ABSTRACT
Objective. To evaluate maternal and perinatal outcome of women with COVID-19 infection, according to vaccination status. Materials and Methods. This was an observational retrospective study of pregnant women with COVID-19 infection who were referred to our center. Women were asked about their vaccination status, and those who had received a COVID-19 vaccination (at least one dose) were compared with those who had not (no dose at all). The primary outcome was preterm birth at less than 37 weeks of gestation. Results. 120 women with COVID-19 infection were included in the study. 57 had no vaccination (control group);13 had received one dose of vaccine;28 had received two doses;and 22 had received three doses. Preterm birth at less than 37 weeks occurred in 27% of the control group and in 11% in the group of women who had received at least one dose. Also the rates of pregnancy induced hypertension and admission to neonatal intensive care unit were significantly lower. Conclusions. Women with a completed vaccination course and COVID-19 infection have better outcomes compared to those without vaccination.
ABSTRACT
Objective. Evaluation of coping strategies in pregnant women with high risk pregnancies during COVID-19 pandemic. Materials and Methods. This was an observational study of pregnant women with high-risk pregnancy admitted for inpatient antenatal monitoring. Women were asked to fill in the Italian version of the Coping Orientation to the Problems Experienced (COPE-NVI). The questionnaire included 5 different dimensions: 1) Social support;2) Avoidance strategies;3) Positive attitude;4) Problem solving;5) Turning to religion. We planned to evaluate the COPE-NVI score according to the different maternal or fetal complications. 100 women filled out the questionnaire and were included in the study. Results. 37 were admitted for preeclampsia, 15 for diabetes, 5 for intrahepatic cholestasis, 14 for hyperemesis gravidarum, while 29 had severe intrauterine growth restriction requiring monitoring. The mean COPE-NVI score for social support was 31.5 +/- 8.6, for avoidance strategies 25.1 +/- 6.7, for positive attitude 31.7 +/- 7.3, for problem solving 30.5 +/- 7.5, and for turning to religion 24.9 +/- 5.3. No statistically significant differences were found for the COPE-NVI score within the different maternal or fetal complications, apart for turning to religion, where the score was higher for women with preeclampsia and lower for women with intrahepatic cholestasis (p = 0.01). Conclusions. Women with high risk pregnancies admitted for antenatal inpatient monitoring have a high score at coping strategies.
ABSTRACT
BACKGROUND Despite the rapid spread of the infection, there is still limited of evidence on maternal and perinatal outcomes of Pregnant Women with SARS-COV-2 METHODS This was a single-center, cohort study on SARS-CoV-2 in pregnancy. Pregnant women with laboratory-confirmed SARS-CoV-2 from 1 August 2020 to 1 January 2021 from University of Naples Federico II were included in the study. A confirmed case of COVID-19 was defined as a positive result on real-time reverse-transcriptase-polymerase-chain-reaction (RTPCR) assay of nasal and pharyngeal swab specimens. The primary outcome was the incidence preterm birth. RESULTS 249 singleton pregnancies, positive to SARS-CoV-2 at RT-PCR nasal and pharyngeal swab, were included in the study. Mean gestational age at diagnosis was 35.1 ± 5.7 weeks, with 0.8% of women being diagnosed in the first, 11.6% in the second and 218% in the third trimester of pregnancy. Mean gestational age at diagnosis was 34.2± 6.9 weeks, with 2.4% of women being diagnosed in the first, 14.1% in the second and 83.4% in the third trimester of pregnancy. The vast majority of the women received therapy with low molecular weight heparin (88.8%). 47 women (18.9%) required oxygen therapy. The rate of admission to maternal intensive care unit was 2.8%. There was one case of maternal death, accounting for a maternal mortality rate of 0.4%. Out of the 249 completed pregnancies, we reported two spontaneous abortion and two stillbirths. Among the 245 live-born babies, no neonatal deaths were recorded. All babies were tested negative at RT-PCR nasal and pharyngeal swab. The incidence of preterm delivery before 37 weeks was 10%.ù CONCLUSIONS SARS-CoV-2 infection in pregnant women is associated with relative low rate of maternal and perinatal adverse outcome.
ABSTRACT
OBJECTIVE To evaluate coping behavior and style in a cohort of pregnant women with high-risk pregnancy admitted for inpatient antenatal monitoring. METHODS This was an observational, prospective, cohort study of pregnant women with high-risk pregnancy admitted for inpatient antenatal monitoring in a single center in Italy. High risk pregnancies included diabetes, preeclampsia, intrahepatic cholestasis, severe intrauterine growth restriction, and hyperemesis gravidarum. Women were asked to fill the Italian version of the Coping Orientation to the Problems Experienced (COPE-NVI). The questionnaire included five different dimensions: (1) Social support;(2) Avoidance strategies;(3) Positive attitude;(4) Problem solving;(5) Turning to religion. We planned to evaluate COPE-NVI score according to the different maternal or fetal complication. RESULTS 100 women, admitted for antenatal inpatient monitoring, met the inclusion criteria, agreed to participate in the study and filled out the questionnaire. 37 were admitted for preeclampsia, 15 for diabetes, 5 for intrahepatic cholestasis, 14 for hyperemesis gravidarum, while 29 had severe intrauterine growth restriction requiring monitoring. The mean COPE-NVI score for social support was 31.5 ±8.6, for avoidance strategies was 25.1±6.7, for positive attitude was 31.7 ±7.3, for problem solving was 30.5±7.5, and for turning to religion was 24.9 ±5.3. No statistically significant differences were found the COPE-NVI score within the different maternal or fetal complications, rather than for turning for religion, where the score was higher for women with preeclampsia and lower for women with intrahepatic cholestasis (p=.01). CONCLUSIONS Women with high risk pregnancies admitted for antenatal inpatient monitoring have a high score at coping strategies.
ABSTRACT
Background: Pregnant women are usually more susceptible to infection due to typical physiological and mechanical changes, such as increased heart rate, stroke volume and pulmonary residual capacity. The aim of this study was to evaluate an innovative anesthesiologic opioid-free management protocol in symptomatic pregnant women, with COVID-19 and with oxygen therapy, undergoing cesarean delivery with spinal anesthesia. Methods: With the patient in the sitting position, spinal anesthesia was performed at the L1-L2 level. Vertebral level has been identified starting from the sacrum, we counted the laminae in the caudal-to-cephalad direction, which was then marked with a surgical pen. The technique was performed in asepsis, in the subarachnoid space after vision of clear Cephalo-Spinal Fluid (CSF) in the spinal needle 27 Gauge, without letting out the CSF, bupivacaine 0.5% 10 mg, dexmedetomidine 10 μg and dexamethasone 4 mg was injected. Results: During the study period, 40 pregnant women with one or more symptoms and supplemental oxygen (FiO2 35-40%) who underwent cesarean delivery were included in the study. All pregnant women had pain visual analog scale (VAS) <3, and no pregnant women required rescue dose. Adverse effects, such as nausea, vomiting, shivering, or pruritus were not recorded in any case. After a mean of 2.5 hours from the spinal anesthesia, all the included women had a complete motility of the lower limbs and were able to mobilize independently within 12 hours after delivery. Mean time to first latus was about 8 hours after delivery. Conclusions: Pregnant women in COVID-19 can safely receive intrathecal dexamethasone and dexmedetomidine during planned cesarean delivery. © 2021 The Author(s). Published by IMR Press.