Treatment of COVID-19 disease in pregnancy and breastfeeding

The physiological and anatomical clinical characteristics of pregnant women make them susceptible to complications caused by coronavirus disease (COVID-19). Increased coagulation and risk of thromboembolic phenomena are common during pregnancy; they are further enhanced when associated with a thrombogenic pathology such as in COVID-19. The treatment of COVID-19 is controversial and limited, even for non-pregnant patients. During pregnancy, the options are even more restricted due to the teratogenicity of some drugs and anatomical and physiological difficulties, especially in advanced pregnancy in patients with respiratory failure. Therefore, the focus of treatment for pregnant patients should be centered on isolation, monitoring fetal and maternal vital signs, uterine activity, and general maternal-fetal well-being. The prescription of drugs and management orientation should be based on gestational age and maternal clinical conditions. The optimal type of delivery is guided by obstetric indications and COVID-19 disease severity. Breastfeeding should be encouraged with the use of masks and hand hygiene. The treatment of pregnant women with COVID-19 brings important peculiarities that should be considered in order to make better decisions for preserving the health of the mother and fetus.

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

10.36106/ijsr/6704051 ◽

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.

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User Perception Towards mHealth Technologies for Health and Well-being Monitoring in Pregnancy Care: Qualitative Study (Preprint)

10.2196/preprints.28628 ◽

2021 ◽

Author(s):

Jane Li ◽

David Silvera-Tawil ◽

Marlien Varnfield ◽

M Sazzad Hussain ◽

Vanitha Math

Keyword(s):

Qualitative Study ◽

Pregnant Women ◽

Mobile Applications ◽

Data Privacy ◽

Perinatal Care ◽

Well Being ◽

Technical Solution ◽

Pregnancy Care ◽

Health And Well Being ◽

In Pregnancy

BACKGROUND Mobile Health (mHealth) technologies, such as wearable devices and mobile applications have become popular for lifestyle and healthcare support. They have the potential to be beneficial for pregnancy monitoring, in the form of health and well-being tools to facilitate the tracking of health status changes, risks and complications of pregnant women. However, research on understanding clinicians’ and pregnant women’s interests, preferences and requirements for mHealth solutions tailored to pregnancy care is limited. OBJECTIVE This qualitative study aimed to understand clinicians’ and pregnant women’s perceptions on the potential use of mHealth to support the monitoring of health and well-being during pregnancy. METHODS Semi-structured interviews were conducted with four pregnant women, four postnatal women, and thirteen clinicians working in perinatal care. RESULTS Clinicians perceived the potential benefit of mHealth in supporting different levels of health and wellbeing monitoring, risk assessment and care provision in pregnancy care. The majority of women participants were open to the use of wearables and health monitoring devices and were more likely to use these technologies if they knew that clinicians can monitor the data. While some pregnancy-related medical conditions can be suitable for an mHealth model of remote monitoring, there are clinical and technical challenges for introducing mHealth in pregnancy care. Incorporating appropriate health and well-being measures, intelligent detection of abnormalities and tailored information for pregnant women were considered critical. Usability and data privacy were among the concerns of participants. The challenges of getting pregnant women engaged in longitudinal mHealth monitoring, the extra work required for clinicians in monitoring data, and the need for an evidence-based technical solution were highlighted. CONCLUSIONS mHealth technologies, such as wearable sensors, smart health devices and mobile applications capable of supporting the pregnancy journey are emerging. Clinical, technical and practical factors associated with the use of mHealth technologies to monitor health and well-being, as well as strategies for motivating pregnant women and clinicians’ in the use of the technologies need to be carefully considered before the introduction of mHealth pregnancy care routine and practices.

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Pregnancy-Related Low Back Pain and The Quality of Life among Pregnant Women : A Narrative Literature Review

Journal of Public Health for Tropical and Coastal Region ◽

10.14710/jphtcr.v4i3.10795 ◽

2021 ◽

Vol 4 (3) ◽

pp. 108-116

Author(s):

Tiara Fatmarizka ◽

Raudhatus Shofy Ramadanty ◽

Dini Afriani Khasanah

Keyword(s):

Quality Of Life ◽

Low Back Pain ◽

Back Pain ◽

Pregnant Women ◽

Well Being ◽

Low Back ◽

Cross Sectional ◽

Cross Sectional Studies ◽

In Pregnancy

Introduction: Around 50-70% of pregnant women have reported pregnancy-related back pain during the second and third trimesters of pregnancy. Physical and physiological aspects during pregnancy might affect the quality of life (QoL) of pregnant women, and the problems due to the alteration can be seen in how they run their daily activities. The effect of LBP in pregnancy on the QoL among pregnant women must be known to avoid the pain that affects pregnant women’s activities and well-being. The aim of this study is to review the relationship between low back pain and the QoL during pregnancy.Methods: Using the search terms via PubMed and Google Scholar, seven cross-sectional studies have met the inclusion criteria and included for further analysis. The appraisal tool for Cross-Sectional Studies (AXIS) is used to assess the quality of the included studies including the risk of bias.Results: The findings show that LBP in pregnancy affects the level of quality of life such as sleep quality and sexual activity, limits the activities and productivities, and even make physical disability among pregnant women. The 75-90% was of the range score obtained from the AXIS critical appraisal.Conclusions: This review mentioned those pregnant women with PRBP had decreased QoL during and after childbirth, so the awareness of health professionals needs to be improved.

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Malaria in Pregnancy in Nigeria: A Literature Review

International Healthcare Research Journal ◽

10.26440/ihrj/0311.02315 ◽

2020 ◽

Vol 3 (11) ◽

pp. 346-348

Author(s):

Joseph Omang ◽

Antor O Ndep ◽

Dominic Offiong ◽

Fidelis Otu ◽

Kenneth Onyejose

Keyword(s):

Pregnant Women ◽

Malaria Infection ◽

Well Being ◽

Malaria In Pregnancy ◽

Sub Saharan Africa ◽

Infected Mosquito ◽

Insecticide Treated Nets ◽

Health Seeking ◽

Systematic Analysis ◽

In Pregnancy

Malaria is caused by the parasite plasmodium which can be spread to humans through the bite of an infected mosquito. Of the five types of plasmodium (P. Falciparium, P.Ovale, P. Malaria, P. Vivax and P. Knowlesi), the plasmodium falciparium is the deadliest and affects the lives of almost 40 per cent of the world’s population with pregnant women and children under-five years of age being the most affected. This mini-review involved the collation of findings from recent studies in regards to the prevalence of malaria infection among pregnant women and infants. A systematic analysis of recent literature on the prevalence of malaria in pregnancy from many authors was carried out and the facts synthesized to make an easy read. From the analysis of literature, Ten Thousand women and 200,000 babies were reported to be dying annually from complications of malaria in pregnancy which recorded a prevalence of 85 per cent in sub-Saharan Africa. More so, Fifty per cent of pregnant women were discovered to be carrying plasmodium falciparium in their placenta without even experiencing malaria signs/ symptoms, and this development was reported to have been responsible for Twenty per cent of stillbirths and 11 per cent of all maternal deaths. Malaria infection is considered a major threat to the lives and well-being of pregnant women and infants. Therefore, stakeholders should ensure that every clinical diagnosis of malaria in pregnancy is confirmed with a laboratory plasmodium falciparium-based diagnosis before the administration of antimalarial drugs. Furthermore there should be a stepping –up on the distribution of insecticide treated nets alongside enlightenment of pregnant women on ways of preventing mosquito bite. Instituting the aforementioned approaches is key to improving the health- seeking behaviour of pregnant women in particular and the wider population in general thus enabling them to stay malaria free throughout the period of pregnancy and infancy.

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Mutations in transcription factor as rare causes of diabetes in pregnancy

Diabetes Mellitus ◽

10.14341/dm9945 ◽

2019 ◽

Vol 22 (3) ◽

pp. 274-280 ◽

Cited By ~ 1

Author(s):

Natalia A. Zubkova ◽

Fatima F. Burumkulova ◽

Vasily A. Petrukhin ◽

Margarita A. Plechanova ◽

Anton E. Panov ◽

...

Keyword(s):

Transcription Factor ◽

Glycemic Control ◽

Pregnant Women ◽

Clinical Characteristics ◽

Diabetes In Pregnancy ◽

Perinatal Complications ◽

Nuclear Factors ◽

Hepatocyte Nuclear Factors ◽

Hnf1a Gene ◽

In Pregnancy

MODY1 and MODY3 represent rare causes of diabetes in pregnancy. Establishing a molecular diagnosis of MODY1 or MODY3 during pregnancy may be important for minimizing risk of perinatal complications and for improving glycemic control after pregnancy. The objective of the study was to evaluate the contribution of mutations in HNF4A and HNF1A genes in development of diabetes in pregnancy and to describe clinical characteristics of diabetes in pregnancy associated with these mutations. 230 pregnant women (20-43 years) with different type of glucose intolerance complicated during their current pregnancy were included in the study. A custom NGS panel targeting 28 diabetes causative genes was used for sequencing. Heterozygous mutations in HNF4A and HNF1A genes were detected in 3% of cases. Mutations p.I271T in HNF4A gene and p.L148F, p.Y265C, p.G288W in HNF1A gene were novel. This study includes a description of patients with pregnancy diabetes due to mutations in hepatocyte nuclear factors.

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The role of proper maternal nutrition during pregnancy for caries prevention in both mother and child. Opinion of the working group of the Polish Alliance for a Cavity-Free Future on dental prophylaxis in pregnant women

Nowa Stomatologia ◽

10.25121/ns.2018.23.2.84 ◽

2018 ◽

Vol 23 (2) ◽

Author(s):

Renata Chałas ◽

Angelika Kobylińska ◽

Magdalena Kukurba-Setkowicz ◽

Anna Szulik ◽

Elżbieta Pels

Keyword(s):

Pregnant Women ◽

Maternal Nutrition ◽

Well Being ◽

Caries Prevention ◽

World Health ◽

Dental Prophylaxis ◽

Mother And Child ◽

Health Organization ◽

In Pregnancy

Introduction. Proper nutrition in pregnancy has effects on the health and well-being of the mother as well as is a key factor responsible for foetal growth and development, which are initiated at conception and last throughout pregnancy. Aim. The aim of the paper was to present relevant data on the role of prenatal maternal nutrition for caries prevention in both mother and child. Material and methods. Pubmed, EMBASE, MEDLINE, guidelines of dental associations and World Health Organization were searched using the following keywords: “diet”, “dentition”, “pregnancy”, “oral health in pregnancy”. Results. The diet of a pregnant woman should be well-balanced and rich in proteins, calcium, phosphorus, fluorine and vitamins (A, C and D). Women should avoid sneaks between meals or at night to avoid dental plaque accumulation and oral pH decrease. Balanced nutrition influences the development of future nutritional habits of the child as taste receptors begin to develop already at month 4 of pregnancy. High maternal consumption of confectionery in this period may in the future increase the child’s tendency to consume sweet food products. Conclusions. There is a need to intensify dental prophylaxis among pregnant women through introduction and promotion of proper nutrition in dental offices, up-dating teaching programs for dental hygienists and education in birth schools.

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A Meta-Analysis on the Effectiveness of Prenatal Yoga in Reducing Cortisol Hormone in Pregnancy

Childhood Stunting, Wasting, and Obesity, as the Critical Global Health Issues: Forging Cross-Sectoral Solutions ◽

10.26911/the7thicph.05.47 ◽

2020 ◽

Author(s):

Shiva Aflahiyah ◽

◽

Didik Gunawan Tamtomo ◽

Hanung Prasetya ◽

◽

...

Keyword(s):

Pregnant Women ◽

Cortisol Level ◽

Controlled Trial ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Well Being ◽

The Body ◽

Inclusion Criteria ◽

In Pregnancy

ABSTRACT Backgrund: A growing body of evidence suggests that activity of the stress-responsive hypothalamic-pituitary-adrenal axis and its end-product cortisol also may be associated with perinatal emotional well-being. A number of preventive interventions, such as Yoga, targeting psychosocial and physiological risk factors for perinatal depression have utilized mind-body practices, which embody the idea that the mind interacts with the body to influence physical functioning, improve symptoms, and promote health. This study aimed to investigate effectiveness of prenatal yoga in reducing cortisol hormone in pregnancy Subjects and Method: This was a meta-analysis and systematic review. This study collected published articles during 2000 to 2020 from PubMed, Science Direct, Springer, Proquest, and Chocrane electronic databases. The inclusion criteria were full text, randomized controlled trial, and prenatal yoga intervention. The study subjects were pregnant women who received prenatal yoga for 8 to 20 weeks. Outcome was cortisol hormone reduction during pregnancy. The selected articles were analyzed by PRISMA flow chart and RevMan 5.3. Results: 5 articles from America and Asia were met the inclusion criteria. This study had high heterogeneity (I2=88%; p<0.001). Therefore, this study used random effect model (REM). Prenatal yoga reduced cortisol level 0.59 times in pregnancy (Mean Difference= -0.59; 95% CI= 1.18 to 0.01; p= 0.050). Conclusion: Prenatal yoga is effective to reduce cortisol level in pregnant women. Keywords: prenatal yoga, cortisol hormone, pregnant women Correspondence: Shiva Aflahiyah. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: [email protected]. DOI: https://doi.org/10.26911/the7thicph.05.47

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Development and evaluation of a novel Vital Signs Alert device for use in pregnancy in low-resource settings

BMJ Innovations ◽

10.1136/bmjinnov-2017-000235 ◽

2018 ◽

Vol 4 (4) ◽

pp. 192-198 ◽

Cited By ~ 5

Author(s):

Hannah L Nathan ◽

Nicola Vousden ◽

Elodie Lawley ◽

Annemarie de Greeff ◽

Natasha L Hezelgrave ◽

...

Keyword(s):

Pregnant Women ◽

Early Warning ◽

Early Warning System ◽

Healthcare Providers ◽

Vital Signs ◽

Warning System ◽

Evidence Based ◽

Traffic Light ◽

Low Resource Settings ◽

In Pregnancy

ObjectivesHaemorrhage, hypertension, sepsis and abortion complications (often from haemorrhage or sepsis) contribute to 60% of all maternal deaths. Each is associated with vital signs (blood pressure (BP) and pulse) abnormalities, and the majority of deaths are preventable through simple and timely intervention. This paper presents the development and evaluation of the CRADLE Vital Signs Alert (VSA), an accurate, low-cost and easy-to-use device measuring BP and pulse with an integrated traffic light early warning system. The VSA was designed to be used by all cadres of healthcare providers for pregnant women in low-resource settings with the aim to prevent avoidable maternal mortality and morbidity.MethodsThe development and the mixed-methods clinical evaluation of the VSA are described.ResultsPreliminary fieldwork identified that introduction of BP devices to rural clinics improved antenatal surveillance of BP in pregnant women. The aesthetics of the integrated traffic light system were developed through iterative qualitative evaluation. The traffic lights trigger according to evidence-based vital sign thresholds in hypertension and haemodynamic compromise from haemorrhage and sepsis. The VSA can be reliably used as an auscultatory device, as well as its primary semiautomated function, and is suitable as a self-monitor used by pregnant women.ConclusionThe VSA is an accurate device incorporating an evidence-based traffic light early warning system. It is designed to ensure suitability for healthcare providers with limited training and may improve care for women in pregnancy, childbirth and in the postnatal period.

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Clinical characteristics, management, maternal and neonatal outcome among seven severe and critically ill pregnant women with COVID-19 pneumonia

Clinical Journal of Obstetrics and Gynecology ◽

10.29328/journal.cjog.1001071 ◽

2020 ◽

Vol 3 (2) ◽

pp. 158-166

Author(s):

Hazari Komal Sundeep ◽

Paulose Litty ◽

Kurien Nimmi ◽

Mohammad Hozaifah ◽

A Elgergawi Taghrid Faek ◽

...

Keyword(s):

Pregnant Women ◽

Clinical Characteristics ◽

Case Series ◽

Fetal Outcome ◽

World Health ◽

Investigational Therapies ◽

Serious Disease ◽

Novel Coronavirus ◽

Health Organization ◽

In Pregnancy

Pneumonia caused by the Novel coronavirus disease 2019 (COVID-19) is a highly infectious disease and the ongoing outbreak has been declared as a Pandemic by the World health organization. Pneumonia is a serious disease in pregnancy and requires prompt attention. Viral pneumonia has higher morbidity and mortality compared to bacterial pneumonia in pregnancy. All efforts are well exerted to understand the newly emerged disease features but still some areas are gray. The treatment is primarily supportive with antivirals, steroids, anticoagulation and antibiotics for secondary bacterial infection. Severe cases require intensive care monitoring with oxygen support, mechanical ventilation. Investigational therapies include convalescent plasma, cytokine release inhibitors and other immunomodulatory agents like interferons. The mortality appears driven by the presence of severe Adult Respiratory Syndrome (ARDS) and organs failure. COVID pandemic is a challenging and stressful socio-economic situation with widespread fear of infection, disease and death. In the specialty of obstetrics and gynecology, studies are being conducted to ascertain the manifestation of disease in pregnant women and the fetal outcome. The aim of our case series is to describe the demographics, clinical characteristics, laboratory and radiological findings, feto- maternal outcome of severe and critical COVID pneumonia in pregnant women in Latifa Hospital.

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Ngaa-bi-nya-nhumi-nya (to Test First): Piloting the Feasibility of Using the Growth and Empowerment Measure with Aboriginal Pregnant Women Who Smoke

The Journal of Smoking Cessation ◽

10.1155/2021/6610500 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Michelle Bovill ◽

Yael Bar-Zeev ◽

Billie Bonevski ◽

Jennifer Reath ◽

Christopher Oldmeadow ◽

...

Keyword(s):

Pregnant Women ◽

Qualitative Interviews ◽

Well Being ◽

Measurement Tool ◽

Nonsignificant Trend ◽

Social And Emotional ◽

Aboriginal Women ◽

Service Staff ◽

Smoking Behaviours ◽

In Pregnancy

Introduction. Aboriginal pregnant women who smoke experience barriers to quitting, including challenges to social and emotional well-being, but these are infrequently quantified. Finding an appropriate measurement tool in this setting is crucial to increase knowledge for holistic smoking cessation interventions. Aims. To pilot the Growth and Empowerment Measure (GEM) with a sample of pregnant Aboriginal women who smoke. Methods. Aboriginal women participating in the step-wedge ICAN QUIT in Pregnancy pilot study completed the GEM comprised of 14-item Emotional Empowerment Scale (EES14), 12 Scenarios (12S), and K6 items at baseline, 4 weeks, and 12 weeks. Qualitative interviews with service staff were held at the end of the study to assess feasibility. Results. 15 pregnant Aboriginal women took part between November 2016 and July 2017. At 12 weeks, n = 8 / 12 (67%) of women reported an increase in both the EES14 and 12S scores. Total 12S scores were significantly higher at 12 weeks ( p = 0.0186 ). Total K6 had a nonsignificant trend for reduction ( p = 0.0547 ). Staff reported that the length of the survey presents challenges in this setting. Conclusions. A shortened, modified GEM is recommended in this setting. We recommend the GEM to be tested in a larger study, powered to assess its associations with smoking behaviours.

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