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Background: The COVID-19 pandemic has affected the performance of several sectors, one of which is the quality of maternal and child health services. One of the factors contributing to the decline in the quality of maternal and child health services is limited access during the COVID-19 pandemic. Telemedicine is here as one of the answers to overcome the problem of limited access to health services during the COVID-19 pandemic. This study aims to analyze the use of telemedicine applications by pregnant women during the COVID-19 pandemic using the ISO 9241-11 framework. Subjects and Method: This research method is an observational study with a descriptive approach to analyze usability in three measurement aspects namely effectiveness, efficiency, and satisfaction. The number of samples used was 42 pregnant women who had used telemedicine applications that had been determined during the COVID-19 period with a sampling technique using random sampling. The instrument used is an adaptation of the Standardized Usability Questionnaire (SUQ) which will be analyzed using the Structural Equation Modeling-Partial Least Square (SEM-PLS) technique to determine the usability score of the application. Results: Based on the results of the Structural Equation Model-Partial Least Square (SEM-PLS) analysis, the ISO 9241-11 model has a goodness-of-fit model with an R-square value of 0.760 and a Q-square value of 0.577 with a Goodness of Fit (GoF) of 0.780. The effectiveness variable has a significant effect on the usability variable of the Teman Bumil application at a significance level of 5% with a statistical T value of 1,955. There is not enough evidence for the efficiency and satisfaction variables to say they have a significant effect on the usability of the Teman Bumil application at a 5% significance level with T-statistic values of 0.866 and 1.452. The usability score for the Friends Pregnant application is 44.45. Conclusion: The usability score obtained by the Teman Bumil application is 44.45, which means that Sahabat Bumil application has not been accepted by users as a system product that can help effectively, efficiently and satisfactorily.
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The coronavirus disease (COVID-19) is a communicable respiratory disease caused by a new strain of coronavirus that causes illness in humans. The disease is caused by a pathogen called Severe Acute Respiratory Syndrome Coronavirus-2 and can be transmitted from person to person through infected air droplets that are projected during sneezing or coughing. The coronavirus disease has generally affected all sectors of the society, including the health sector and reproductive health in particular. Reproductive health contributes greatly to physical and psychosocial comfort and closeness between individuals. Adequate and balanced reproductive health can be impaired and deprived by diseases, abuse, exploitation, unwanted pregnancy, and death. This review paper looked into possible effects of COVID-19 pandemic on reproductive health. Human and nonhuman primate literatures were examined to extract empirical data detailing the impact of COVID-19 on reproductive health. Literatures were sourced from Ovid MEDLINE, SCOPUS, the Cochrane Library, Ovid EMBASE, CINAHL Plus, PROQUEST, PUBMED, and Web of Science. Experimental and clinical evidence were used to examine whether COVID-19 adversely impacted on the reproductive health of infected and non-infected population. The global outbreak of COVID-19 has led to measures driven by the pandemic, to prevent further spread and effectual treatment of those affected. This has literally caused decrease in sexual and reproductive health care services due to global lockdowns and closures of health sectors deemed to be non-essential in combating the disease.
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Background: Maternal mortality is one of the health statuses that is considered global. Central Java Province has the highest maternal mortality rate in Indonesia, and one of the regencies with a high MMR (Maternal Mortality Rate) is Grobogan. Purpose: This research wants to describe maternal mortality in Grobogan in 2020-2021. In further research, we can determine the relationship between risk factors that cause maternal death and use them to develop program decisions to reduce maternal mortality in Grobogan. Methods: This study used a descriptive-quantitative study using Maternal and Infant Mortality data from the Health Office of Grobogan in 2020-2021 and analyzed averages and proportions. Results: This study showed that 103 mothers died, 69% mothers at the age of 20-35 years, 46.60% mothers had Junior High School, 8% were in the Purwodadi 2 area, 73% with gestational age >28 weeks, 52% had 2-3 parity, 87.38% of mothers never abortion, 57% of mothers died during the puerperium, and 39% caused by being infected of COVID-19. Conclusion: Maternal mortality in Grobogan Regency during the 2020-2021 COVID-19 pandemic, most of the causes of death were due to COVID-19 infection, which mainly occurred in mothers aged 20-35 years, last educated at junior high school, at gestational age >28 weeks, parity 2-3, more common in mothers who have never had a history of abortion, and is currently experiencing the puerperium. This maternal death occurred in 28 of the 30 Puskesmas in Grobogan.
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Introduction: universal neonatal hearing screening is a test that enables to identify or suspect hearing loss, performed via habilitation or rehabilitation plan. Background: determine the coverage of universal hearing screening in the epidemiological context of COVID-19 in Guantanamo province, during the period of march 2020 to march 2021. Method: a descriptive, retrospective cross-sectional study was carried out. A total of 5 999 newborns (as Universe) were involved in the study. Variables used were as follow: sex, newborns with or without risk factors, and otoacoustic emissions, which outcomes allowed for the evaluation of universal hearing screening coverage. The standard indicator (95%) and the time at which the first otoacoustic emissions were made were defined. The percentage of newborns detected before one month of life was established as indicator. Results: the 51.1% of the 5 999 newborns were male and 48.3% were female. The 100% of newborns (5 838) without risk factors underwent to the first examination, meanwhile, among those with risk factors (151 newborns) 0.2% (10) could not be tested. Screening of newborns without factors occurred between 1 and 3 days after birth. Screening was never performed after 30 days of birth in those who presented risk factors. Coverage was 99.8% and the reference rate was 0.2%. Conclusions: Universal Hearing Screening Program application in the context of COVID-19 pandemic in Guantanamo province shows a fulfillment in the coverage indicator.
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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.
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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.
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Pregnant women generally constitute a group at high risk of infectious diseases due to gestational immunological and physiological changes in their system. That is why the objective of this work is to analyze the implications of the physiological changes of pregnancy in SARS-CoV-2 disease. Physiological changes in pregnant women not only increase their susceptibility to the virus, but also increase the severity of the disease. Changes in the respiratory and immune systems, the role of the placenta in coagulation, and the function of endothelial cells are the physiological changes that most influence the disease. The decrease in lung capacity and the variations that occur in the immune system represent new treatment challenges for pregnant women with COVID-19 disease and therefore new areas of research limited so far.
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Background: Pregnant women and fetuses are populations that are at high risk of being infected with the virus. COVID-19 in pregnant women is considered a risk factor for causing complications in pregnancy such as premature rupture of membranes. This study aims to analyze complications of premature rupture of membranes in mothers infected with COVID-19. Subjects and Method: This was a systematic review and meta-analysis. Article searches were conducted using electronic databases such as Google Scholar, PubMed and Science Direct. The articles used are articles published from 2020-2022. Keywords to search for articles were: "COVID-19" OR "2019-nCoV" OR "novel coronavirus" OR "SARS-CoV-2" OR "coronavirus 2" AND "premature rupture of membrane" OR "prelabour rupture of membrane" AND "pregnancy." The inclusion criteria used were full text articles in English with a cohort study design, multivariate analysis with Adjusted Odds Ratios (aOR), research subjects were pregnant women, intervention was COVID-19 infection, comparison was not infected with COVID-19, the outcome of the study was premature rupture of membranes. The results of the search for articles were included in the PRISMA diagram and analyzed using the Review Manager 5.3 application. Results: A total of 9 cohort study articles from the United States, Bangladesh, China, India, Mexico, Romania, and Spain were selected for systematic review and meta-analysis. The results showed that pregnant women infected with COVID-19 had a risk of complications of premature rupture of membranes as much as 2.26 times compared to pregnant women who were not infected with COVID-19 and the results were statistically significant (aOR = 2.26;95% CI = 1.33 to 3.82;p = 0.002). Conclusion: Pregnant women infected with COVID-19 increase the risk of premature rupture of membranes.
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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.
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Background: India is one of the most severely affected countries due to the COVID-19 pandemic. A higher risk of severe illness and complications from COVID-19 had been observed in pregnant women as compared to nonpregnant women. The government of India on July 2, 2021, provided approval for the vaccination of pregnant women against COVID-19. A little data regarding the safety or harm during pregnancy of vaccination were available that time. Lack of safety data, fear, mistrust, underestimation of efficacy of vaccine, and chaos due to pandemic makes indecisive surrounding for pregnant women and this causes hesitancy with decision making about the COVID-19 vaccination. Aims and Objectives: This study aims to analyze the willingness and hesitancy of pregnant women to get vaccinated against COVID-19. Materials and Methods: This prospective study was conducted in a tertiary care institute in Northern India. Five hundred antenatal women who were eligible for COVID-19 vaccination were included in this study. Informed consent has been taken and data were analyzed after filling face to face questionnaire regarding vaccine acceptance or hesitancy. Results: The present study revealed low acceptance of COVID-19 vaccination in pregnancy. Prime reasons for the same are no allowance by the family and the possibility of vaccine harming the baby. Conclusion: Specific efforts should be directed toward high-risk populations including pregnant women and those who are planning for pregnancy. This will promote vaccination rates by increasing people's trust in immunization and the health-care system.
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This article discussed the importance of women's health in the growth and development of societies and emphasized the need to prioritize women's health challenges in health programs. The Health Policy Research Center in Shiraz, Iran, had launched the International Conference on Women's Health in 2011 to address interdisciplinary approaches to women's health. The Islamic World Educational, Scientific, and Cultural Organization had recommended the tagline "Healthy Women, Healthy World" and emphasized the priority of women's health in their activities. The article outlines the topics that were discussed at the 11th International Conference on Women's Health (ICWH 2022), including maternal health during the pandemic, new approaches to maternal health, sustainable development goals and maternal health, mental and physical health during the pandemic, intimate partner violence against women, and health systems and women's health. The article highlights the need for research-informed policies, continuous evaluation, and implementation of programs to promote women's health.
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Background: High risk of COVID-19 infection is reported in neonates of COVID-19-affected females along with adverse effects secondary to the infection. Limited work in literature is done on COVID-19 infection transmission from affected females to neonates born to them with few studies reporting vertical transmission of COVID-19. Aim: To evaluate SARS-CoV-2 vertical or perinatal transmission and describe neonatal clinical findings and short-term outcomes in babies born to Covid- 19 positive mothers. Methods: The study assessed 19 females and 19 neonates. All neonates immediately after birth were breastfed and kept with the mother in cases with the clinically stable situation for babies and mothers both. For all the babies, nasal swab samples were sent to detect SARS-CoV-2 on day 1 of their birth. The neonates were followed for 7-14 days after their birth followed by reassessment for SARS-CoV-2 from nasal swab specimens. Results: All babies were healthy with no detection of SARS-CoV-2 seen from the neonates from the nasopharyngeal swabs. Also, no separation was done from mothers, and breastfed was given to all the neonates which showed no transmission of SARS-CoV-2 from breast milk to the neonates. Conclusion: Benefits of breastfeeding are higher compared to the risk of perinatal or vertical transmission depicting that there is no need for separation of the neonate from SARS-CoV-2 positive mothers. Also, neonates can be breastfed from COVID-19-positive mothers without the risk of virus transmission.
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Background: Corona-virus pandemic has become a major health problem worldwide. It evokes mental health disorders affecting the population globally, especially pregnant women and is associated with adverse maternal and fetal outcomes. The aim of the study was to assess anxiety and depression in pregnant women during the Covid-19 pandemic. Material & Methods: This was a cross-sectional study conducted at Islami Bank Central Hospital Kakrail, Dhaka, Bangladesh. Pregnant women visiting the gynae& obs outpatient department, and women who had recently delivered in the gynae ward (in the past 15 days) were included in the study and asked to fill out a questionnaire. Results: A total of 152 patients were enrolled and analyzed in this study. Out of the total, 108 (71.05%) of the patients were less than 30 years, 38 (25.00%) were between 31 and 35 years old, and only 6 (3.95%) were older than 35 years. We found that 103(67.76%) of pregnant women had developed mental health disorders during this pandemic and there is a need to reform policies for the care and counseling of pregnant women as they are particularly susceptible. Conclusions: This study examined the mental health of pregnant women during the COVID-19 pandemic. The majority of the women thought COVID-19 could affect their pregnancy. Proper screening and diagnosis would bring early treatment to the needy thus preventing complications to both the mother and the newborn.
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Background: With the onset of COVID-19 pandemic, the life of humankind had changed a lot. With a change in health-care approach, contraception became a non-essential service and faced a downfall. Aims and Objective: This study objective is to find out the changes in contraceptive usage in a tertiary care center. Materials and Methods: The study is a retrospective observational study, in which contraceptive usage was compared between 2019 and 2020. Data obtained from record section of the institute were used as source. Attendance in Gynecological Outpatient Department, admission in maternity ward, and delivery rates were also compared between 2 years. Results: Total contraceptive usage was decreased by 11.1% in 2020. Long-acting reversible contraceptives or short-acting both types were decreased in 2020, but maximum decrease was barrier method condom by 25.1% and oral contraceptive pills by 24.9%. Hospital maternity ward admission was less by 7% and delivery rates by 2.4%. Only medical termination of pregnancy showed an increased trend in 2020. Conclusion: Pandemic also had caused a toll in family planning, and thus, overall decrease in usage was seen which can be detrimental to population control.
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Background : Data pertaining to preventable causes of maternal mortality are valuable in each set up to design interventional steps for the significant reduction of the maternal mortality ratio. Objectives : (1) To study the trend on Maternal Mortality Rate (MMR);(2) To find out the factors for the Maternal Mortality. Material and Methods : A retrospective cross-sectional study of maternal death was conducted in the Obstetrics Department of Tertiary Care Hospital of Ahmedabad city. The data of total 9 years from 1st April 2013 to 31st January 2021 were taken in the study. Epidemiological factors and causes affecting maternal mortality were assessed through pretested questionnaire that includes parity, duration between admission and mortality etc. Results: Maternal Mortality Rate (MMR) was 180.2 per 1 lac live births during the study period. Young mothersaged 20 to 30 years (78.5%), and rural residence (76.6%), multiparous mothers (66.7%)were at risk for Maternal Mortality. Obstetric haemorrhage (25.8%) was the most common cause whereas COVID-19 pandemic later on were indirect causes contributing to Maternal Mortality. Conclusion: Great Care should be taken for high-risk pregnancy like young age, multiparous women and also of postpartum women. Postpartum haemorrhage was the commonest direct cause of Maternal Mortality. Strengthening of existing obstetric care facilities, facility for easy transport, appropriate referral linkages are keys to reduce Maternal Mortality to further extent.
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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.
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Malaria is an endemic disease in a true sense. It is an acute febrile disease caused due to the parasite Plasmodium. However, unlike COVID-19, it failed to raise an international concern or gain the scientific limelight. Most of the 200 million globally affected by malaria, half of them are from Africa. Four of the nations, Nigeria (25%), the Democratic Republic of the Congo (11%), Mozambique (5%), and Uganda (4%), account for half of the world's malaria burden and is the leading cause of illness and death. In 2019, an estimated 5-6 million people died of malaria - most of them are young children in sub-Saharan Africa. Many of the countries affected by malaria have the lowest economic status. In the malaria-endemic region, the most vulnerable groups are young children and pregnant women. The costs of malaria are enormous to individuals, families, communities, societies, and nations. After a struggle for three decades, the much-awaited malaria vaccine, RTS, S (brand name Mosquirix), was finally launched;but it came with its controversies and allegations. This review explored the different angles of this disease, the vaccine development, and the emerging debates.
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Due to the physiological changes of the pregnancy and considering the susceptibility of the fetus, pregnant women are among the vulnerable health groups. The current COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has multiplied the health burden on vulnerable and susceptible groups. With over 500,000 new cases daily, the vulnerable groups are in danger more than ever. Therefore, early diagnosis, effective treatment, and efficient prevention strategies are significant among these groups. Since the clinical knowledge about the diagnosis, management, prevention, and many other aspects of pregnancy and lactation during COVID-19 has significantly changed and improved from the pandemic's beginning, most of the previous knowledge has changed, and the previous publications might not be helpful anymore. This review aims to provide an updated and comprehensive review of the mutual impact of pregnancy and COVID-19 infection, discuss the current controversies based on the most recent findings, and highlight the existing knowledge gaps. Due to the increased susceptibility, undesired outcomes are more expected among pregnant women with COVID-19 infection. Still, prevention measures are the best way of managing COVID-19 in this population. Moreover, further clinical studies should address the long-term complications, outcomes, safety of vaccination, and the impact of the pandemic on mental health.
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Background: Information regarding effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant strains on clinical manifestations and outcomes of coronavirus disease 2019 (COVID-19) in pregnant women is limited. Methods: A retrospective observational study was conducted using the data from the nationwide COVID-19 registry in Japan. We identified pregnant patients with symptomatic COVID-19 hospitalized during the study period. The Delta and Omicron variants of concern (VOC) predominant periods were defined as August 1 to December 31, 2021 and January 1 to May 31, 2022, respectively. Clinical characteristics were compared between the patients in the Delta and Omicron VOC periods. In addition, logistic regression analysis was performed to identify risk factors for developing moderate-to-severe COVID-19. Results: During the study period, 310 symptomatic COVID-19 cases of pregnant women were identified;111 and 199 patients were hospitalized during the Delta and Omicron VOC periods, respectively. Runny nose and sore throat were more common, and fatigue, dysgeusia, and olfactory dysfunction were less common manifestations observed in the Omicron VOC period. In the multivariable logistic regression analysis, onset during the later stage of pregnancy (OR: 2.08 [1.24-3.71]) and onset during the Delta VOC period (OR: 2.25 [1.08-4.90]) were independently associated with moderate-to-severe COVID-19, whereas two doses of SARS-CoV-2 vaccine were protective against developing moderate-to-severe COVID-19 (OR: 0.34 [0.13-0.84]). Conclusions: Clinical manifestations of COVID-19 in pregnant women differed between the Delta and Omicron VOC periods. SARS-CoV-2 vaccination was still effective in preventing severe COVID-19 throughout the Delta and Omicron VOC periods.