RESUMEN
Objectives: Severe acute respiratory syndrome-coronavirus 2/COVID-19 infection is still a global concern, with pregnant women are considered as vulnerable population. Until now, the characteristics of pregnant women in Indonesia who are infected with COVID-19, as well as pregnancy and neonatal outcomes, are still unknown. This study aims to obtain national data, which are expected to be useful for the prevention and management of COVID-19 in pregnant women in Indonesia. Method(s): There were 1,427 patients recruited in this retrospective multicenter study. This study involved 11 hospitals in 10 provinces in Indonesia and was carried out using secondary patient data from April 2020 to July 2021. COVID-19 severity was differentiated into asymptomatic-to-mild symptoms and moderate-to-severe symptoms. The collected data include maternal characteristics, laboratory examinations, imaging, pregnancy outcomes, and neonatal outcomes. Result(s): Leukocyte, platelets, basophil, neutrophils segment, lymphocytes, monocytes, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, alanine aminotransferase (ALT), aspartate aminotransferase (AST), C-reactive protein (CRP), urea, and creatinine were found to be significantly associated with severity differences (p < 0.05). Moderate-severe symptoms of COVID-19 also shown to have suggestive pneumonia findings on chest X-ray findings. Patients with asymptomatic-to-mild symptoms had significantly (p < 0.001) higher recovery rate, shorter hospital stay, less intensive care unit (ICU) admission, and had more vaginal delivery. Neonates from mother with mild symptoms also had significantly (p < 0.001) higher survival rate, higher birth weight, and higher APGAR score. Conclusion(s): Several laboratory and radiology components, as well as maternal and neonatal outcomes are related to the severity of COVID-19 in pregnant women in Indonesia.Copyright © The Author(s). 2023.
RESUMEN
Background: Pregnant women infected with SARS-CoV-2 experienced increased pro-inflammatory cytokines, including TNF-alpha, resulting in a cytokine storm condition. This study aimed to compare TNF-alpha levels between pregnant women infected and not infected with COVID-19 in the third trimester.Method: This observational research was conducted with cross sectional design. Our study included pregnant women who came to the delivery room/inpatient at Dr. Soetomo General Hospital Surabaya before or during labor between May and June 2021. The inclusion criteria were third trimester gestational age or >28 weeks with SARS-RT-PCR nasopharyngeal swab result. The exclusion criteria were all significant pregnancy complications. The pregnant woman coming to the delivery room will be screened for COVID-19, and blood samples will be examined using the flow cytometry method for the cytokine Th1: TNF-alpha.Result: There were no significant differences in TNF-alpha levels in pregnant women who were infected and not infected with COVID-19 (median 3.42 (7.24) pg/ml vs. 2.70 (3.06) pg/ml. p=0.138). There was also no significant difference in TNF-alpha levels in pregnant women with symptomatic vs. asymptomatic COVID-19 infection (3.21(3.97) vs. 2.41(2.71) pg/ml;p=0.314).Conclusion: This study revealed no significant difference in TNF-alpha serum level between SARS-CoV-2 infected pregnant women with normal pregnant women.
RESUMEN
Introduction: Pregnant women infected with SARS-CoV-2 experienced increased pro-inflammatory cytokines, including TNF-alpha, resulting in a cytokine storm condition. This study compares TNF-alpha levels between pregnant women infected and not infected with Covid-19 in the 3rd trimester. Methods: This observational research was conducted with cross sectional design. Our study included pregnant women who came to delivery room/inpatient at RSUD Dr. Soetomo Surabaya before or during the labor period between May and June in 2021. The inclusion criteria were 3rd trimester gestational age or > 28 weeks with SARS-RT-PCR nasopharyngeal swab result. The exclusion criteria were all significant pregnancy complications. The pregnant woman coming to the delivery room will be screened for COVID-19, and blood samples will be examined using the flow cytometry method for the cytokine Th1: TNF-alpha. Results: There were no significant differences in TNF-alpha levels in pregnant women who were infected and not infected with COVID-19 (median 3.42 (7.24) pg/ml vs. 2.70 (3.06) pg/ml. p=0.138). There were also no significant differences in TNF-alpha levels in pregnant women with symptomatic vs. asymptomatic COVID infection (3.21(3.97) vs. 2.41(2.71) pg/ml;p=0.314). Conclusion: This study revealed no significant difference in TNF-alpha serum level between SARS-CoV-2 infected pregnant women with normal pregnant women.
RESUMEN
Background: The emergency, labor and delivery conditions in obstetric cases need a clinical decision in a timely manner. The identification of Covid-19 especially in asymptomatic obstetric cases with ease and rapid antibody test need further investigation. Objective: To analyze the usability and performance of rapid antibody test in obstetric cases. Methods: Case control study using medical record on Covid-19 obstetric cases over 9 months with paired nasopharyngeal reverse transcriptase polymerase chain reaction severe acute respiratory syndrome coronavirus 2 and rapid antibody test results. Results: There were 92 Covid-19 obstetric cases (incidence: 17.4%) and 210 reactive rapid antibody test (seroprevalence: 39.6%). The sensitivity, specificity, positive predictive value and negative predictive value of rapid antibody tests was 89%, 24%, 40%, 80%. Symptomatic cases have lower sensitivity (73% vs. 96%) and higher specificity (48% vs. 20%). The presence of Covid-19 symptoms (p<0.05) and reactive rapid antibody test (p<0.001) were associated with Covid-19. Rapid antibody test will identify larger Covid-19 obstetric cases compare with the presence of symptom only (89.4% vs. 27.7%. Conclusion: Screening by rapid antibody test had a high sensitivity but low specificity. This test will identify more Covid-19 cases compared by symptoms only due to majority asymptomatic obstetric cases. This simple, cheap and rapid antibody test still has a place in initial screening to help identify Covid-19 in areas with widespread transmission and has limited capacity to carry out universal screening.
RESUMEN
Background: Covid-19 infection in vulnerable obstetric patients still requires a lot of re-search, especially in developing countries to help determine the best policy to manage it. Objective: To analyze the characteristic of Covid-19 infection in obstetric patients. Methods: In an East Java tertiary Covid-19 referral hospital, a case control analysis was conducted using medical records on obstetric cases of Covid-19 infection from March until November 2021. Results: Covid-19 was identified in 109 cases (9.3%) from 1170 patients who came to our obstetric room. Majority came in pregnancy state with 76% and had delivered 93.6%. Most patients were as-ymptomatic (68.8%) with minimal contact history (2.8%). Comorbidity found in 41.3% cases, obesity and hypertension in pregnancy dominated the cases. Symptomatic cases were associated with lower gestational age (p=0,005) and birthweight (p=0,015), low lymphocyte count (p=0,006), abnormal chest X-Ray (p<0,001), intensive care admission (p=0,002) and maternal death (p<0,001), while asymptomatic cases were associated with more reactive antibody test (p=0,002). Conclusion: There were a high number of Covid-19 obstetric cases with the majority as-ymptomatic and came for delivery. Significantly higher reactive antibody tests in asymptomatic cases may aid Covid-19 identification. Covid-19 symptoms should be given more consideration, because they are linked to a lower gestational age, birth weight, poor clinical parameters, the need for intensive care, and maternal mortality. © 2021, Yerevan State Medical University. All rights reserved.
RESUMEN
Background: Covid-19 infection in vulnerable obstetric patients still requires a lot of research, especially in developing countries to help determine the best policy to manage it. Objective: To analyze the characteristic of Covid-19 infection in obstetric patients. Methods: In an East Java tertiary Covid-19 referral hospital, a case control analysis was conducted using medical records on obstetric cases of Covid-19 infection from March until November 2021. Results: Covid-19 was identified in 109 cases (9.3%) from 1170 patients who came to our obstetric room. Majority came in pregnancy state with 76% and had delivered 93.6%. Most patients were asymptomatic (68.8%) with minimal contact history (2.8%). Comorbidity found in 41.3% cases, obesity and hypertension in pregnancy dominated the cases. Symptomatic cases were associated with lower gestational age (p=0,005) and birthweight (p=0,015), low lymphocyte count (p=0,006), abnormal chest X-Ray (p<0,001), intensive care admission (p=0,002) and maternal death (p<0,001), while asymptomatic cases were associated with more reactive antibody test (p=0,002). Conclusion: There were a high number of Covid-19 obstetric cases with the majority asymptomatic and came for delivery. Significantly higher reactive antibody tests in asymptomatic cases may aid Covid-19 identification. Covid-19 symptoms should be given more consideration, because they are linked to a lower gestational age, birth weight, poor clinical parameters, the need for intensive care, and maternal mortality.
RESUMEN
Background: COVID-19 identification in obstetric emergency cases with limited resources is problematic, particularly in asymptomatic cases. Aim: To examine the screening strategies of COVID-19 obstetric emergency cases in low-resource health care settings. Method: A retrospective cohort design was carried out on patients with COVID-19 positive screening results. It was assessed based on symptoms, contact history, lymphocytopenia, chest X-rays, and rapid antibody tests compared to RT-PCR results SARS-COV-2. Result: Out of the 190 cases that came to the delivery room, the staff suspected 69 COVID-19 cases (36.3%) through the first screening protocol. Positive SARS-COV-2 RT-PCR was found in 23 cases with a majority asymptomatic (52.2%). The percentages of sensitivity and specificity from the parameters as follow: 48% and 74% in COVID-19 symptoms (febris or respiratory symptoms);9% and 100% in contact history;22% and 83% in lymphocytopenia;52% and 48% in chest x-ray;78% and 30% in rapid antibody test. Rapid antibody tests have the highest sensitivity to increase the identification of 12 asymptomatic cases. Conclusion: Other screening beyond symptoms and contact history such as lymphocytopenia, chest x-ray, and rapid antibody test can improve the identification, especially for asymptomatic cases in areas with the limited testing ability and high Covid-19 transmission. © 2021 Lahore Medical And Dental College. All rights reserved.