COMPARATIVE STUDY OF MATERNAL AND NEONATAL OUTCOME OF COVID POSITIVE PREGNANT WOMEN IN FIRST AND SECOND WAVE

Introduction: Corona virus disease-19 (COVID-19), produced by severe acute respiratory syndrome Corona virus 2 (SARS-CoV2), has become a global pandemic, giving rise to a serious health threat globally. In India we have seen a two wave pattern of reported cases with peak of rst wave in September 2020 and peak of second wave in May 2021.Women undergoing pregnancy and those at the time of child birth and puerperium constitute potentially vulnerable populations for covid-19. Aims And Objectives: To evaluate differences in clinical presentation, co-morbidities, pregnancy complications and outcomes in women with covid-19 during rst wave and second wave of covid-19 pandemic. Materials And Methods: We conducted a retrospective observational cohort study of all hospitalized pregnant and postpartum woman with SARS-CoV2 infection in Government General Hospital, Kurnool. All the patients admitted from 1st May to 31st October 2020 were considered to be in the rst wave and those admitted from 1st April to 31st June were considered to be in second wave. Results: Incidence of cases has increased from 14.18 to 16.8%.There was two fold increase in the symptomatic cases from 4.2 to 8%patients in the second wave were younger in the age group of 16-25yrs.The number of pregnant women delivered by Caesarean section have increased from 57.5 %to 61.1 %.ICU admissions have signicantly increased from 2.7% to 3.1% Case fatality rate has increased from 0.4%-1.1%. As observed from the above results there is higher frequency of severe Covid 19,increased ICU ad Conclusion: missions and maternal deaths in second wave of Covid 19 pandemic as compared to the rst wave .Although the exact causes of increase in severity and mortality are unknown ,but probably due to emergence of most pathological strains of SARS-Co2.

POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME IN A POSTPARTUM NORMOTENSIVE POST CESAREAN PATIENT - A CASE REPORT

Posterior reversible encephalopathy syndrome { PRES } is a reversible neurological entity characterised by seizures , headaches , visual symptoms , impaired consciousness and other focal neurological findings . There are a variety of causes behind this syndrome but eclampsia takes the lead and preeclampsia also significantly contributes . We present here a case of young postpartum woman with atypical findings and imaging results leading to diagnosis of PRES .

Stent encrustation or fragmentation? A case report of post stent removal encrustation in postpartum woman and literature review

Background Ureteral stents are commonly used in the field of urology to relieve ureteral obstruction. However, complications relating to ureteral stent use, such as encrustation continue to occur, especially with prolonged indwell time. Case presentation Here we present a 37-year-old postpartum woman with a foreign body in her bladder after removing a ureteral stent 1 month before. She insisted that the foreign body was the fragment of stent and asked for medical malpractice indemnity payments while the surgeon of her insisted that the stent was intact during the procedure. Finally, the foreign body was confirmed as an encrustation by cystoscopy and the patient received 10,000 yuan ($ 1500) as indemnity payments after encrustation removal. Conclusion In the absence of guidelines, stent indwelling time vary with centers’ habits, stent materials and patient’s education. Early detection of stent encrustation and timely removal of the encrusted stent are still the best way to avoid stent retention. Violent stent removal is of danger and not recommended in any case.

FACTORS INFLUENCING THE PROCESS OF PERINEAL WOUND HEALING IN POSTPARTUM WOMEN IN SERUI HOSPITAL, PAPUA

Background: The process of giving birth has a risk of perineal rupture. The 4.9% incidence of delayed perineal wound healing resulted from non-fused perineal wounds and clinical infection. This process can be interrupted or recovery delayed due to various factors such as age, nutrition, pain, and poor hygiene. This study aims to analyze the factors that influence the healing process of perineal wounds in postpartum mothers. Method: analytic observational research method with cross sectional approach and analityc statistic Chi-Square. The samples are postpartum woman in Serui Hospital, Papua. The number of samples were 30 respondents with purposive sampling technique. The instrument used was the REEDA scale, the pain scale, the food consumption survey with the 24-hour recall method and the personal hygiene questionnaire. Results: The results of statistical tests showed a relationship between pain with the perineal wound healing process is p 0,017, age with the perineal wound healing process is p 0,000, nutrition with the perineal wound healing process is p 0,000, and personal hygiene pain with the perineal wound

Atypical Posterior Reversible Encephalopathy Syndrome in a Postpartum Woman With Moyamoya Disease: A Case Report and Literature Review

Background: Moyamoya disease is a rare cerebrovascular occlusive disease, which is characterized by stenosis and gradual occlusion of the internal carotid arteries, causing the progression of characteristic collateral vessels. To date, most studies investigating moyamoya disease have focused on medical implications, and the potential implications for neurocognitive and/or neuropsychiatric functioning were inconclusive.Case Presentation: we present a case of a 26-year-old Chinese postpartum woman who presented to the emergency department with a 19-h history of cognitive decline, vomiting, and convulsions. Blood pressure, heart rate, and respiration rate were 200/120 mmHg, 115 beats/minute, and 30 breaths/minute, respectively, on arrival. The Glasgow Coma Scale, modified RANKIN scale (mRS), and National Institute of Health stroke scale (NIHSS) scores were 3, 5, and 18, respectively. Moyamoya disease was diagnosed using cerebral angiography and digital subtraction angiography. The cognitive functions of orientation, use of language, ability to calculate, and memory significantly improved after 11 days of treatment (Glasgow Coma Scale: 15; mRS: 0; NIHSS: 0).Conclusions:This patient was diagnosed with reversible posterior leukoencephalopathy syndrome related to moyamoya disease. This case highlights that atypical posterior reversible encephalopathy syndrome can occur in patients with moyamoya disease, and should be considered for the differential diagnosis of cerebral infarcts and hemorrhage in a postpartum female.

Masked Pituitary Macroadenoma Presenting as Pituitary Apoplexy Triggered by Sepsis in Postpartum Period-A Rare Case Report

Apoplexy of the Pituitary gland is rarely seen critical disorder marked by acute throbbing of head / altered mental status / visual disturbances /decreased consciousness, due to sudden haemorrhagic changes of the pituitary or infarction of the same. There are numerous factors which precipitate apoplexy of the pituitary, sepsis being one of the least common cause, as is elaborated in this case study. Inspite of having a distinctive presentation, pituitary apoplexy eludes diagnosis and proper management as it is complicated by related co-morbidities. Its occurrence in a postpartum lady is an even rarer incident. This article shows a rare occurrence of apoplexy of macroadenoma in a postpartum woman which was managed conservatively.

Severe COVID-19 in a Postpartum Woman: A Three-Month Challenge with Convalescent Plasma and Corticosteroid

Introduction: Management of seriously ill patients infected with new corona virus (SARS-CoV-2) is challenging especially in pregnancy and postpartum state. Case presentation: A 39- year-old primigravid critically ill woman with acute respiratory distress (ARDS) due to confirmed SARS-CoV-2 infection underwent urgent cesarean delivery (a healthy neonate) at 33 weeks and 5/7 of pregnancy. She received treatments including hydroxychloroquine, antivirals and broad-spectrum antibiotics while she was intubated for mechanical ventilation. In spite of all treatments, she developed a critical course after the mild primary clinical improvement. Convalescent plasma transfusion as a rescue treatment was performed and led to an improvement in her general condition and delayed gradual recovery in respiratory function after two months. Conclusion: The promising role of early treatment with convalescent plasma transfusion in seriously ill pregnant women infected with SARS-CoV-2, needs to be elucidated by further randomized studies.

Mortality of a postpartum woman presented with massive vulvar edema in association with Covid-19: a case report with clinical and radiological findings

Background In this case report, we presented a rare case of maternal death with massive vulvar edema and Covid-19 diagnosis. Case presentation The case was a 20-year-old woman who was referred to with pain and massive vulvar edema by passing 7 days from her labor. The laboratory tests showed leukocytosis, lymphopenia, and elevated C-reactive protein levels. The high-resolution computed tomography was in favor of Covid-19 changes. Finally, she died because of respiratory distress, ON the 8th day postpartum. Conclusion Given the increasing prevalence of Covid-19, it is important and vital to be aware of its potential complications and then to try prevent and manage them, especially during high-risk periods such as pregnancy and postpartum.