Prolonged newborns and prolong pregnancy

The article is devoted to the current problems of obstetrics, perinatology and neonatology. The article presents a literary review and covers scientific views on the factors of births and hazardous factors that lead to transfer and prolonged pregnancy. The most common perinatal complications of a delayed pregnancy are stillbirth, asphyxia, and birth trauma. Neonatal morbidity in premature infants is 29% and perinatal mortality is 19%, which is higher than in preterm infants. If the pregnancy is 43 weeks or more, these rates will increase. All of these diseases are associated with a decrease in the fetal resistance to hypoxia due to the large size of the brain and morphological changes in the placenta. Therefore, the incidence of meconium aspiration syndrome and fetal distress syndrome at birth increases, leading to high perinatal morbidity and mortality.

Severe Neonatal COVID Pneumonia With Cytokine Storm

COVID infection is not as common in children as in adults. In the first wave, symptomatic SARS-CoV-2 infection was less common with mild symptoms in children and neonates. But in the second wave, more children and neonates were affected with severe manifestations. COVID infection in neonates is mostly asymptomatic and published data from various neonatal units of India shows that most COVID positive newborns have good prognosis; poor outcomes are due to perinatal complications and rarely due to COVID. 1 However, in the second wave, newborns too were affected. We are presenting the case of a preterm neonate who developed severe COVID pneumonia on day 10 of life with cytokine storm and succumbed to death.

PARTO HUMANIZADO Y LA FUNCIÓN DE ENFERMERÍA EN LOS ESTABLECIMIENTOS DE SALUD PÚBLICA.

Introducción: la humanización del parto asegura el respeto de los derechos fundamentales, reproductivos y sexuales de la gestante y la familia, reduciendo complicaciones perinatales y morbi-mortalidad materno-infantil. Objetivo: Caracterizar el parto humanizado y las funciones de enfermería en los establecimientos de salud pública. Métodos: diseño documental con revisión bibliográfica sobre humanización del parto para lo cual se realizó una búsqueda en bases de datos como: PubMed, Taylor y Francis, LILACS, MEDLINE, BVS, SCIELO, LATINDEX, GOOGLE ACADÉMICO, en idioma español e inglés. Resultados: En base a revisión y análisis de 40 artículos se pudo conocer que el parto humanizado es reconocido mundialmente como una estrategia eficiente para reducir complicaciones perinatales y lograr una maternidad satisfactoria y que a nivel latinoamericano; Brasil, Perú, Argentina, Ecuador, Venezuela y México ya cuentan con iniciativas del sector público, privado y de organizaciones civiles para promocionar parto humanizado, y con ello reducir las tasas de cesáreas, parto instrumentado, morbi-mortalidad materno infantil y lograr una maternidad satisfactoria, segura basada en prácticas no invasivas ni farmacológicas para el alivio del dolor, educación y autorización sobre procedimientos, autonomía, buen trato y respeto por sentimientos y creencias. Conclusiones: En el pato humanizado, el rol de enfermería es esencial sobre todo en los establecimientos públicos en donde se asume maltrato, negligencia o falta de respeto por el parto, por lo que la enfermera está llamada a educar a la parturienta sobre el trabajo de parto y parto. Palabras clave: parto humanizado, atención perinatal, enfermería, recién nacido. ABSTRACT Introduction: the humanization of childbirth ensures respect for the fundamental, reproductive and sexual rights of the pregnant woman and the family, reducing perinatal complications and maternal and infant morbidity and mortality. Objective: To characterize humanized delivery and nursing functions in public health establishments. Methods: documentary design with bibliographic review on the humanization of childbirth for which a search was carried out in databases such as: PubMed, Taylor and Francis, LILACS, MEDLINE, BVS, SCIELO, LATINDEX, GOOGLE ACADEMICO, in Spanish and English. Results: Based on a review and analysis of 40 articles, it was possible to know that humanized delivery is recognized worldwide as an efficient strategy to reduce perinatal complications and achieve a satisfactory maternity and that at the Latin American level; Brazil, Peru, Argentina, Ecuador, Venezuela and Mexico already have initiatives from the public and private sectors and civil organizations to promote humanized delivery, and thereby reduce the rates of cesarean sections, instrumented delivery, maternal and infant morbidity and mortality and achieve motherhood, satisfactory, safe based on non-invasive or pharmacological practices for pain relief, education and authorization on procedures, autonomy, good treatment and respect for feelings and beliefs. Conclusions: In the humanized duck, the role of nursing is essential especially in public establishments where abuse, neglect or lack of respect for childbirth is assumed, so the nurse is called to educate the woman in labor about the labor of labor and delivery. Keywords: humanized delivery, perinatal care, nursing, newborn

Assessment of correction effectivenes of psychoemitional state in pregnant women after application of assisted reproductive technologies

To determine the role and effectiveness of the proposed the­rapeutic and preventive complex in the correction of psychoemotional state in the dynamics of pregnancy in pregnant women after assisted reproductive technologies (ART) application in order to improve the tactics of antenatal obser­vation and prevention of obstetric and perinatal complications. 299 pregnant women were comprehensively examined and a set of therapeutic and preventive measures was carried out: the main group included 249 women whose pregnancy occurred as a result of ART application. The control group consisted of 50 pregnant women with spon­taneous pregnancy. The complex of measures for pregnant women after ART application included: micronized pro­gesterone, magnesium oxide, folic acid, L-arginine aspartate, Omega-3 polyunsaturated fatty acids and long-term psychological correction – before ART program, at 8-10 weeks of pregnancy, at 16-18 weeks of pregnancy and at 28-30 weeks of pregnancy. Introduction of the proposed complex of psychoemotional correction contributed to the formation of reactive anxiety and personal anxiety levels at a moderate level in women of subgroups IA-44 (89.8%) and 43 (87.6%), IIA – 43 (89.6%) and 44 (91.7%) and IIIA – 30 (83.3%) and 26 (72.2%), which is considered to be an adaptive, physiological type during pregnancy. The positive effect of the proposed complex of psychoemotional correction demonstrates the improvement of processes of formation of type of component gestational dominant, its return to the optimal type in women of subgroup IA – 41 (83.6%), IIA – 39 (81.3%) and IIIA – 26 (72.2%) that is close to the physiological course of pregnancy and contributes to the reduction of perinatal and obstetric complications among pregnant women of these subgroups.

Pregnancy and delivery in women treated with renal replacement therapy: A literature review

The problem of pregnancy and delivery in women with end-stage kidney disease is becoming increasingly important, and the number of such women who are pregnant, receiving kidney replacement therapy, is growing every year. Improvements in dialysis therapy have led to improved obstetric and perinatal outcomes, but the risk of various obstetric and perinatal complications remains extremely high. In this review, we analyzed recently published data on management and outcomes of pregnancy in women with end-stage kidney disease receiving dialysis.

PREDICTION OF PERINATAL COMPLICATIONS IN WOMEN WITH NONCARRYING OF PREGNANCY AT EARLY GESTATION TERMS (LITERATURE REVIEW)

Objective – to analyze modern views on the mechanisms of perinatal complications’development in order to predict them in women with miscarriage in the first trimester ofgestation.Conclusions. The need for further study of this problem, taking into account theethiopathogenesis, in order to develop algorithms for predicting gestational complicationsand timely diagnosis, which will improve perinatal outcomes, was shown. Therefore, thepriority task, aimed at reducing reproductive losses, is the prevention of miscarriage byfinding new screening markers that will detect preclinical forms of pathology.

Ureaplasma parvum meningitis following atypical choroid plexus papilloma resection in an adult patient: a case report and literature review

Background While Ureaplasma parvum has previously been linked to the incidence of chorioamnionitis, abortion, premature birth, and perinatal complications, there have only been rare reports of invasive infections of the central nervous system (CNS) in adults. Owing to its atypical presentation and the fact that it will yield sterile cultures using conventional techniques, diagnosing U. parvum meningitis can be challenging. Case presentation We describe a case of U. parvum meningitis detected in an adult patient following surgical brain tumor ablation. After operation, the patient experienced epilepsy, meningeal irritation, and fever with unconsciousness. Cerebrospinal fluid (CSF) analysis showed leukocytosis (484 * 106 /L), elevated protein levels (1.92 g/L), and decreased glucose concentrations (0.02 mmol/L). Evidence suggested that the patient was suffering from bacterial meningitis. However, no bacterial pathogens in either CSF or blood were detected by routine culture or serology. The symptoms did not improve with empirical antibiotics. Therefore, we performed metagenomic next-generation sequencing (mNGS) to identify the etiology of the meningitis. Ureaplasma parvum was detected by mNGS in CSF samples. To the best of our knowledge, this case is the first reported instance of U. parvum meningitis in an adult patient in Asian. After diagnosis, the patient underwent successful moxifloxacin treatment and recovered without complications. Conclusions As mNGS strategies can enable the simultaneous detection of a diverse array of microbes in a single analysis, they may represent a valuable means of diagnosing the pathogens responsible for CNS infections and other clinical conditions with atypical presentations.

Duration of Exposure to General Endotracheal Anesthesia during Cesarean Deliveries at Term and Perinatal Complications

Objective To examine whether the duration of time from initiation of general endotracheal anesthesia (GETA) to delivery for cesarean deliveries (CDs) performed is related to perinatal outcomes. Study Design This is a retrospective study of patients with singleton nonanomalous gestations undergoing CD ≥37 weeks of gestation under GETA with reassuring fetal status at a single tertiary care center from 2000 to 2016. Duration from GETA initiation until delivery was calculated as the time interval from GETA induction to delivery (I-D), categorized into tertiles. Outcomes for those in the tertile with the shortest I-D were compared with those in the other two tertiles. The primary perinatal outcome was a composite of complications (continuous positive airway pressure or high-flow nasal cannula for ≥2 consecutive hours, inspired oxygen ≥30% for ≥4 consecutive hours, mechanical ventilation, stillbirth, or neonatal death ≤72 hours after birth). Secondary outcomes were 5-minute Apgar score <7 and a composite of maternal morbidity (bladder injury, bowel injury, and extension of hysterotomy). Bivariable and multivariable analyses were used to compare outcomes. Results Two hundred eighteen maternal–perinatal dyads were analyzed. They were dichotomized based on I-D ≤4 minutes (those in the tertile with the shortest duration) or >4 minutes. Women with I-D >4 minutes were more likely to have prior abdominal surgery and less likely to have labored prior to CD. I-D >4 minutes was associated with significantly increased frequency of the primary perinatal outcome. This persisted after multivariable adjustment. In bivariable analysis, 5-minute Apgar <7 was more common in the group with I-D >4 minutes, but this did not persist in multivariable analysis. Frequency of maternal morbidity did not differ. Conclusion When CD is performed at term using GETA without evidence of nonreassuring fetal status prior to delivery, I-D interval >4 minutes is associated with increased frequency of perinatal complications. Key Points

A case report on placental chorioangioma

Chorioangioma is the term used to describe an abnormal proliferation of vessels arising from chorionic tissue, which is most commonly observed in the third, and less frequently in the second trimester of pregnancy as a solitary nodule or, less commonly, as multiple nodules. We here report a case of placental chorioangioma which presented as a case of preterm labour. 21 year old primigravida presented to us at 26 weeks of gestation with history of PV leak and pain in abdomen. Ultrasound showed a single live foetus corresponding to 24-26 weeks of gestation with amniotic fluid index (AFI): 5 cm (oligohydramnios) there was evidence of 58×42 mm heterogeneously hypoechoic lesion noted over placenta likely s/o chorioangioma. Patient went into spontaneous preterm labour on day 5 and delivered vaginally. Placenta weighted 700 gm. A globular mass of size 6×7 cm was attached to foetal surface of placenta with a pedicle with confirmed the finding of ultrasonography. Placental chorioangioma is associated with high rates of perinatal complications. Most complications may appear early and delivery is problematic due to prematurity. Thus better prenatal investigations and regular follow up is required for early diagnosis and treatment.

Gestagenes in the treatment of endometriosis: efficiency, safety, bioequivalence, transferability

Endometriosis is a chronic disease that requires long-term treatment, the goal of which is effectively use drugs and avoids repeated surgical interventions.The quality of patients’ life depends on the varying degrees of symptoms such as pelvic pain, dyspareunia, dysmenorrhea. Endometriosis causes infertility and perinatal complications. The symptoms of endometriosis often affect psychological and social well-being, and threaten the relationships, sexuality and mental health of women. Women with endometriosis have high levels of anxiety, depression, and other psychiatric disorders that can aggravate the severity of their pain.The existing statistics on the endometriosis incidence is underestimated given the diagnostic difficulties. So far, there are no final, only generally an accepted method of treating endometriosis, and in most cases, treatment is only eliminates the symptoms. Today, it is desirable to take a conservative approach to treatment, avoiding surgery, and hormone therapy is recommended to relieve pain associated with endometriosis. An individual approach is important in the management of patients with endometriosis, taking into account the reproductive plans and needs of woman. Medical treatment methods should be used as much as possible, for example, dienogest 2 mg (in particular, Savis drug). Dienogest is a derivative of 19-nortestosterone, which has an antiproliferative effect on the endometriosis foci.Savis is a drug specially formulated for the endometriosis treatment. Savis may be prescribed to relieve symptoms before and after surgery to prevent relapse. The safety profile of dienogest has been studied and data is constantly accumulating, given the popularity of its prescription.The effectiveness of dienogest should be assessed primarily by its effect on pain and quality of life, on maintaining fertility, and on the possibility of avoiding or postponing surgery. This is important for various forms of endometriosis: endometriomas, extragenital endometriosis, adenomyosis.