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Objective: The current study aimed to describe the clinical characteristics of mild SARS-CoV-2 infected pregnant women with abnormal liver function (ALF), explore the association between ALF with maternal and fetal outcomes. Method(s): This retrospective analysis included 87 pregnant patients with mild SARS-CoV-2 infection admitted and treated from December 1, 2022, to 31, 2022 in the department of Obestircs at Beijing Obstetrics and Gynecology Hospital. We evaluated patients for demographic and clinical features, laboratory parameters and pregnancy complications. Result(s): 27 Patients in this cohort had clinical presentations of ALF. Compared with the control group, the peripheral blood platelet (PLT), D-dimer quantitative determination (D-Dimer), lactate dehydrogenase (LDH), total protein (TP), albumin (ALB), indirect bilirubin (DBIL), gamma- glutamyltranspeptidase (GGT) and total bile acid (TBA) showed significantly differences (p<0.05). 12 cases (44.44%) complicated with pregnancy induced hypertension (PIH), 14 cases (51.85%) complicated with intrahepatic cholestasis of pregnancy (ICP), 2 cases (7.4%) complicated with acute fatty liver during pregnancy (AFLP) and 5 cases (14.81%) complicated with postpartum hemorrhage in patients with abnormal LFT were significantly higher than those in the control group (p<0.05). Compared with the control group, the incidence of premature delivery (22.22%) and fetal distress (37.04%) in the experiment group were significantly higher (p<0.05), and the incidence of neonatal asphyxia was not significantly different (p>0.05). Conclusion(s): Pregnant women are generally susceptible to mild SARS-CoV-2 and may induce ALF. ALF is associated with increased risk of mother and infant. The maternal and infant outcomes of those who terminated pregnancy in time are acceptable. Therefore, pregnant women with COVID-19 who received antiviral treatment should be closely monitored for evaluating liver function and relevant indicators. The long-term outcomes in the future are worth to further study.Copyright © 2023
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A 25-year-old woman, gravida 2, with no medical history of cardiovascular nor other chronic diseases, came to the gynaecologist and described symptoms of a flu-like disease, including very high fever. The gyneacologist prescribed her antibiotics and paracetamol to calm down the fever. At 37 week of gestation she was admitted to the provincial COVID-19 treatment center for isolation and health care in University Clinical Center of Kosovo in Gynecology/Obstetrics department. All bacteriological tests, including hemocultures and cultures of urines were negative. She received antipyretics (acetaminophen), antispasmodics trimethylphloroglucinol and antibiotics (oral azithromycin for 5 days and intravenous ceftriaxone). Despite this treatments, fever and uterine contractions persisted therefor the commission of doctors decided to deliver the baby via ceserean section. The peritoneal cavity and uterus were found to be very inflamed. Fetal appendages as well as the bladder were strewn with eruptive, vesicular lesions bleeding on contact. After few hours after the delivery her temperature (36.5 degreeC) and blood pressure (120/60 mmHg) were normal. The baby was healthy and tested negative on the COVD-19 tests performed. The patients after 2 weeks of treatment and a negative COVID-19 result she was released to go home and was counselled to eat healthy and prescribed multivitamins for her immune system and regular follow ups with the gynecologist. In a period of 8 months the patient became pregnant again and got infected with the COVID-19 again at 25 weeks pregnant. This time the symptoms were not severe and she was followed up at home. The delivery was planned with cesarean section and the baby was in healthy conditions. The patient got vaccinated with Astra Zeneca COVID-19 vaccine after the delivery. Because of their changed physiology, susceptibility to infections, and weakened mechanical and immunological processes, pregnant women are a particularly vulnerable group in any infectious disease outbreak. The requirement to protect the fetus adds to the difficulty of controlling their health. Keywords: COVID-19, pregnant women, cesarean section, Kosovo, astra-zeneca vaccineCopyright © 2023
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Objective: This study quantified the COVID-19 pandemic's impact on same-day discharges for minimally invasive hysterectomy and evaluated the effect on postoperative morbidity and health care use.Materials and Methods: This retrospective cohort study, from March 2018 to October 2021 at a single institution, included women older than age 18 who had laparoscopic, vaginal, or robotic-assisted hysterectomy by any gynecologic surgeon. Primary outcome was rate of same-day hospital discharge. Secondary measures were length of stay and rates of 30-day postoperative morbidity and health care use. Univariate and multivariable logistic regression analyses were conducted to evaluate associations between patients' characteristics and likelihood of same-day discharge.Results: There were 1608 women included, 896 in a prepandemic cohort and 712 in a postpandemic cohort. Surgeon subspecialty rates were similar between groups, but surgical approaches differed, with more laparoscopic procedures in the postpandemic cohort (p = 0.007). Case order and lengths, and concurrent procedures were not different between groups. Postpandemic patients were more likely to be discharged on the same day even after controlling for confounders in a multivariable regression (32% versus 54%, respectively;odds ratio: 2.78;p < 0.001). Rates of 30-day postoperative complications, transfusions, emergency department visits, readmissions, reoperations, and mortality were not significantly different.Conclusions: The COVID-19 pandemic was associated with increased same-day discharges without increases in 30-day postoperative complications. The data confirmed that same-day discharge following minimally invasive hysterectomy was safe for managing hospital constraints caused by the COVID-19 pandemic. (J GYNECOL SURG 20XX:000)
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BACKGROUND: "Laparoscopist's thumb," or thenar paresthesia, can result from prolonged or excessive grip force during laparoscopy, as can more general syndromes, such as carpal tunnel syndrome. This is particularly relevant in gynecology, where laparoscopic procedures are standard. Although this method of injury is well known, there is a paucity of data to guide surgeons in selecting more efficient, ergonomic instruments. OBJECTIVE: This study compared the ratio of applied tissue force and required surgeon input in a sample of common ratcheting laparoscopic graspers in a small-handed surgeon, to provide potential metrics applicable to surgical ergonomics and surgeon instrument choice. STUDY DESIGN: Laparoscopic graspers with varied ratcheting mechanisms and tip shapes were evaluated. Brands included Snowden-Pencer, Covidien, Aesculap, and Ethicon. A Kocher was used as an open instrument comparison. Flexiforce A401 thin-film force sensors were used to measure applied forces. Data were collected and calibrated using an Arduino Uno microcontroller board with Arduino and MATLAB software. Single-handed, complete closure of each device's ratcheting mechanism was performed 3 times. The maximum required input force in Newtons was recorded and averaged. The average output force was measured with a bare sensor and the same sensor between 2 different thicknesses of LifeLike BioTissue. RESULTS: The most ergonomic ratcheting grasper for a small-handed surgeon was identified by the output ratio: the highest output force relative to the required surgeon input (the most force for the least amount of effort). The Kocher required an average input force of 33.66 N, with its highest output ratio of 3.46 (112 N output). The Covidien Endo Grasp was the most ergonomic, with an output ratio of 0.96 on the bare force sensor (31.4 N output). The Snowden-Pencer Wavy grasper was the least ergonomic, with an output ratio of 0.06 when applied to the bare force sensor (5.9 N output). All graspers except for the Endo Grasp had improving output ratios as tissue thickness and subsequent grasper contact area increased. Input force above that provided by the ratcheting mechanisms did not increase output force in a clinically relevant amount for any of the instruments evaluated. CONCLUSION: Laparoscopic graspers vary widely in their ability to provide reliable tissue force without requiring excessive input by the surgeon, and a point of diminishing returns often exists with increased surgeon input over designed ratcheting mechanisms. Output force and output ratio are potential quantitative measures of the efficiency of laparoscopic instruments. Providing users with this type of data could assist in optimizing instrument ergonomics.
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Endometriosis is a common and painful gynaecological condition that takes an average of 6.4years to diagnose. While laparoscopic surgery is the recommend gold standard in diagnosis of endometriosis, transvaginal ultrasound (TVS) is able to assist surgeons in the planning and management of patients, especially when there is limited visualisation in the posterior compartment. Uterosacral ligaments (USL) are located in the posterior compartment and are one of the first and most common places that endometriosis deposits, The International Deep Endometriosis Analysis (IDEA) group consensus, which are the current guidelines for DE imaging, recommends a thorough ultrasound assessment to identify endometriotic disease. This includes an assessment of anatomic structures in the posterior compartment including the USLs. However, IDEA does not explicitly articulate specifics of USL imaging and measurements on ultrasound. The primary aim of this review is to determine is to identify ultrasound techniques and characteristics of USLs in the diagnosis of deep infiltrative endometriosis (DE). The secondary aim is to describe and summarise these findings into normal and pathological findings. A systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A population, interventions, comparator, and outcome framework was used to define a search strategy. Articles were screened using Covidence review management system, and data was extracted by two authors using a standardised and piolet-tested form. Quality assessment was conducted using the Critical Appraisal Skills Programme (CASP). Medline, Embase and Scopus and Google Scholar were searched yielding 250 articles, with 22 being included in the review. Analysis of the data demonstrated inconsistent reporting of ultrasound techniques and characteristics of USLs. Most (20/22) papers described abnormal criteria of USLs, only 5/22 papers determined what the normal USL appearance is or what techniques (11/22) were applied. Even though reporting was heterogeneous, there was a high level of tertiary centre participation with gynaecological experienced operators, therefore was a high level of agreement. Through review of the current literature, this study has investigated ultrasound techniques and characteristics of USLs for the diagnosis of DE. All papers included in this review reported presence of pathological sonographic findings of the USLs when DE was presented therefore it is recommended that USL examination become a part of TVS exams when DE is clinically suspected. This study also demonstrated that there was lack of data and no agreement when it comes to measuring USLs with DE. Even so, the current evidence demonstrates that scanning the USLs, and locating, identifying, and describing USL thickening and endometriotic nodules in the various locations using the described techniques and characteristics in this review has clinical value in early diagnosis.
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Objective: Although these days the priority is to fight the Covid-19 pandemic, the importance of human papillomavirus (HPV) infection is not to be neglected. Mechanism: Cervical cancer is caused mainly by a chronic infection with one or more of the high-risk subtypes of HPV -most commonly a sexually transmitted disease acquired early in life. Most HPV infections go away on their own, but some can lead to a precancerous state that, if left untreated, can undergo complete neoplastic transformation. Findings in Brief: There is a hope that in the future the combination of screening tests with vaccinations against oncogenic strains of HPV will allow reductions in the percentage of those contracting cervical cancer. Conclusion(s): The importance of educational activities should be emphasized in developmental gynecology in the context of oncological prevention. The roles of both doctors and nurses are important here. During the Covid-19 Pandemic, these kinds of activities are not to be abandoned. In addition, efforts should be made to develop more practical and workable HPV and cervical screening strategies for use during a pandemic.Copyright © 2022 The Author(s). Published by IMR Press.
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COVID-19 has affected the population worldwide drastically with a tremendous impact on obstetric population which has led to serious concerns regarding maternal and fetal outcomes. Although there are recommended guidelines regarding delivery and management of complications, due to changes in characteristics of COVID-19 infection, they are constantly changing and evolving. Method(s): Prospective cohort study done during the covid pandemic from 1st April 2020 to 15th Feb 2022 in the department of Obstetrics & Gynecology, SKIMS MCH Srinagar J&K. The parameters measured were severity of covid disease, maternal age, gestational age, parity, blood investigations, mode of delivery, APGAR score, neonatal infection status and post-delivery complications. Result(s): A total of 311 pregnant covid 19 positive patients were included in the study who were actively managed.239 (76.85%) were delivered by casearean section and 72 (23.15%) by NVD. 92% patients had mild symptoms only, 8% had severe symptoms with 1.6% rate of ICU admission and 1.2% mortality rate. 83% delivered at term, 17% had preterm deliveries.8% patients had pneumonitis with positive findings on CT scan.24% patients had anemia, 12% had GDM, 10% had PIH, 10% had IHCOP, 5% had PPH, 1.6% had APH. All the neonates were negative for covid 19. 80% babies had an APGAR score of >= 8/10 at 1 min of birth with a mean birth weight of 2400 g +/- 500. No postdelivery complication was noted. Conclusion(s): Our study concludes that SARS-CoV-2 infection can lead to unfavorable maternal and perinatal outcomes.
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INTRODUCTION AND OBJECTIVE: Given widespread disruptions to healthcare during the COVID-19 pandemic, the objective was to assess the national case logs of graduating Female Pelvic Medicine and Reconstructive Surgery (FPMRS) fellows for effects on surgical volume. METHOD(S): The nationally aggregated Accreditation Council for Graduate Medical Education case logs were obtained for graduating FPMRS fellows, both urology and obstetrics and gynecology (OBGYN), for available academic years (AYs) 2018-2019, 2019-2020, and 2020- 2021. Standard deviation was derived from percentile data. Case volume differences for tracked index category averages were compared between AYs with one-way analysis of variance. RESULT(S): Graduating fellows logged an average of 517.4 (SD 28.6) and 818.0 (SD 37.9) cases, for urology and OBGYN respectively, over their fellowship training during the examined period. Total surgical procedures were not statistically different between pre-COVID AY 2018- 2019 and COVID-affected AYs 2019-2020 and 2020-2021 for either specialty. For urology fellows, the only index case category with a statistically significant difference was a decrease in AY 2020-2021 compared to 2019-2020 in GI procedures (8.9 vs 4.2, p=0.04). Reclassification of mesh removal cases to genital procedures in 2020- 2021 resulted in a statistical decrease for both specialties of graft/mesh augmentation prolapse cases for that same AY. There were no other statistically significant differences between AYs for OBGYN fellows. CONCLUSION(S): Compared to pre-pandemic case volumes, FPMRS urology and FPMRS OBGYN graduating fellow surgical volume remained stable. Both total surgical procedures and index case categories showed no statistically significant difference between pre-COVID and COVID-affected years. Despite nationwide disruptions in health care, FPMRS trainee case volumes remained consistent.
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The proceedings contain 358 papers. The topics discussed include: role of early prophylactic aspirin on Covid-19 outcome in antenatal patients - an audit of a hospital in India;partial intestinal obstruction complicating pregnancy: diagnostic dilemma and management;a case report of uterine rupture recognized during cesarean section at the site of a previous hysteroscopy-related perforation;menstrual characteristics and its related morbidities among adolescent girls living in North Borneo, Malaysia: a questionnaire-based study;the volume of posterior cervical varicose correlates with intraoperative blood loss in placenta previa;implications of large fibroids in pregnancy: a multidisciplinary approach;unexpected ovarian malignancy in postmenopausal women following laparoscopic surgery for adnexal masses - a review of 5 years;post radiotherapy outcome on cervical cancer stage IIIB patients with and without paraaortic lymph nodes enlargement;and evaluation of the relationship between thrombocytosis and clinico-pathological factors of patients with epithelial ovarian cancer.
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RESUMEN La docencia en obstetricia y cirugía en el Perú empezó a principios del siglo XIX, por iniciativa de Hipólito Unanue. Cayetano Heredia y otros la estructuraron académicamente al crearse la Facultad de Medicina de la Universidad Nacional Mayorde San Marcos, en 1856. La cátedra de clínica ginecológica fue creada finalizando el siglo XIX, nombrándose como catedrático a Constantino T. Carvallo. En 1947 se fundó la Sociedad Peruana de Obstetricia y Ginecología (SPOG), con la finalidad de desarrollar la ciencia y la capacitación continua de especialistas en ginecología y obstetricia. Desde 1955, la Revista Peruana de Ginecología y Obstetricia es el medio de comunicación científica de la SPOG, que publica experiencias e investigaciones en la especialidad. El residentado en Obstetricia data de 1958 en la Maternidad de Lima y, entre 1961 y 1962, Abraham Ludmir comenzó el residentado escolarizado de obstetricia y ginecología en el Hospital Materno Infantil San Bartolomé. El continuo y rápido avance dado por la investigación científica, información y modernización de la tecnología en la especialidad ha ocasionado la aparición de varios capítulos relacionados a la patología de la mujer y el perinato, integradas en instituciones médicas que avanzan a diferente velocidad e importancia. La actual pandemia del coronavirus SARS-CoV-2 ha puesto en evidencia los problemas en la atención de salud nacional, ocasionando congestión hospitalaria, insuficiencia de equipos, medicamentos y recursos humanos, indicadores desfavorables de vigilancia, infecciones y muertes, lo que requerirá girar la gestión en salud. La docencia en medicina también se vio afectada, con conversión de la educación presencial a virtual, prohibición de atención presencial de estudiantes y docentes mayores, que recién retornarán a los hospitales. La educación médica, los avances científicos y tecnológicos y la visión de un mundo rápidamente cambiante deben originar nuevos planes curriculares para los estudiantes de medicina y residentes en la especialidad, para una apropiada atención en salud.
ABSTRACT The teaching of obstetrics and surgery in Peru began at the beginning of the 19th century, at the initiative of Hipólito Unanue. Cayetano Heredia and others structured it academically when the Faculty of Medicine of the Universidad Nacional Mayor de San Marcos was created in 1856. The chair of clinical gynecology was created at the end of the 19th century, appointing Constantino T. Carvallo as professor. In 1947, the Peruvian Society of Obstetrics and Gynecology (SPOG) was founded with the purpose of developing the science and continuous training of specialists in gynecology and obstetrics. Since 1955, The Peruvian Journal of Gynecology and Obstetrics is the scientific communication media of the SPOG, which publishes experiences and research in the specialty. The residency in Obstetrics dates back to 1958 at the Maternity Hospital of Lima and, between 1961 and 1962, Abraham Ludmir began the schooled residency in obstetrics and gynecology at the Hospital Materno Infantil San Bartolomé. The continuous and rapid progress given by scientific research, information and modernization of technology in the specialty has caused the emergence of several branches related to the pathology of women and perinates, integrated in medical institutions that advance at different speed and importance. The current SARS-CoV-2 coronavirus pandemic has highlighted the problems in national health care, resulting in hospital congestion, insufficient equipment, drugs and human resources, unfavorable indicators of surveillance, infections and deaths, which will require a change in health management. Teaching in medicine was also affected, with the conversion from classroom to virtual education, prohibition of on site care for students and senior teachers, who will be returning to the hospitals. Medical education, scientific and technological advances and the vision of a rapidly changing world must give rise to new curricular plans for medical students and residents in the specialty, for appropriate health care.
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BACKGROUND: Studies have shown that mobile health technologies (mHealth) enhance the use of maternal health services. However, there is limited evidence of the impact of mHealth use by community health workers (CHWs) on the use of maternal health services in sub-Saharan Africa. OBJECTIVE: This mixed method systematic review will explore the impact of mHealth use by CHWs on the use of the maternal health continuum of care (antenatal care, intrapartum care, and postnatal care [PNC]), as well as barriers and facilitators of mHealth use by CHWs when supporting maternal health services. METHODS: We will include studies that report the impact of mHealth by CHWs on the use of antenatal care, facility-based births, and PNC visits in sub-Saharan Africa. We will search 6 databases (MEDLINE, CINAHL, Web of Science, Embase, Scopus, and Africa Index Medicus), with additional articles identified from Google Scholar and manual screening of references of the included studies. The included studies will not be limited by language or year of publication. After study selection, 2 independent reviewers will perform title and abstract screening, followed by full-text screening to identify the final papers to be included. Data extraction and risk-of-bias assessment will be performed using Covidence software by 2 independent reviewers. We will use a Mixed Methods Appraisal Tool to perform risk-of-bias assessments on all included studies. Finally, we will perform a narrative synthesis of the outcomes, integrating information about the effect of mHealth on maternal health use and barriers and facilitators of mHealth use. This protocol follows the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols) guidelines. RESULTS: In September 2022, we conducted an initial search in the eligible databases. After removing duplicates, we identified 1111 studies that were eligible for the title and abstract screening. We will finalize the full-text assessment for eligibility, data extraction, assessment of methodological quality, and narrative synthesis by June 2023. CONCLUSIONS: This systematic review will present new and up-to-date evidence on the use of mHealth by CHWs along the pregnancy, childbirth, and PNC continuum of care. We anticipate the results will inform program implementation and policy by highlighting the potential impacts of mHealth and presenting contextual factors that should be addressed to ensure the success of the programs. TRIAL REGISTRATION: PROSPERO CRD42022346364; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=346364. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/44066.
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Research shows that while inhaling gas and air (Entonox) in labour is safe for mothers and babies, long-term cumulative exposure may carry health risks. Work notice The right to strike The UK government's Strikes (Minimum Service Levels) Bill is, at the time of going to press, at the committee stage in the House of Lords (the first chance for line-by-line examination). Visit bit.ly/ Clementine-register Working mums Maternity leave Careers After Babies research has found that of 848 mothers interviewed, 98% want to return to work after having a child but just 13% can make it work full-time, citing the cost of childcare and lack of flexibility from businesses as the reason. Find out more at hegenbergermedical.com/training Research Healthy eating support Researchers at the University of Hertfordshire are calling for better information on diet and nutrition to be made available to expectant parents.
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Based on what is known at this time, pregnant women are at an increased risk for severe illness from COVID-19 compared to non-pregnant women. Additionally, pregnant women with COVID-19 might have an increased risk of adverse pregnancy outcomes, such as preterm birth. The study was conducted in the city of Kirkuk city during the period between February 1, 2020, and September 1, 2020, at Gynecology and children hospital. Through the study, 100 pregnant women were received, complaining of Covid-19 infections, which were diagnosed in Kirkuk, and now Real Time PCR was confirmed through nasopharyngeal swabs that were taken from the Hospital. The study also included measuring the level of blood pressure, sugar and IL-6 in those women during the fifth to eight week, where we were infected, and then in the 12th week of pregnancy took place, where communication was made, and a level was measured, and as a result, these women who completed the period with a pre-term labor, miscarriage before the 24th week of pregnancy or those completed the period with successful pregnancyThe study showed that were asymptomatic, 45% of cases of COVID-19 patients were with mild infection and 10% were with severe infection (P<0.001) In this study, 10 % of COVID-19 pregnant women suffer from hypertension, 13% were with Diabetes, 35% with UTI while 70% were suffered from fever. When reaching 24th week of pregnancy, and as shown in Table 3. The study showed that 40% COVID-19 pregnant women experienced completed the period with a preterm labor, 10% was with miscarriage before the 24th week of pregnancy, while 50% of them completed the period continued the pregnancy. In this study, 82.5 % of COVID-19 pregnant women with preterm labor were suffered previously from fever comparing with 55% of COVID-19 pregnant women without preterm labor.The study showed that the highest mean of serum IL-6 was found in women infected with COVID-19 comparing with healthy control (12.8+/-3.6 v.s. 29.3+/-3.1 ng/ml) (P: <0.001). Conclusion(s):The study showed a significant relation of COVID-19 infection with pregnant women who pre-term labor especially who have high body temperature.Copyright © 2020 Ubiquity Press. All rights reserved.
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Objectives: To find out the personal, professional, and educational challenges in training by the post-graduate residents of Obstetrics and Gynecology in the three tertiary care hospitals of Peshawar during the Covid-19 Pandemic. Method(s): This was a web-based cross-sectional study conducted among the postgraduate residents of Gynecology and Obstetrics in the three main teaching hospitals of Peshawar, from 1st April 2020 to 31st July 2020. A structured survey using Google forms was distributed among 98 postgraduate residents through emails and social media platforms. The challenges faced and their severity was assessed using the Likert Scale. Results were analyzed in Microsoft Excel. Result(s): Total number of participants was 98, with 99% being female. The mean age was 28.3+/-1.8 years. Their worst fear was of the family getting infected (86.7%). Their greatest challenge was the inability to practice social distancing due to the nature of their work (85%) amidst a lack of PPEs (51%). Their training suffered due to inadequate opportunities for elective surgeries (78%). Conclusion(s): Post-graduate residents in Gynaecology/Obstetrics faced substantial personal, professional, and educational challenges while training during the covid-19 pandemic.Copyright © 2023, Khyber Medical College. All rights reserved.
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I Early Pregnancy Loss i (Obstet Gynecol 2018;132:e197-e207) has been updated by ACOG Practice Advisory: Updated Mifepristone REMS Requirements (January 2023) ACOG Practice Bulletin No. 225. I Medication Abortion Up to 70 Days of Gestation i (Obstet Gynecol 2020;136:e31-e47) has been updated by ACOG Practice Advisory: Updated Mifepristone REMS Requirements (January 2023) For the most up-to-date documents on COVID-19, visit https://www.acog.org/covid-19. I Increasing Access to Abortion i (Obstet Gynecol 2020;136:e107-e115) has been updated by ACOG Practice Advisory: Updated Mifepristone REMS Requirements (January 2023) ACOG Practice Bulletin No. 200. [Extracted from the article] Copyright of Obstetrics & Gynecology is the property of Lippincott Williams & Wilkins 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.)
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Background: COVID-19 is the most important health problem in the world nowadays. Since the publication of the first cases, the symptoms have become more numerous. Anosmia has been recently recognized as a frequent and relevant symptom for the detection of COVID-19, especially in pauci-symptomatic forms. Objective(s): To determine the prevalence of anosmia in health care workers affected by SARS-COV2 and to identify its associated factors. Method(s): This is a cross-sectional analytical study, carried out over a six-month period, which included all healthcare workers of Farhat Hached Academic Hospital of Sousse, Tunisia, affected by SARS-COV2 and confirmed by polymerase chain reaction or antigen rapid test. Result(s): A total of 474 healthcare workers were enrolled with a mean age of 41.02+/-10.67 years and a sex ratio of 0.2. The gynecology department was the most represented one (13.9%). Nurses were the most affected (31.4%). Hospitalization was required for 16 patients (3.4%). The average time of work was 17.04 +/- 11.6 days. Anosmia persisted for more than 90 days in 35 patients (7.4%). After multiple binary logistic regression, anosmia was statistically associated with female gender (p = 0.001;ORIC95%:2.46 [1.4-4.2]) and blue-collar occupational category (p = 0.002;ORIC95%:3.1 [1.5-6.5]). A significant association was also noted between the presence of anosmia and professional seniority (p = 0.019;OR IC95%: 0.97 [0.95-0.99]) and the duration of work (p = 0.03;OR IC95%: 0.97 [0.95-0.99]). Conclusion(s): Although anosmia seems to be frequent in COVID-19 patients, there is still not enough evidence to affirm that it is a strong predictor of the diagnosis of COVID-19.
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Objective: Can a way forward be created to establish baseline criteria to better assist aeromedical transport crews with optimizing care and increasing the probability of survival of acutely distressed women in their third trimester of pregnancy with SARS-COV-2 symptoms? Information has been derived from a mixed methods research approach. Pregnant individuals with SARS-COV-2 are at increased risk of intensive care unit admission, mechanical ventilation, and death compared with both pregnant individuals without SARS-CoV-2 infection and nonpregnant adults with SARS-CoV-2 infection1. Hypertensive disorders of pregnancy affect up to 20% of pregnancies in the United States and are leading causes of serious obstetric morbidity1. The focus of this research included nearly 2,400 pregnant women infected with SARS-CoV-2 and found that those with moderate to severe infection were more likely to have a cesarean delivery, to deliver preterm, to die around the time of birth, or to experience serious illness from hypertensive disorders of pregnancy, postpartum hemorrhage, or from infection other than SARS-CoV-2. They were also more likely to lose the pregnancy or to have an infant die during the newborn period. Mild or asymptomatic infection was not associated with increased pregnancy risks. Method(s): We intend to develop an algorithm based on current guidelines to smooth the transition of care from prehospital to intrahospital. We will use the guidelines set forth by The American College of Obstetrics and Gynecology (ACOG). In addition, we will take an example of the policies and procedures from a prehospital care aeromedical flight service for inclusion in our proposed treatment recommendation(s). Result(s): We will then use the guidelines to make an all-encompassing protocol to guide the whole trip from onset of symptoms to in hospital care. We believe that a protocol that encompasses the whole of both systems, prehospital flight and in hospital, will help to streamline patient care tasks and reduce the probabilities of morbidity and mortality. Conclusion(s): The aeromedical community should seek out partnerships with the appropriate entities to provide invaluable information about a critical time of transitioning the patient from the point of access to the healthcare system to the appropriate definitive care facility. The aeromedical community has specialized paramedics, nurses, and physicians with knowledge and experience that cannot easily be quantified. These efforts could result in treatment modalities addressing acute management intra/inter hospital upon initial publication and equip air medical personnel with additional critical care education and knowledge to take back to their perceptive communities to enhance the probability of survival with pregnant women adversely affected by SARS-COV-2.Copyright © 2022