Two major challenges for pregnancy: labor emergencies and SARS-CoV-2 infection - our experience in Saint John hospital, Bucharest, Romania

Introduction: Obstetric emergencies that occur during labor, often present as a major indication for prompt completion of labor by instrumental methods or emergency cesarean section. The purpose of this study was to present the clinical features of emergencies, the evolution of labor, maternal and fetal or neonatal complications at patients with SARS-COV-2 infection. Materials and methods: We performed a retrospective study that included 150 pregnant women who gave birth in Bucur Maternity, St John Hospital, Bucharest, between 2018-2020 that fulfilled the features of obstetrical emergency during labor and SARS-CoV-2 infection. The study group was divided in patients positive for SARS-CoV-2 and negative for SARS-CoV-2. Results: Following PCR testing for SARS-CoV-2 were 26.67% of patients positive and 73.33% had a negative result. Analyzing the data obtained from this group of patients, it resulted that the average hospitalization is higher in the positive group (7.05 days) versus the negative group (5.47 days). The average gestational age at birth of SARS-CoV-2 positive patients was 37.26 weeks, lower than the gestational age of neonates from uninfected mothers (38.41 weeks). The average of the APGAR scores in the COVID group is 8.41, and for the negative group is 8.90. Conclusions: The associated SARS-CoV-2 infection played a significant role in terms of the APGAR score and the early peripartum outcomes of new-borns, negatively influencing the value of the APGAR index. Gestational age was considerably lower in patients diagnosed with the infection. The SARS-CoV-2 virus infection has a significant influence in unsatisfactory neonatal outcomes compared to new-borns of healthy mothers.

Coinfection in the cases of feline panleukopenia: a literature review

Coinfection caused by bacteria, parasites, or viruses complicates almost all feline panleukopenia virus (FPV) infections. Pathogens that colonize the gastrointestinal tract, Clostridium perfingens, Clostridium piliforme, Cryptosporidium spp, Giardia spp, Tritrichomonas fetus, canine parvovirus type 2,Salmonella sp., feline coronavirus, feline bocavirus, and feline astrovirus were isolated in the presence of FPV infection. Complex mechanisms between viruses, bacteria, protozoa, and hosts contribute to the pathogenesis and severity of coinfection. Prompt and accurate diagnosis, vaccination precautions, and appropriate treatment play important roles in reducing morbidity and mortality. This article outlines the etiology, pathogenesis, diagnosis, prevention, and treatment that can help veterinarians and pet owners improve their knowledge of managing the diseases.

Development of PCR diagnostic method for Trichomonas foetus infection based on 18S rRNA.

To establish a PCR detection method for Trichomonas foetus, the primers were designed and synthesized according to the 18S rRNA gene sequence of T. foetus published by GenBank. The positive recombinant plasmid pUCm-T-TF18S of T. foetus was used as the template, and the genomic DNA of Giardia felis, Coccidia +e-lis, feline parvovirus and cDNA of feline coronavirus were used as the control for PCR detection to analyze the specificity of this method. The positive T. foetus recombinant plasmid was serial to 8 different concentrations with a gap of 10 folds, and PCR was performed to analyze the sensitivity of this method. The pUCm-T-TF18S plasmids stored at -20 " for 3, 6, 9 and 12 months were detected by PCR to analyze the stability of the method. Twenty cat fecal samples were tested using this established PCR assay and compared with those of microscopic examination. The results showed that the recombinant plasmid pUCm-T- TF18S gave specific bands after PCR amplification. The sequencing results showed that the length of the product sequence was 1 264 bp, and the BLAST sequence comparison analysis showed 99.53% sequence identity, which is consistent with that of T. foetus from cats (GenBank registration number M81842.1). The PCR method for detection of T. foetus had no cross-reactivities with C. felis, G. felis, feline coronavirus and feline parvovirus;the minimum detectable template concentration is 4.52 X 105 copies/xl;The target band of T. foetus DNA can still be detected after being stored in the refrigerator at -20 " for 12 months. This method detected 16 positive samples of T. foetus nucleic acid from 20 cat fecal samples, which is more accurate and sensitive than the results from traditional microscopy (13 samples). It is suggested that the PCR method for the detection of T. foetus is highly specific, sensitive and stable, and can be used for clinical detection and epidemiological investigation of T. foetus.Copyright © 2022, National Institute of Parasitic Diseases. All rights reserved.

Citizen Fetus: The Changing Image of Motherhood

This book discusses many aspects of fetuses and motherhood from fields as wide as sociology and medicine. It examines changing perceptions of the fetus over recent decades, comparing western ideas with those of non-western countries;examining maternal mental health during COVID-19 and charting the ascent of the 'fetus' to a cult phenomenon, which has currently reappeared in the courts. This work, given its multifaceted approach, will be of interest to a varied and wide range of people, from parents to doctors and nurses, to anthropologists and ethnologists, to scientists, to students of various disciplines, to psychologists and psychoanalysts, to lawyers dealing with the topic and to a general public simply interested in these fundamental themes. © The Editor(s) (if applicable) and The Author(s), under exclusive licence to Springer Nature Switzerland AG 2022.

Pregnant pause: Celebrity performance of pregnancy during the pandemic

This article explores how celebrity performance of pregnancy was disrupted in the United States during COVID-19. Celebrities had to renegotiate the public performance of pregnancy within a more complicated world filled with contradictions: giving birth while deaths surged, gaining access to hospitals overrun with COVID-19 patients and enjoying time at home while others were forced to stay home. This article explores how celebrities negotiated the balance of privacy and public revelation and the unexpected consequences of these shifts in the presentation of pregnancy. © 2023 Intellect Ltd Article. English language.

Vertical transmission of acute respiratory syndrome viruses from mother to the foetus

Since early in month of Dec-2019, the infection of Coronavirus Disease 19 has been prevalent in Wuhan City of China and ultimately virus spread to other countries. Literature survey was carried out by using different scientific sources such as PubMed, Scopus, Google scholar etc. There is a scarcity of literature of COVID-19 happening at some stage in pregnant women and possibilities of transmission vertically are may be due to COVID-19. So, there is an alarm situation as foetus may be at risk of congenital COVID-19. Up until August 28, 2020, we investigated at the risk of COVID-19 vertical transmission to the foetus of infected women using a database of published articles and government sites. Middle East Respiratory Syndrome MERS and Severe acute Respiratory syndrome SARS were related to poor obstetrical conclusion, so there was no recognized case of ‘intrauterine transmission’ of either Middle East Respiratory Syndrome-coronavirus (MERS-CoV) or severe acute Respiratory syndrome-coronavirus (SARS-CoV). © 2022 MEDIC SCIENTIFIC. All right reserved.

Limb ischaemia at birth in a new-born whose mother tested positive for COVID-19 one month before delivery.

We report a case of right upper limb ischaemia diagnosed at birth in a neonate whose mother had presented with paucisymptomatic COVID-19 four weeks previously. Typical causes were investigated and excluded. Maternal morbidity and mortality resulting from COVID-19 during pregnancy is well recognised and documented, however, foetal and neonatal complications are increasingly being reported. Our case sheds further light on the diverse nature of such complications, and in particular this type of possible association related to their delayed onset.

Ki-67 expression level in placentas with COVID-19 infected women

Objective: The SARS-CoV-2 virus, which emerged in December 2019 in Wuhan, China, spread very quickly in a short time and was declared a pandemic by the World Health Organization in March 2020. Physiological and immunological changes during pregnancy cause complications in respiratory tract infections. Complications by COVID-19 lead to a systemic effect that causes maternal and fetal mortality and morbidity. In this study, we aimed to investigate histopathological changes and Ki-67 expression in placentas of women with positive COVID-19 infection. Study Design: Placentas of 10 samples COVID-19 positive and 10 samples Covid-19 negative pregnant patients who were hospitalized in the Gynecology and Obstetrics Clinic of Dicle University Faculty of Medicine were included in the study. Placental tissues were fixed in 10% formaldehyde (24 hours) and processed for routine paraffin wax tissue staining. Hematoxylin Eosin dye and Ki-67 immunohistochemical staining were performed.

Clinical characteristics and outcomes of pregnant women confirmed with SARS-CoV-2 admitted in the hospitals in Baghdad

Background: Pregnant women are considered one of the most vulnerable groups for COVID-19. Routine but essential services are the most affected during emergencies, therefore practitioners must pay closer attention to women and newborns to minimise the impact of the pandemic on these vulnerable populations. Objectives: To describe clinical characteristics and outcomes of pregnant women admitted to hospitals with SARS-CoV-2 in Baghdad during 2020.

Case report on antenatal mother infected with corona virus disease -2019

The World Health Organization declared a public health emergency on January 30, 2020, as a result of the coronavirus illness 2019 (COVID-19), which was caused by the novel severe acute respiratory syndrome coronavirus 2. (SARS-CoV-2). Newborns may show COVID-19 indications, according to the findings of current investigations. Despite the fact that the disease expresses itself differently in different cultures, only a few studies have been conducted on COVID-19-infected mothers. The World Health Organization termed the new coronavirus illness 2019, caused by severe acute respiratory syndrome. coronavirus disease on January 7, 2020. (COVID-19) reported in ANC-MOTHER : as a percentage of the total number of cases in the general population Because the United Nations Children's Fund (UNICEF) estimates that 0.35 million kids are born each year, screening pregnant women and providing perinatal care to babies of COVID-19 positive moms is critical. Initially, there was little evidence of mother-to-infant transmission, and only a few deaths in ANC- MOTHER and her newborn were reported, but now that transplacental transmission has been demonstrated, transmission can be controlled with good care or all preventive measures. Patient history: Due to uterine contractions, a 35-year-old woman was referred to the AVBRH Hospital, Sawangi Meghe, Wardha. She was gravida4, para3, with a 39-week pregnancy and three previous caesarean sections. She had no underlying illnesses and had no previous exposure to COVID-19-infected people. On admission, she didn't have a fever or any other symptoms like cough, sore throat, or muscle weakness. Clinical Findings: The patient had undergone with various investigations like blood test, USG, physical examination and CT scan, Computers tomography, and newborn assessment Medical Management: Patient was treated with calcium supplement and iron supplement. Inj. Piptaz 4.45gm, it is antibacterial Drug, It's Prevent the growth or spread of bacteria. Inj. clindamycin 600 mg, it is a antibiotic drug, and it's action is slowing and stopping the growth of bacteria. Inj Levoflox 750 mg, it is a antibiotic drug, Inj neomol 100 ml, it is a painkiller;Tab Limcee 500 mg, it is vitamin supplement. Tab zincovit, it is nutrition suppliment and preventing vitamin and mineral deficiency;Inj dexa 6 mg, it is a steroid, it is treat a condition such as a inflammatory and autoimmune condition, Tab ecosprin 75 mg, it is (NSAID) non-steroid Anti inflammatory drug, it decrease the formation harmful blood clots. Inj ramdesivir, it is antiviral drug used to treat Covid infection. Nursing management: Administered fluid replacement i.e. DNS and RL, Fetal monitoring, monitored all vital signs hourly. Do physical examination, Give proper information regarding the disease condition, provide proper environment to the patient, provide proper care to the patient, give psychological support to the patient, educate patient regarding the disease condition, discuss about the health issues of the patient with doctor. Conclusion : In conclusion, the intensity of Covid -19 Antenatal mother's stage and degree of sickness.

Maternal and perinatal outcomes with COVID-19: a systematic review of 1008 pregnancies isolation department in Zliten medical center

Background: As the COVID-19 outbreak unfolds, more and more pregnant women are infected with SARS-CoV-2, concerns have been raised about its clinical manifestations in pregnancy and the potential risk of vertical transmission from mother to fetus in pregnant women. Hence, in this review, we summarize the latest research progress related to COVID-19 epidemiology and the reported data of pregnant women with COVID-19. Patients and methods: We searched databases for all case reports and series from 20 February 2020 to 30 April 2021. Multiple terms and combinations were used including COVID-19, pregnancy, maternal mortality, maternal morbidity, complications, clinical manifestations, neonatal morbidity, intrauterine fetal death, neonatal mortality and SARS-CoV-2. and quantitative real-time polymerase chain reaction (PCR) or dual fluorescence PCR-confirmed SARS-CoV-2 infection. Unpublished reports, unspecified date and location of the study or suspicion of duplicate reporting, cases with suspected COVID-19 that were not confirmed by a laboratory test, and unreported maternal or perinatal outcomes were excluded. Data on clinical manifestations, maternal and perinatal outcomes including vertical transmission were extracted and analyzed.

A histomorphological study of placentas of COVID 19 affected patients at a state COVID hospital

Background: Covid 19 pandemic has caused a significant death toll across the world, its effects on placental morphology are of great concern to the obstetricians and pregnant women because it effects the health of the fetus.

Vaccinate: protecting pregnant patients from COVID-19

It is now clear that there are increased risks of maternal and fetal morbidity and mortality when COVID-19 is contracted during pregnancy. Preventing severe COVID-19 in this population must be a priority.

Placental swab in supporting diagnosis of vertical transmission in SARS-CoV-2 positive mothers

Aims: To review the evidence regarding the possibility of fetal vertical transmission in COVID-19 positive pregnant mothers by diagnosing through placental swabs. Methods The search terms 'pregnant COVID-19 positive mothers', 'fetal vertical transmission' and 'placental swabs' were used. 20 papers were selected. Results 183 COVID-19 positive pregnant women were identified whose 184 placentas and 185 neonates were also analysed by RT-PCR or immunohistochemistry and/or in situ hybridization for the presence of SARS-CoV-2 (one case of monochorionic diamniotic twins and one case of dichorionic diamniotic twins). 183 liveborn neonates were successfully delivered primarily via caesarean section (99%). 2 mothers did not deliver liveborn infants due to severe preeclampsia resulting in a termination of pregnancy and a miscarriage, both occurring in the second trimester. 9 neonates tested positive for SARS-CoV-2 (5%). We report no neonatal mortality after live birth and no maternal mortality. 17 placentas tested positive for SARS-CoV-2 out of a total of 184 tested (9%). Of these 17, 7 cases of SARS-CoV-2 were identified in the maternal, neonatal and placental tissue. Conclusion There is no concrete evidence of vertical transmission occurring between mother and infant. We propose further research investigating the effects of COVID-19 on pregnant women by using RT-PCR to test the mother, placenta, vaginal fluid, breast milk and infant for SARS-CoV-2 at various stages of transmission.

The role of inositol, folic acid and polyunsaturated fatty acids in pregnancy and fetal development

Historical reasons have led to knowledge that would not have been possible to obtain through research without gross violations of ethical norms. Quantification of macro- and micro-nutrient intake is hampered by a number of barriers. It has been observed that changes in fetal nutrition and its endocrine status can result in developmental adjustments that permanently alter the structure, physiology, and metabolism of children, thus exposing individuals to the risk of metabolic, endocrine, and cardiovascular diseases in adulthood. In research on the process better known as "fetal programming", the influence of the in utero environment on the epigenetic mechanisms of the fetus has been observed. Decreased or increased amounts of food intake may interfere with placental function and interfere with fetal growth. Altered placental function can lead to endothelial dysfunction, leading to changes in fetal growth and development. More recently, there has been increasing research on the impact of dietary supplementation on pregnant women and perinatal outcome. Among the more frequently examined variables are micronutrients such as folic acid, antioxidants, iron, magnesium and zinc, but also polyunsaturated fatty acids. The Covid-19 pandemic further highlighted the need to create disease registries and systematically monitor data, especially given the differences in health care availability on one hand and the incredible global differences in nutrient availability on the other.

Characteristics and outcomes of COVID-19 (SARS-CoV-2)positive pregnant women admitted to a dedicated COVID hospital in central India: a single-center observational study

Aim and objective: To identify characteristics of coronavirus disease-2019 (COVID-19) infection in pregnancy, maternal, and fetal outcomes and study changes in inflammatory markers and chest imaging findings. Materials and methods: This study is an observational study on pregnant COVID positive women admitted for treatment in the Maharaja Tukojirao Holkar Dedicated COVID Hospital, Indore, Madhya Pradesh, India from April 17, 2020, to April 30, 2021. There were two notable peaks of infection with different clinical characteristics. Group A included data from April 17, 2020, to February 28, 2021, and group B from March 1, 2021, to April 30, 2021. A detailed comparative analysis was done, comparing clinical parameters, investigational findings, and outcomes in both groups.

Incidence of postpartum depression in a tertiary care hospital in Navi Mumbai amid COVID-19 pandemic

Introduction: Coronavirus disease-2019 (COVID-19) pandemic has changed health care drastically, especially looking at how obstetrics functions. This places mothers in a situation of greater psychological vulnerability and heightens the risk of postpartum depression and disrupted mother-infant bonding, which may be weighted or worsened by the balance of the couple. We expect this impact to be even greater in vulnerable mothers in the context of dysfunctioning social services. This study intends to identify the incidence of postpartum depression in women delivering during COVID-19 pandemic among lockdown protocols in a tertiary center in Navi Mumbai and identify its sociocultural triggers so that strategies may be evolved to reduce the morbidity costs attributable to the mother and child in the future. Materials and methods: This study was a cross-sectional study, performed over a period of 2 months from June 2020 to August 2020 at DY Patil School of Medicine and Dr DY Patil Hospital, a teaching hospital in Western India. Two hundred postnatal mothers were recruited for the study in the postpartum period from 1 to 6 weeks after delivery. A specially designed questionnaire was used to record various determinants to assess the risk factors, which could contribute to postpartum depression. A predesigned and pretested questionnaire (EDPS-Edinburgh Postnatal Depression Scale) was used to detect the depressive symptoms in postnatal mothers. The results for qualitative data were presented in frequency and percentage. Binary logistic regression was used to predict the contribution of each independent risk factor to arrive at the depression level, which happens to be the dependent risk factor in this study. The statistical analysis was done by using SPSS 21.0. The significant level was used at p < 0.05.

Pharmacological Treatments against COVID-19 in Pregnant Women.

The recent respiratory virus known as SARS-CoV-2 has caused millions of deaths worldwide, causing great uncertainty due to the lack of a specific treatment, which has been mitigated by the use of various drugs traditionally used against other types of pathologies. Pregnancy presents special physiological conditions that expose the pregnant woman and the foetus to greater risk. Pregnant women are often excluded from trials due to possible risk of toxicity or side effects, resulting in a lack of knowledge about the use of drugs and treatments during pregnancy. The main objective of this review was to compile existing knowledge about currently available drug treatments for COVID-19 in pregnant women. The review report met the criteria of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) review protocol and was registered with the registration number CRD42021251036. The electronic databases searched were Scopus, PubMed, CINAHL and SciELO. Finally, 22 articles were included, resulting in an analysis of drugs with an acceptable safety profile in the treatment of pregnant women with COVID-19.

Generation COVID-19 - Should the foetus be worried?

AIM: The aim of this narrative review was to evaluate the risks, both direct and indirect, to the foetus from the COVID-19 pandemic. METHODS: Direct and indirect risks were defined as (a) vertical infection (congenital or intrapartum), (b) maternal infection and its sequelae, and (c) sources of maternal stress during lockdown, including social isolation and altered healthcare provision. RESULTS: Early studies suggest that vertical viral transmission is low; however, there may be an important effect of maternal infection on foetal growth and development. The impact of various degrees of lockdown on prospective mothers' health, habits and healthcare provision is of concern. In particular, increased maternal stress has been shown to have a significant effect on foetal brain development increasing the risk of mental health, and cognitive and behavioural disorders in later life. CONCLUSION: From the evidence available to date, direct risks to the foetus from the SARS-CoV-2 virus are low. Indirect effects of the pandemic, particularly resulting from the effect of maternal stress on the developing brain, can have lifelong detrimental impacts for this generation of children.

COVID-19 (SARS-CoV-2) Infection in Pregnancy: A Systematic Review.

INTRODUCTION: To review published studies related to the association of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections with pregnancy, foetal, and neonatal outcomes during coronavirus disease 2019 (COVID-19) pandemic in a systematic manner. METHODS: A comprehensive electronic search was done through PubMed, Scopus, Medline, Cochrane database, and Google Scholar from December 01, 2019, to May 22, 2020, along with the reference list of all included studies. All cohort studies that reported on outcomes of COVID-19 during pregnancy were included. Qualitative assessment of included studies was performed using the Newcastle-Ottawa scale. RESULTS: Upon admission, most pregnant women underwent a low-dose radiation CT scan; the reports of which included unilateral/bilateral pneumonia in most patients. A marked lymphopenia was also noted in many patients with COVID-19. 513 titles were screened, and 22 studies were included, which identified 156 pregnant women with COVID-19 and 108 neonatal outcomes. The most common maternal/foetal complications included intrauterine/foetal distress (14%) and premature rupture of membranes (8%). The neonatal clinical manifestations of COVID-19 commonly included shortness of breath (6%), gastrointestinal symptoms (4%), and fever (3%). CONCLUSION: COVID-19 infection in pregnancy leads to increased risk in pregnancy complications such as preterm birth, PPROM, and may possibly lead to maternal death in rare cases. There is no evidence to support vertical transmission of SARS-CoV-2 infection to the unborn child. Due to a paucity of inconsistent data regarding the impact of COVID-19 on the newborn, caution should be undertaken to further investigate and monitor possible infection in the neonates born to COVID-19-infected mothers.