ABSTRACT
Background: Undiagnosed ectopic pregnancies are among the main gynecological emergencies, and hemorrhage from an ectopic pregnancy is still the leading cause of maternal mortality in the first trimester. During the first lockdown period in Italy (March-April 2020) and in March 2021 restrictive measures were issued by the Italian government, but their impact on the incidence of ruptured tubal pregnancies remains unknown. Method(s): The purpose of this study was to evaluate the impact of restrictive measures for the COVID-19 outbreak on the incidence of ruptured tubal pregnancies at our referral center for endoscopic gynecologic surgery. In particular, the primary outcome was the comparison of the incidence of ruptured tubal pregnancies between the lockdown phases and the other months of the pandemic. For this retrospective cohort study we considered all women examined for tubal ectopic pregnancy at our emergency unit from 1 January 2019 to 30 April 2021. We divided patients into three groups according to the period they were referred to our center: 10 March 2019-10 March 2020 (Pre-Covid period);11 March-4 May 2020 and 6 March-30 April 2021 (Lockdown periods);5 May 2020-5 March 2021 (COVID-19 pandemic period without restrictive policies). We compared data acquired during the lockdown phases with data collected both before the COVID-19 pandemic and during the restriction-free COVID-19 period. Result(s): 31 of 85 women were diagnosed with a ruptured tubal pregnancy. The proportion of ruptured ectopic pregnancies was higher during the lockdown period than the other two periods combined (62.5% vs 30.4%, p = 0.016). Mean gestational age and beta-HCG levels showed the same tendency (7.31 +/- 1.25 weeks vs 5.99 +/- 1.28 weeks, p < 0.0001;7392.56 +/- 4337.50 mUI/mL vs 4188.36 +/- 3235.95 mUI/mL, p = 0.001). There were no differences between the proportion of ruptured pregnancies during the whole COVID-19 pandemic and the months preceding it (45.7% vs 25.6%, p = 0.07). Conclusion(s): Our study demonstrated that restrictive lockdown policies for the containment of the COVID-19 outbreak are associated with an increased rate of ruptured extrauterine tubal pregnancies. Copyright: © 2022 The Author(s).
ABSTRACT
Coronavirus Disease 2019 (COVID-19) continues to be a serious public health problem around the world, however, to date, there is limited information on the behavior of this pandemic in Latin America and in particular in Venezuela. In this article, we describe the experience of the Caracas University Hospital (HUC) during the COVID-19 pandemic. After the report of the first case of infection in the country (March 13), the HUC set up a tent for the care and diagnosis of suspected COVID-19 patients;As of August 31, a total of 6 532 patients had been treated at the HUC, and 1 589 RT-PCR tests had been performed, confirming the infection in 732 (46 %) patients, with a mean age of 47 years (12-82), the majority being men (57.7 %). The under-registration of cases has been a common factor in the development of the COVID-19 pandemic in all countries, Venezuela is no exception. Prospective studies warn us of a greater frequency of catastrophic events in the coming decades, so it becomes necessary to prepare societies to anticipate and manage risks, this pandemic may be the first of many to come. © 2020 Academia Nacional de Medicina. All rights reserved.
ABSTRACT
COVID-19 pandemic caused a huge overload of healthcare systems worldwide. For such reason, in a preventive manner, governments and scientific societies recommended to stop any elective medical or surgical treatment in order to reduce the eventual burden on hospitals. Fertility treatments have since then been reserved only to urgent cases as oncologic patients asking for fertility preservation. However, the relevance of such policy on natality rate and on ovarian aging has soon induced the main scientific societies to ask for a fast return to action, considering that infertility should be treated as an urgent condition. In this regard, phase 2 recommendations have been issued to ensure working requirements to be settled in the safest way possible. Therefore, the Special Interest Group on Sterility (GISS) of the Italian Society of Gynecology and Obstetrics (SIGO) and its federates released their guidelines as Italy has been one of the first Western countries to face the phase 2 restart of treatments.