  
Maternal Death ◽  
Maternal Age ◽  
Case Series ◽  
Advanced Maternal Age ◽  
Limited Information ◽  
First Case ◽  
History Of ◽  
Maternal And Neonatal Outcomes

BACKGROUND: As of January 2021, Indonesia had the 21st highest number of total COVID-19 cases and the 17th highest total deaths among all countries. COVID-19 infection in pregnant women seems to negatively affect both maternal and neonatal outcomes. CASE REPORT: We describe four cases of pregnant women confirmed with severe and critical COVID-19 that resulted in maternal death from November until December 2020. The first case was complicated with thrombocytopenia, her condition quickly deteriorated post-delivery. Pulmonary embolism was suspected as the cause of death. Second and third cases were complicated with preeclampsia, obesity, and advanced maternal age. Second case came in sepsis condition. Her SARS CoV-2 RTPCR swab test came out after her death. Third patient did not have COVID-19 symptoms at admission. She starts having symptoms on second day and was confirmed positive a day after. She falls in septic shock. Fourth patient has history of fever, cough, and dyspnea. She was confirmed positive on first day and her condition worsened, diagnosed with bacterial co-infection sepsis on day eight. All patients underwent cesarean section. CONCLUSION: Limited information and studies for COVID-19 management in pregnant women are challenging for obstetricians. Management should be individualized weighing the benefit and risks in presence of comorbidities or accompanying disease.

Advanced Maternal Age and Adverse Maternal and Neonatal Outcomes in Pregnant Women

2020 ◽  
Vol 16 ◽  
Author(s):  
Reza Omani-Samani ◽  
Saman Maroufizadeh ◽  
Nafise Saedi ◽  
Nasim Shokouhi ◽  
Arezoo Esmailzadeh ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Maternal Age ◽  
Unwanted Pregnancy ◽  
Advanced Maternal Age ◽  
Neonatal Outcomes ◽  
Maternal And Neonatal Outcomes

Background: Advanced maternal age is an important predictor for maternal and neonatal outcomes such as maternal mortality, low birth weight, stillbirth, preterm birth, cesarean section and preeclampsia. Objective: To determine the association of advanced maternal age and adverse maternal and neonatal outcomes in Iranian pregnant women. Methods: In this hospital-based cross-sectional study, 5117 pregnant women from 103 hospitals in Tehran, Iran, were participated in the study in 2015. The required data were gathered from hospitals which equipped to the department of obstetrics and gynecology. Advanced maternal age was considered as an independent variable and unwanted pregnancy, preeclampsia, preterm birth, cesarean section and low birth weight were considered as interested outcomes. Results: In our study, the prevalence of advanced maternal age was 12.08%. Advanced maternal age was significantly associated with higher risk of unwanted pregnancy (OR: 1.39, 95% CI: 1.12-1.73), preterm birth (OR: 1.75, 95% CI: 1.28- 2.39) and cesarean section (OR: 1.34, 95% CI: 1.03-1.74). In our study, there was no significant relationship between advanced maternal age and preeclampsia but this relationship could be clinically important (OR: 1.48, 95% CI: 0.99-2.20, P=0.052), and there is no significant relationship between advanced maternal age and low birth weight (OR: 1.08, 95% CI: 0.67-1.74, P=0.736). Conclusion: Advanced maternal age is associated with higher risk of unintended pregnancy, preterm birth and cesarean section but our findings did not support advanced maternal age as a risk factor associated with low birth weight.

scholarly journals Gambaran Kondisi Ibu Hamil dengan Diabetes Mellitus di RSD dr. Soebandi Jember Tahun 2013-2017 (Description of Pregnant Women Condition with Diabetes Mellitus in RSD dr. Soebandi Jember on 2013-2017)

2018 ◽  
Vol 6 (1) ◽  
pp. 46
Author(s):  
Meggeria Dyah Matrika Tito Putri ◽  
Pudjo Wahjudi ◽  
Irma Prasetyowati
Keyword(s):  
Diabetes Mellitus ◽  
Pregnant Women ◽  
Maternal Age ◽  
Maternal Education ◽  
Case Series ◽  
Sampling Technique ◽  
The Body ◽  
Family History Of Diabetes ◽  
Low Education ◽  
History Of

Abstract Diabetes Mellitus or diabetes is a chronic metabolic disease disorder caused by pancreas does not produce enough insulin or the body can’t effectively use produced insulin. In pregnant women with a family history of diabetes mellitus, the prevalence of pregnancy with diabetes mellitus is 5.1%. This research aim to determine description of pregnant women condition with diabetes mellitus in RSD dr. Soebandi Jember. This research used descriptive method with case series design. The sample size of 19 pregnant women with diabetes mellitus was selected by total sampling technique. The results showed that the high maternal age (52.6%), low education (89.5%), unemployment or housewife (89.2%), had a genetic 78.9%), BMI overweight (57.9%), glucosuria (89.5%), history of pre-eclampsia (57.9%), low parity (79%), never miscarried (84.2%). Based on the result of the research, it was concluded that maternal education, maternal job, genetic, overweight BMI, glucosuria, and history of pre-eclampsia had an effect towards the occurrence of pregnant women with diabetes mellitus, also maternal age, parity and history of miscarriage had no effect on the occurrence of pregnant women with diabetes mellitus. To raise awareness of the risks of pregnancy with diabetes mellitus can be done with screening for diabetes mellitus.  Keywords: diabetes mellitus, pregnant women, RSD dr. Soebandi.  

Spontaneous Miscarriage in Women Having More Than Three Miscarriages and Advanced Maternal Age

2021 ◽  
Vol 15 (8) ◽  
pp. 2172-2174
Author(s):  
Hina Zubair ◽  
Amber-u-Nissa Soomro ◽  
Shafqat Mukhtar ◽  
Aurooj Fatima
Keyword(s):  
Pregnant Women ◽  
Maternal Age ◽  
Clinical History ◽  
Advanced Maternal Age ◽  
First Trimester ◽  
Age Group ◽  
Recurrent Miscarriages ◽  
Spontaneous Miscarriage ◽  
History Of ◽  
Azad Kashmir

Background: Miscarriages are negative outcomes of a pregnancy. Their ratio increases in women with recurrent miscarriages. Objective: To identify the role of age and recurrent miscarriages in spontaneous abortions. Study Design: Comparative analytical study Place and Duration of Study: Department of Obstetrics & Gynecology, Mohtarma Benazir Bhutto Medical College Mir Pur, Azad Kashmir from 1st October 2020 to 31st March 2021. Methodology: One hundred and twenty pregnant women between the age group of 19-40 years. The clinical history of recurrent miscarriages and demography was noted. Results: The mean age was 29.85±4.71 years with 42% of previous miscarriage occurred in pregnant women at their first trimester. The highest number of recurrent miscarriages (>4) was noted in 36-40 years of age group. Conclusion: The rate spontaneous miscarriages increases with increasing age and recurrent history of miscarriages Key words: Spontaneous miscarriage, Advanced maternal age, Recurrent

scholarly journals Efficiency of non-invasive prenatal screening in pregnant women at advanced maternal age

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hui Zhu ◽  
Xiaoxiao Jin ◽  
Yuqing Xu ◽  
Weihua Zhang ◽  
Xiaodan Liu ◽  
...  
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Predictive Value ◽  
Trisomy 21 ◽  
Maternal Age ◽  
Prenatal Screening ◽  
Advanced Maternal Age ◽  
Youden Index ◽  
Non Invasive ◽  
Sensitivity Specificity

Abstract Background Non-invasive prenatal screening (NIPS) is widely used as the alternative choice for pregnant women at high-risk of fetal aneuploidy. However, whether NIPS has a good detective efficiency for pregnant women at advanced maternal age (AMA) has not been fully studied especially in Chinese women. Methods Twenty-nine thousand three hundred forty-three pregnant women at AMA with singleton pregnancy who received NIPS and followed-up were recruited. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), receiver operating characteristic (ROC) curves and the Youden Index for detecting fetal chromosomal aneuploidies were analyzed. The relationship between maternal age and common fetal chromosomal aneuploidy was observed. Results The sensitivity, specificity, PPV, NPV of NIPS for detecting fetal trisomy 21 were 99.11, 99.96, 90.98, and 100%, respectively. These same parameters for detecting fetal trisomy 18 were 100, 99.94, 67.92, and 100%, respectively. Finally, these parameters for detecting trisomy 13 were 100, 99.96, 27.78, and 100%, respectively. The prevalence of fetal trisomy 21 increased exponentially with maternal age. The high-risk percentage incidence rate of fetal trisomy 21 was significantly higher in the pregnant women at 37 years old or above than that in pregnant women at 35 to 37 years old. (Youden index = 37). Conclusion It is indicated that NIPS is an effective prenatal screening method for pregnant women at AMA.

The effect of advanced maternal age on maternal and neonatal outcomes of placenta previa: A register-based cohort study

2018 ◽  
Vol 227 ◽  
pp. 1-7 ◽  
Author(s):  
Zahra Roustaei ◽  
Katri Vehviläinen-Julkunen ◽  
Tomi-Pekka Tuomainen ◽  
Reeta Lamminpää ◽  
Seppo Heinonen
Keyword(s):  
Cohort Study ◽  
Maternal Age ◽  
Placenta Previa ◽  
Advanced Maternal Age ◽  
Neonatal Outcomes ◽  
Maternal And Neonatal Outcomes

COVID-19 during pregnancy: an overview of maternal characteristics, clinical symptoms, maternal and neonatal outcomes of 10,996 cases described in 15 countries

2020 ◽  
Vol 48 (9) ◽  
pp. 900-911 ◽  
Author(s):  
Ernesto Antonio Figueiro-Filho ◽  
Mark Yudin ◽  
Dan Farine
Keyword(s):  
General Population ◽  
Pregnant Women ◽  
Clinical Symptoms ◽  
Case Series ◽  
Perinatal Outcomes ◽  
Neonatal Outcomes ◽  
Eligibility Criteria ◽  
Maternal Characteristics ◽  
Th2 Immune Response ◽  
Maternal And Neonatal Outcomes

AbstractThe objective of this review was to identify the most significant studies reporting on COVID-19 during pregnancy and to provide an overview of SARS-CoV-2 infection in pregnant women and perinatal outcomes. Eligibility criteria included all reports, reviews; case series with more than 100 individuals and that reported at least three of the following: maternal characteristics, maternal COVID-19 clinical presentation, pregnancy outcomes, maternal outcomes and/or neonatal/perinatal outcomes. We included eight studies that met the inclusion criteria, representing 10,966 cases distributed in 15 countries around the world until July 20, 2020. The results of our review demonstrate that the maternal characteristics, clinical symptoms, maternal and neonatal outcomes almost 11,000 cases of COVID-19 and pregnancy described in 15 different countries are not worse or different from the general population. We suggest that pregnant women are not more affected by the respiratory complications of COVID-19, when compared to the outcomes described in the general population. We also suggest that the important gestational shift Th1-Th2 immune response, known as a potential contributor to the severity in cases of viral infections during pregnancy, are counter-regulated by the enhanced-pregnancy-induced ACE2-Ang-(1–7) axis. Moreover, the relatively small number of reported cases during pregnancy does not allow us to affirm that COVID-19 is more aggressive during pregnancy. Conversely, we also suggest, that down-regulation of ACE2 receptors induced by SARS-CoV-2 cell entry might have been detrimental in subjects with pre-existing ACE2 deficiency associated with pregnancy. This association might explain the worse perinatal outcomes described in the literature.

Approach to dyspnoea in pregnancy in the COVID-19 era

2020 ◽  
Vol 19 (4) ◽  
pp. 230-234
Author(s):  
Anita Banerjee ◽  
◽  
Lindsay A Arrandale ◽  
Srividhya Sankaran ◽  
Guy W Glover ◽  
...  
Keyword(s):  
Decision Making ◽  
Pregnant Women ◽  
Correct Diagnosis ◽  
Case Series ◽  
Differential Diagnoses ◽  
Shared Decision ◽  
First Case ◽  
Compromise Design ◽  
A Current ◽  
In Pregnancy

Importance: Dyspnoea and hypoxia in pregnant women during the COVID-19 pandemic may be due to causes other than SARS Co-V-2 infection which should not be ignored. Shared decision-making regarding early delivery is paramount. Objective: To highlight and discuss the differential diagnoses of dyspnoea and hypoxia in pregnant women and to discuss the risks versus benefit of delivery for maternal compromise. Design, setting and participants: Case series of two pregnant women who presented with dyspnoea and hypoxia during the COVID-19 pandemic. Results: Two pregnant women presented with dyspnoea and hypoxia. The first case had COVID-19 infection in the 3rd trimester. The second case had an exacerbation of asthma without concurrent COVID-19. Only the first case required intubation and delivery. Both recovered and were discharged home. Conclusion and relevance: Our two cases highlight the importance of making the correct diagnosis and timely decision-making to consider if delivery for maternal compromise is warranted. Whilst COVID-19 is a current healthcare concern other differential diagnoses must still be considered when pregnant women present with dyspnoea and hypoxia.

Effect of advanced maternal age on maternal and neonatal outcomes in assisted reproductive technology pregnancies

2017 ◽  
Vol 216 ◽  
pp. 178-183 ◽  
Author(s):  
Amirhossein Moaddab ◽  
Frank A. Chervenak ◽  
Laurence B. Mccullough ◽  
Haleh Sangi-Haghpeykar ◽  
Amir A. Shamshirsaz ◽  
...  
Keyword(s):  
Assisted Reproductive Technology ◽  
Maternal Age ◽  
Advanced Maternal Age ◽  
Reproductive Technology ◽  
Neonatal Outcomes ◽  
Maternal And Neonatal Outcomes

scholarly journals Maternal Risk Factors of Placenta Praevia and Its Effects on Maternal and Fetal Outcome

2019 ◽  
Vol 48 (2) ◽  
pp. 7-12
Author(s):  
Alpana Adhikary ◽  
Anwara Begum ◽  
Fahmida Sharmin Joty ◽  
Nihar Ranjan Sarker ◽  
Rifat Sultana
Keyword(s):  
Risk Factors ◽  
Maternal Age ◽  
Advanced Maternal Age ◽  
Fetal Outcome ◽  
Placenta Praevia ◽  
Maternal Risk Factors ◽  
High Parity ◽  
Maternal Risk ◽  
Antepartum Haemorrhage ◽  
History Of

Placenta praevia is one of the most serious obstetric emergencies, which continues to be an important contributor to perinatal mortality and is responsible for leading maternal and infant morbidity. Very few data on etiology of placenta praevia are available till now. This study aims to explore the maternal risk factors related to occurrence of placenta praevia and its effects on maternal and fetal outcome. This cross-sectional observational study was carried out among 3279 obstetrics patients admitted in labour ward in the Department of Obstetrics and Gynecology, Sher-e-Bangla Medical College Hospital from January to December 2006. Out of 3279 obstetrics patients 93 placenta praevia cases were identified purposively as study subjects. The patients of placenta praevia were selected either diagnosed clinically by painless antepartum haemorrhage or asymptomatic placenta praevia diagnosed by ultrasonography irrespective of age, gestational age, parity, booking status. Pregnant woman admitted with painful antepartum haemorrhage were excluded from the study. With the ethical approval from the Institutional Ethical Committee (IEC), patients were selected after taking their written consent. A structured questionnaire and a chick list were designed with considering all the variables of interest. Out of 93 respondents, 73.88% were associated with risk factors in addition to advanced maternal age and high parity. Among them 24.73%, 33.33% and 7.52% had history of previous caesarean section (CS), MR and abortion and both CS & abortion previously. Patients aged above 30 years were 47% and 35.48% were in their 5th gravid and more; whereas, 31.18% patients were asymptomatic, 68.82% patients presented with varying degree of vaginal bleeding, among them 12.08% were in shock. Active management at presentation was done on 76.34% patients and 23.66% were managed expectantly. CS was done o 82.79% patients and only 17.2% were delivered vaginally. Case fatality rate was 1.07% and about 22% perinatal death was recorded, majority belonged to low birth weight (<1500 gm). About 10% patients required caesarean hysterectomy, 3.22% required bladder repair. Advanced maternal age, high parity, history of previous CS and abortion found to be common with the subsequent development of placenta praevia. Proper diagnosis, early referral and expectant management of patients will reduce prematurity, thereby improvised foetal outcome but to improve maternal outcome rate of primary CS have to be reduced and increase practice of contraception among women of reproductive age. Bangladesh Med J. 2019 May; 48 (2): 7-12

scholarly journals Support, Access and Antenatal Care to Women with a history of Preeclampsia in Pregnancy

2020 ◽  
Vol 11 (2) ◽  
pp. 86
Author(s):  
Evi Diliana Rospia ◽  
Andari Wuri Astuti ◽  
Retno Mawarti
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Maternal Death ◽  
Information Search ◽  
Health Workers ◽  
Qualitative And Quantitative ◽  
Lack Of Information ◽  
Need Support ◽  
History Of ◽  
In Pregnancy

Preeclampsia and eclampsia are the second direct cause of maternal death worldwide, estimated to complicate 2-8% of all pregnancies, the global prevalence of preeclampsia is around 4.6%. The purpose of this scoping review is to provide an overview of studies related to antenatal support, access and services to mothers with a history of preeclampsia in pregnancy. The authors identify studies that explain preeclampsia in pregnancy from several databases namely PubMed, ProQuest, EBSCO and Springer Link. Searches are limited to studies published in English and present data for the 2009-2019 period. The identified study was reviewed using PRISMA Flowchart. Studies with qualitative and quantitative designs that explore the experiences of pregnant women regarding antenatal support, access and services were selected for review, while studies that were not experience related to antenatal support, access and services to mothers with a history of preeclampsia in pregnancy were excluded. A total of twelve articles were reviewed which obtained three sub-themes of support, namely the support of husband, family and health workers, from the theme of access obtained three sub-themes namely information search, modification programs and the availability of health workers. From the theme of antenatal care, four sub-themes are found, namely unsustainable care, lack of information, screening and feeling empowered. Pregnant women with preeclampsia need support from a partner or family and health workers. Information and screening need to be improved in antenatal care.

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