Pregnancy and COVID-19

Pregnancy is a physiological state that alters the body’s response to infections. COVID-19 has been found to cause severe disease in pregnancy with morbidity and mortality that is higher than in non-pregnant adults. There is risk of transmission of SARS-CoV2 infection to fetus during ante-natal period, intra-partum and post-delivery from an infected mother. It is necessary to provide an un-interrupted ante-natal care and delivery services to pregnant women during the pandemic. Tele-consultation is important modality to reduce the physical exposure of pregnant women to the hospital environment and should be utilised. Screening, isolation, testing and treatment for SARS-CoV2 infection in pregnant women should follow the local guidelines and remain essentially the same as in non-pregnant adults. Admission, if required, should be in a facility that can provide obstetric maternal and fetal monitoring in addition to care for COVID-19 illness. Use of nitrous oxide and inhalational oxygen for fetal indication should be avoided during labor. Second stage of labor is considered an aerosol generating procedure and should be managed with adequate precautions. Mode of delivery should be as per obstetric indications. Regional anaesthesia should be preferred during caesarean. COVID-19 is not a contra-indication to breast feeding. For antenatal women, COVID-19 vaccination can be considered after shared decision making.

Literature Review : Pemberian Posisi Miring Dan Setengah Duduk Terhadap Lama Persalinan Kala

In the delivery process, the position of the mother giving birth has an effect on the smoothness of the process. This scientific paper aims to determine the description of giving oblique position and half-sitting position to the duration of the second stage of labor based on a literature review. It has taken three articles from Google scholar with tilt nosition half cit-fino nosition and the second stncre as the kevwords A Il Are full-text the first article was published in 2014, the second one was in 2019, and the latter was in 2020. The analysis result showed from 206 respondents, the average of labor duration on the second stage was 23.786 minutes In tilt position. Meanwhile, In halt Sitting position, it was 43.34 minutes. Furthermore, the first position was 19.554 minutes faster than the second one. And. the result is the conclusion. Therefore- it is suggested for the birth attendant to recommend a maternity mother to apply tilt position to speed up the delivery processKeywords: Tilt position; halfsitting position; second stage. AbstrakPosisi pada ibu bersalin berpengaruh terhadap proses persalinan. Pemilihan posisi yang tepat dan benar akan berdampak pada jalannya proses persalinan. Karya tulis ilmiah ini bertujuan untuk mengetahui gambaran pemberian posisi miring dan posisi setengah duduk terhadap lama persalinan kala II berdasarkan literature review. Desain dalam karya tulis ilmiah ini adalah literature review dengan jumlah artikel tiga yang diambil dari laman jurnal google scholar dengan kata kunci “posisi miring”, “posisisetengahduduk” dan “lama kala II”, berupaartikel fultext. Artikel 1 terbit tahun 2019, artikel 2 tahun 2020 dan pada artikel 3 tahun 2014. Hasil analisis dari ketiga artikel menunjukan jumlah responden 206, rata-rata lama persalinan kala II menggunakan posisi miring adalah 23,786 menit dan posisi setengah duduk 43,34 menit. Poisisi miring 19,554 menit lebih cepat saat persalinan kala II dibandingkan posisi setengah duduk. Simpulannya adalah pada ibu bersalin persalinan kala II dengan posisi miring lebih cepat waktu persalinannya dibandingkan posisi setengah duduk. Saran bagi penolong persalinan dapat menganjurkan ibu bersalin menggunakan posisi miring pada proses persalinan kala II.Kata kunci: Posisi miring ;posisi setengah duduk; lama kala II.

Ultrasound Image-Guided Pudendal Nerve Block on Analgesic Effect of Perineotomy under Optimized Fast Super Resolution Reconstructed Convolutional Neural Network Algorithm

This work was aimed to study the analgesic effect of pudendal nerve block on obstetrics and gynecology under the guidance of ultrasound image based on optimized fast super resolution reconstructed convolutional neural network (FSRCNN) algorithm. A total of 110 primiparas from hospital who gave birth through vagina were randomly rolled into experimental group (55 cases) and control group (55 cases). The optimized FSRCNN algorithm was constructed, compared with the FSRCNN algorithm and the Bicubic algorithm and applied to 110 cases of maternal patients undergoing perineotomy under ultrasound image-guided pudendal nerve block. Visual analogue scoring (VAS), incision suture pain VAS score, occurrence of complications, puerpera labor time, and newborn weight were recorded and compared, so did Apgar score of newborns, numbness of maternal thigh, recovery of puncture site, and satisfaction of maternal analgesia. The results showed that the peak signal-to-noise ratio (PSNR) of the high-resolution image reconstructed by the FSRCNN algorithm was 32.68 dB and that reconstructed by the optimized FSRCNN algorithm was 32.19 dB. The PSNR of the Bicubic algorithm processed image was 28.51 dB. In the lateral resection of episiotomy in the second stage of labor, the visual analog score (2.3 ± 1.5 points) of the experimental group was inferior to that of the control group (7.1 ± 2.6 points) ( P < 0.05 ). The visual analogue score of stitch pain (1.3 ± 0.8 points) was also inferior to that of the control group (5.2 ± 1.9 points) ( P < 0.05 ). Moreover, the satisfaction of the parturients in the experimental group (9.86 ± 0.41 points) was considerably superior to that of the control group (7.36 ± 1.25 points) ( P < 0.05 ). In short, the optimized FSRCNN algorithm had a short training time and good reconstruction effect. Ultrasound-guided pudendal nerve block had a substantial analgesic effect on the second stage of labor and improved parturients’ satisfaction.

Effect of maternal BMI on labor outcomes in primigravida pregnant women

Background This study aims to detect the effects of increased BMI on labor outcomes in primigravida pregnant women. Methods A cross-sectional study involved 600 full-term singleton primigravida pregnant women who presented in the active phase of labor to the labor ward. They were divided according to BMI into three equals groups; women with normal BMI (group I), overweight women (group II), and women with class I obesity (group III). Results We found that high BMI was associated with a significantly increased risk of Caesarean section (C.S.) (13% in group I, 18% in group II and 40% in group III). Women with higher BMI and delivered vaginally had a significantly prolonged first and second stage of labor, consequently increased the need for oxytocin augmentation as well as the oxytocin dose. Regarding the maternal and fetal outcomes, there are significantly increased risks of postpartum sepsis, perineal tears, wound infection, as well as significantly increased birth weight and longer neonatal stay in the neonatal unit (NNU). Conclusion Obese primigravida pregnant women were at higher risk of suboptimal outcomes. Besides, prolonged first and second stages of labor and the incidence of C.S. have also been increased.

Urological complications in obstetrics

Urinary tract injury is a rare but severe complication during abdominal delivery. Over the past quarter of the last century, the frequency of abdominal delivery in Russia has more than tripled due to the increase in the number of pregnant women at high risk for the development of maternal and perinatal complications. Intraoperative diagnosis of urinary tract injuries allows timely treatment with better postoperative outcomes. Given the high percentage of caesarean sections in many countries, the risk of the above complications remains high. Risk factors for urinary tract injury during cesarean section are an increase in womens average age and body mass index, high parity, the presence of adhesions, prior cesarean section, emergency cesarean section, and cesarean section in the second stage of labor. This article discusses several clinical cases on the development of urological complications in obstetrics and gynecology. Due to modern progress in the field of operative obstetrics, vesicouterine fistulas caused by obstetric causes may not occur as often as in the last century. Nevertheless, even despite this, one should not forget about elementary preventive measures in operative delivery, especially in such obstetric situations as placental ingrowth, bleeding, hematoma, and parametria.