ABSTRACT
COVID-19 is a widespread contagious viral infection that can severely affect the respiratory system. Although many people recover from using the disease without special care or treatment, pregnant women are particularly vulnerable to pulmonary infections due to their hangers systems system and physiology. To investigate the treatment provided to pregnant women who are PCR-positive for COVID-19 in their early three months of pregnancy, a reanalyzed analyzed data from 84 participants who received treatment at Tangerang Regional Hospital in 2 study was the study conducted based on an ases of observational investigation with a cross-sectional approach. It assembled the data for analysis of the chi-square test. The results showed that 92.9% of participants underwent a cesarean section, while the remaining 7.1% were discharged after giving birth typically or recovering. Additionally, the study did not find any correlation between factors such as age, education, work, gravida, ANC visit, and the impact of COVID-19 on the third trimester of pregnancy at Tangerang Hospital in 2022. The study recommends that pregnant women seek information about pregnancy care from healthcare providers, particularly midwives, posyandu officers, and the media, to make well-known decisions about their health and well-being during this critical period, ensuring a safe and healthy pregnancy outcome.
ABSTRACT
Caesarean section is performed when there are pregnancy related complications and vaginal delivery cannot be tried or fails. The effect of pandemic lockdown on the availability as well as accessibility of health services is a global concern. The aim of this study was to find out the caesarean section rate and its indication at a tertiary care hospital during COVID-19 pandemic. Methods: A hospital-based cross-sectional study was conducted among women admitted for delivery in the Department of Obstetrics and Gynecology of a tertiary teaching hospital during the second wave of COVID-19 (1 May 2021-30 July 2021). Convenience sampling technique was applied and 1350 women were categorized into groups using Robson ten group classification system. Group size, group caesarean rate, absolute and relative contribution of each group to overall caesarean rate were calculated. Results: Out of 1350 total deliveries during COVID-19, lower segment caesarean section was done in 446 (33.04%) (30.53-35.55 at 95% Confidence Interval). Major indication for caesarean section was previous caesarean in 185 (41.48%). Most women 202 (45.29%) were from the age group 24-30 years and gestational age between 37 and 42 weeks. Major contributor to the overall caesarean section rate was Robson group 5 (37%). Conclusions: This study showed higher prevalence of caesarean section delivery rate during COVID-19 pandemic than that compared with 2016 national statistics of Nepal. Despite of several challenges brought by the pandemic, pregnant women were still able to access the emergency obstetric care services in the Eastern part of Nepal. However, future studies should focus on exploring the situation in rural areas too.
ABSTRACT
BACKGROUND: Surgical site infection (SSI) is a health-threatening complication following Caesarean section (CS); however, to our knowledge, there is no worldwide estimate of the burden of post-CS SSIs. Therefore, this systematic review and meta-analysis aimed to estimate the global and regional incidence of post-CS SSI and its associated factors. METHODS: We systematically searched international scientific databases for observational studies published from January 2000 to March 2023, without language or geographical restrictions. The pooled global incidence rate was estimated using a random-effects meta-analysis (REM), and then stratified by World Health Organization (WHO)-defined regions as well as by socio-demographic and study characteristics. We also analysed causative pathogens and associated risk factors of SSIs using REM. We assessed heterogeneity with I2. RESULTS: We included 180 eligible studies (207 datasets) involving 2,188,242 participants from 58 countries. The pooled global incidence of post-CS SSI was 5.63% (95% CI, 5.18%-6.11%). The highest and lowest post-CS SSI incidences were estimated for African (11.91%, 9.67-14.34%), and North-America (3.87%, 3.02-4.83%) regions, respectively. The incidence was significantly higher in countries with lower levels of income and human development index. The pooled incidence estimates have steadily increased over time, with the highest incidence rate during the COVID-19 pandemic (2019-2023). Staphylococcus aureus and Escherichia coli were the most prevalent pathogens. Several risk factors were identified. CONCLUSION: We found an increasing and substantial burden from post-CS SSIs, especially in low-income countries. Further research, greater awareness, and the development of effective prevention and management strategies are warranted to reduce post-CS SSIs.
ABSTRACT
Introduction: COVID19 has exposed vulnerable populations, including pregnant women, to an unprecedented public health crisis, leading to increased risk of infection and adverse maternal and perinatal outcomes. Case report: A 31 year old morbidly obese female presented to Nair Hospital with complaints of breathlessness, fever, dry cough, and loss of taste and smell. Her RTPCR of 04/09/2020 was positive for COVID19. Discussion: The decision to use a particular anesthetic technique for cesarean delivery is based on a variety of factors, including risks to the parturient or fetus and the skill set of the provider. Spinal anesthesia was preferred to general anesthesia due to the benefits outweigh the risk. Regional anesthesia aids in the reduction of pain scores and opioid consumption, postoperative nausea and vomiting, and the risk of aspiration and difficult airway associated with general anesthesia. During tracheal intubation, the risk of transmission of upper respiratory tract infection to healthcare providers is known to be 6.6 times greater than those not exposed to intubation. Additionally, the maintenance of pulmonary function may reduce postoperative complications in a patient with COVID-19 and associated pneumonia or acute respiratory distress syndrome. Conclusion: The number of COVID-19 cases has exceeded 92.3 million worldwide, and there is still limited data on the care and management of parturients with COVID-19. It is important to share experiences and practices to ensure the best care for these women. [ FROM AUTHOR] Copyright of Journal of Cardiovascular Disease Research (Journal of Cardiovascular Disease Research) is the property of Journal of Cardiovascular Disease Research and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
ABSTRACT
Background: Good antenatal care helps a woman face labour in good health and optimum conditions. The National Institute for Health and Care Excellence (NICE) and WHO guidelines suggest 15 visits in the whole pregnancy. Keeping in view the COVID-19 pandemic to reduce the exposure of pregnant ladies the number of antenatal visits was reduced to 7 milestone visits and outcome was noted. This study aimed to do a comparative study of feto-maternal outcome in antenatal cases at our centre using standard WHO protocol vs. revised antenatal protocol during COVID-19 pandemic. Subjects and Method: This was an observational study done at a tertiary care center of an Armed forces hospital with target population as pregnant ladies attending antenatal care Out patient department of the hospital during COVID19 pandemic Vs Antenatal cases in previous 1 year. A comparative analysis of pregnancy outcome, maternal variables during pregnancy and delivery along with neonatal variables was done. Results: There were lesser deliveries by 41.7% as compared to non-COVID times. There was an increase in the caesarean delivery rate and instrumental delivery rate during COVID times by 11% and 53% respectively. There was increase in Vaginal birth after caesarean (VBAC) by 26.6%. The incidence of fetal growth restriction, placental abruption, maternal anaemia and gestational diabetes mellitus, oligohydramnios and polyhydramnios was low. The incidence of spontaneous abortions was also low in our study. In contrast, the incidence of pre-term deliveries doubled from 7.4% to 13.4%. Neonatal morbidity and mortality indicators like Neonatal Intensive care unit (NICU) admissions showed a rising trend of 1.7% during the COVID (14.6% to 16.3%) with a minimal rise in early neonatal deaths by 0.2%. Conclusion: Our model doesn't show an increase in maternal, neonatal morbidity, and mortality. This model can be used as a standard of care for Antenatal patients during Pandemics. It reduces the risk exposure of the gravid mother without any significant increase in maternal and neonatal morbidity and mortality.
ABSTRACT
Introduction: risk factors associated with complications in the mother-child pair include: history of hypertensive disorders, adolescent pregnancy, drug use, unfavorable obstetric history with a background of miscarriages or abortions, sexually transmitted diseases and urinary tract infections. Background: to identify the obstetric risk in times of COVID-19 pandemic at the "Bastion Popular" health area, Guayaquil, Ecuador, from January to June 2021. Method: a descriptive-transversal field research was carried out, with a quantitative approach, which favored the analysis of the obstetric risk categories recorded in the medical history of 117 pregnant women, who signed an informed consent, for the collection of data through home visits, using the obstetric risk scale or score. Results: outcomes assessment showed, as main result, that the most frequent obstetric risk group was the age group 20 to 24 and the high risk factor was the main category identified. Obstetric risk increased proportionally when the interpregnancy interval was reduce. Conclusions: young women between 20 and 24 years of age are those who presented the highest obstetric risk, which is correlate with a higher number of gestations, abortions, deliveries and cesarean sections. Therefore, it is necessary to provide women with information about pregnancy and its complications, so that they are able to identify risk factors during pregnancy, delivery and the puerperium.
ABSTRACT
The article highlights and discusses several current topics that have been published in the field of anaesthesiology in obstetrics in the Czech Republic and abroad last year. It summarizes the influence of the COVID-19 pandemic on anesthesiological praxis in obstetrics. It also presents new developments in systemic and neuraxial obstetric analgesia, Caesarean Section anesthesia, and emergencies in the peripartum period.Copyright © 2022, Czech Medical Association J.E. Purkyne. All rights reserved.
ABSTRACT
Background: The Coronavirus disease 2019 (COVID-19) pandemic is a significant challenge for public health and clinical medicine. COVID-19 mainly impairs the respiratory tract. However, gastrointestinal manifestations of COVID-19 are increasingly being recognized. Although acute viral pancreatitis has been described in other viral infections, pancreatic involvement in SARS-CoV-2 disease is still poorly defined. We reported a case of acute maternal pancreatitis in an early postpartum period woman with confirmed COVID-19. Case Presentation: A 31-year-old woman in term pregnancy had a caesarean section due to acute respiratory distress syndrome (ARDS) caused by COVID-19 pneumonia. One day after surgery, her stomach appeared bloated, bowel sounds were weak, and her abdominal circumference increased. Ultrasound examination did not reveal any suspicion of bleeding or hematoma. Her abdominal contrast-enhanced computerized tomography (CT) scan showed small bowel obstruction and oedematous pancreas. Amylase levels increased to 382 units/litre and lipase levels to 724 units/litre. C-reactive protein and procalcitonin were also increased. The diagnosis of sepsis was made, and she received broad-spectrum antibiotics and treatment for the COVID-19 infection. Recovery was characterized by a gradual resolution of abdominal and pulmonary signs and symptoms. A decline of amylase and lipase was observed by the tenth day. On the 13th day, she was extubated and gradually recovered from respiratory symptoms, with a negative result for COVID-19 RT-PCR. Based on this case, we consider that pregnancy and COVID-19 support each other as the cause of acute pancreatitis. Conclusion(s): Early diagnosis and severity classification are essential steps for successful management because late recognition and treatment may allow a greater prevalence of associated complications.Copyright © 2022, Philippine College of Physicians. All rights reserved.
ABSTRACT
Background: The health-care system has encountered exceptional circumstances, experiencing unique challenges, and manifesting as acute challenges in health-care services due to the spread of COVID-19. Aims and Objectives: The present study aimed to report the difficulties faced by the anesthetists while performing a cesarean section under the subarachnoid block (SAB) in COVID-19 patients at a dedicated COVID Level 3 hospital. Materials and Methods: Twenty healthy anesthetists (six consultants and 14 postgraduate) aged 20-40 years performed 60 elective or emergency cesarean sections of known COVID-19-positive gravida patients aged 20-35 years with no comorbidity and no spine abnormality under the SAB. Anesthetist;s responses to the challenges faced while performing procedures wearing the Level 3 personal protective equipment were recorded using a pre-structure self-administered questionnaire. To quantify the intensity of these problems, all the physical and psychological difficulties were graded as mild, moderate, and severe. Results: In the present study, 75% experienced moderate-to-severe sweating, and 60% experienced moderate-to-severe headaches. A total of 45% experienced moderate-to-severe breathlessness. Though there was little difficulty in communication among doctors and staff, almost 75% of anesthetists faced it. The fear of contracting the disease and spreading it to the family members was expressed by 75-80% of anesthetists. Conclusion: The present scenario has increased physical stress and other psychological problems among health workers. Therefore, hospital support with regular psychological counseling sessions is needed for healthcare workers to cope with the current situation.
ABSTRACT
A 44-year-old woman at 30 weeks of pregnancy was admitted to the Intensive Care Unit with a diagnosis of severe COVID-19 pneumonia. Her condition worsened quickly, defined by prolonged hypoxia even with intensive therapy and oxygen supplementation. This led to the decision to perform a caesarean delivery and continue pulse corticosteroids therapy after delivery. Soon after she recovered from COVID-19 pneumonia, her life was threatened again by septic shock from hospital-acquired pneumonia. After nearly 1 month of hospitalization, she was discharged and fully recovered on the re-examination day 10 months later.
ABSTRACT
The prevalence of venous thromboembolism (VTE) in COVID-19 patients is higher than in non-COVID-19 patients. Since the beginning of the pandemic, deep vein thrombosis, myocardial infarction, ischaemic stroke and pulmonary embolism (PE) have been reported in patients with COVID-19. D-dimer levels are now routinely measured in hospitalized patients so that prophylaxis can be initiated. However, a standardized protocol for prophylaxis has yet to be developed for pregnant women with COVID-19, who have an increased risk of VTE. We describe the case of a young primigravida woman with a positive COVID RT-PCR test who developed PE despite receiving adequate prophylaxis. LEARNING POINTS: COVID-19 patients may develop venous thromboembolism (VTE) and so adequate prophylaxis should be provided.VTE may still develop despite adequate prophylaxis, especially in patients at high risk.A standardized prophylactic protocol to prevent VTE in pregnant women should be developed to reduce mortality before and after caesarean section.
ABSTRACT
Background: The present study aims to understand the perceptions, apprehensions, and fears of peripartum COVID-positive women in low-resource settings. Study design: Cross-sectional observational study. Methodology: All COVID-positive postpartum women who delivered in the institution (vaginal delivery and cesarean section) were included in the study. Exclusion criteria included ICU admission and known mental illness. Results: A total of 61 COVID-positive women delivered in the facility during the study period. About 33 out of 61 women were nulliparous, while 28 were multigravida. Two babies tested positive for COVID-19 within 24 hours of birth. Majority of the patients were anxious prior to coming to hospital (51/61, i.e., 83.6%). The most common perceived fear reported by patients was fear of not receiving support from partner and provider (80%). Due to restrictions imposed on birth companion, 80% (49/61) women feared loneliness during labor. Apprehension of not receiving respectful maternity care was experienced by 75.4% (46/61) of women. Only 16 (26.2%) patients feared progression of disease, and 32 women (52%) were afraid of infection being transmitted to baby. However, 85% of the women reported a positive birthing experience. Good support from the family was observed in 76% of women. Despite regular visits by the doctors, eight patients (13%) felt a lack of connect due to the prevailing situation. Inability to celebrate joyful moments with family, neonatal separation, and delay in discharge were the major causes of discontent among the postpartum women. Conclusion: The study shows that the excitement and joy of pregnancy and delivery in pre-COVID times has been replaced by fear, anxiety, and uncertainty in this COVID era. Strategies, like good communication and provision of adequate support, may be particularly useful to help these women have a positive birthing experience.
ABSTRACT
Background and Aims: Parturients with coronavirus disease (COVID)-19 are increasingly presenting for operative delivery. The aim of this study was to outline the foetomaternal outcome in COVID-19-afflicted pregnant women who underwent lower segment caeserean section (LSCS). Methods: Data of all COVID-19 positive pregnant females who underwent caesarean section surgery between 1 April and 30 June 2021 was collected. Clinical parameters, including oxygen requirement, laboratory investigations, treatment measures, complications, length of hospital and intensive care unit/neonatal intensive care unit stay, and outcome of parturients and neonates, were collected and analysed. All patients were followed up either during their visits to the obstetric outpatient department or by making phone calls between 1 and 2 months of discharge. Statistical Package for the Social Sciences statistical software 16.0 was used for analysis. Independent group t-test or Mann-Whitney test was used for mean of continuous data. Chi-square test or Fisher's test was used for proportion of categorical data. A P value of <0.05 was considered significant. Results: A total of 71 parturients delivered by caesarean section. 36.51% had mild COVID-19, and 87.5% had moderate COVID-19 at admission. One each with mild and moderate disease expired. The median (interquartile range) length of hospital stay was 7 (5-5.9) days for those with mild disease, and it was significantly longer for those with the moderate disease at 14 (9.5-17.5) days. Our study found that after a mean of 41.72 days of follow-up, of the 69 surviving mothers, 17 complained of fatigue, five complained of myalgia and one needed intermittent supplemental oxygen. Out of 74 babies born, seven died, which is 94.6 per 1000 live births. Conclusion: COVID-19 parturients delivered by LSCS stand a higher risk of maternal and neonatal mortality and adverse effects, including more hospital stay and increased mortality.
ABSTRACT
The pandemic of COVID-19-related respiratory failure has increased utilization of ECMO in diverse patient populations. There are limited published reports of ECMO use in pregnancy, and reports of successful delivery of the fetus with survival of the mother on ECMO are exceptionally rare. We present a case of Cesarean section while on ECMO for COVID-19-related respiratory failure with survival of both mother and infant.A 37-year-old pregnant female presented with dyspnea following a positive COVID-19 test. D-Dimer and CRP were elevated and chest radiography was consistent with COVID-19 pneumonia. Her respiratory status rapidly decompensated-requiring endotracheal intubation within 6 hours of presentation, and ultimately veno-venous ECMO cannulation. Three days later, fetal heart rate decelerations prompted emergent caesarean delivery. The infant was transferred to the NICU and progressed well. The patient improved and she was decannulated on hospital day 22 (ECMO day 15) before discharge to rehab on hospital day 49.In this case, ECMO allowed survival of both mother and infant in an otherwise non-survivable respiratory failure. Consistent with existing reports, we believe ECMO is a viable strategy for refractory respiratory failure in the pregnant patient.
ABSTRACT
BACKGROUND: With the increasing prevalence of coronavirusdisease 2019 (COVID-19), the number of pregnant women with this virus who give birth is also increasing. This study evaluates the clinical features and consequences of COVID-19 infection in pregnant women undergoing delivery in Kurdistan Province, Iran. METHODS: In this descriptive study, we analyzed the clinical characteristics and delivery outcomes of pregnant women with laboratory-confirmed COVID-19 disease admitted to Besat Hospitalof Kurdistan University of Medical Sciences, Sanandaj, Iran, from February 25, 2020, to August 21, 2020. RESULTS: Among 192 pregnant women with laboratory-confirmed COVID-19 infection during the study period, 37 were admitted for delivery. Out of the 37 patients, 15 patients had a normal vaginal delivery, and 22 patients were delivered by cesarean. Fever and cough (32.40%) and shortness of breath (11.37%) were the main symptoms of the pregnant women in our study. None of our patients needed ventilator support or died. CONCLUSION: Based on the results of our survey, pregnancy augments neither the signs and symptoms of COVID-19 nor the mortality rate. However, the rate of cesarean and preterm delivery increased.
ABSTRACT
Introduction: Intensification of immune system sensitivity after pregnancy with cytokine storm caused by Covid 19 can lead to coagulation disorders and increase the amount of bleeding after delivery. Since bleeding following cesarean section is more likely to occur in women with Covid-19 than in women without the disease, the present study was performed aimed to investigate the amount of bleeding during caesarean section in women with covid-19.
ABSTRACT
Currently, intensive study of the clinical and epidemiological features of COVID-19 is continuing. In this regard, the development of new means of its prevention and treatment is becoming increasingly relevant. The most vulnerable category of people, along with older people, is pregnant women. Due to their low immune reactivity, they are more susceptible to severe complications than others. In this article, we conducted a retrospective analysis of 280 case histories of pregnant women living in Republics of the North Caucasus Federal District of the Russian Federation (the Republic of Ingushetia, the Republic of Dagestan and the Republic of North Ossetia-Alania) who received medical care in 2021 with an officially confirmed diagnosis of mild and moderate COVID-19 coronavirus infection. Analyzing the pregnancy outcomes in patients with COVID-19, we found that 15.3% of women were delivered through the natural birth canal, 10.7% of women in labor due to an increase in respiratory failure and, as a consequence, fetal hypoxia, were delivered by caesarean section. 2.5% of cases ended in spontaneous abortion in the first trimester. 71.4% of pregnant women who underwent COVID-19 were hospital discharged with progressive pregnancy at different gestation periods. As a result of the work carried out, we analyzed a number of clinical and laboratory data in pregnant women with COVID-19 in dynamics assessed the course of the disease in different periods of pregnancy by region and assessed the effectiveness of pharmacotherapy.
ABSTRACT
BACKGROUND: Since there is no available data on temporal trends of caesarean section (CS) rates in pregnant women with COVID-19 through the pandemic, we aimed to analyze the trends in caesarean section rate in a large cohort of pregnant women with COVID-19, according to the Robson Ten Group Classification System of deliveries. METHODS: We prospectively enrolled pregnant women with a diagnosis of COVID-19 who delivered in our center between March 2020 and November 2021. Deliveries were classified, according to the Robson group classification, and according to three time periods: (1) deliveries from March 2020 to December 2020; (2) deliveries from January 2021 to April 2021; (3) deliveries from May 2021 to November 2021. We compared pregnancy characteristics and incidence of caesarean section, according to the Robson category in the total population, and according to the three time periods. RESULTS: We included 457 patients matching the inclusion criteria in our analysis. We found that overall CS rate significantly decreased over time from period 1 to period 3 (152/222, 68.5% vs. 81/134, 60.4% vs. 58/101, 57.4%, χ2 = 4.261, p = 0.039). CS rate significantly decreased over time in Robson category 1 (48/80, 60% vs. 27/47,57.4% vs. 8/24, 33.3%, χ2 = 4.097, p = 0.043) and Robson category 3 (13/42, 31% vs. 6/33, 18.2% vs. 2/22, 9.1%, χ2 = 4.335, p = 0.037). We also found that the incidence of induction of labor significantly increased over time (8/222, 3.6% vs. 12/134, 9% vs. 11/101, 10.9%, χ2 = 7.245, p = 0.027). CONCLUSION: Our data provide an overview of the temporal changes in the management and obstetric outcome of COVID-19 pregnant women through the pandemic, confirming that standards of obstetrical assistance for pregnancies complicated by SARS-CoV-2 infection improved over time.
ABSTRACT
Cardiac arrest in pregnancy is very rare. Various methods have been proposed to return spontaneous circulation and prevent mortality, such as Perimortem Caesarean Section (PMCS). Since 2019, the COVID-19 pandemic has added to the difficulty in decision making and performing PMCS. Infection prevention being a priority due to the rapid spreading of the virus could cause hesitation upon initiating an emergency procedure, especially PMCS. We have reviewed the issues impacting on basic and advanced life support in adults with suspected or confirmed COVID-19.
ABSTRACT
Introduction: Coronavirus disease 2019 (COVID-19) is an acute respiratory infection caused by SARS-CoV-2, which can potentially cause severe acute respiratory syndrome and cause the death of the patient. Objective: To present a patient with COVID-19 associated with aggravated preeclampsia, in a preterm pregnant woman. Clinical case: A 25-year-old patient with a gestation of 35.2 weeks, a history of apparent health that was received since her arrival at the intensive care unit, referred for being positive for COVID-19, with respiratory symptoms of an associated lung disease, as high blood pressure figures, without other symptoms. Through physical examination and complementary humoral studies, an aggravated preeclampsia and oligohydramnios were diagnosed due to rupture of the ovular membranes. She was treated and compensated;Induction was started and during the procedure a risk of loss of fetal well-being was diagnosed, so it was decided to perform an urgent cesarean section. A healthy newborn was received. The patient did not present post-surgical complications and was treated according to current standards for cases of severe mother with COVID-19;she had a favorable evolution. Conclusions: The early diagnosis and treatment of a pregnant woman with COVID-19 and associated preeclampsia allows a satisfactory evolution of the mother-fetus binomial. © 2022, Editorial Ciencias Medicas. All rights reserved.