COVID-19 during pregnancy one year on - what lessons did we learn?

It is now more than a year since the first case of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) disease (COVID-19) was diagnosed in China. Current data suggest that pregnancy may not only be a risk factor for the development of severe forms of COVID-19, but that the SARS-CoV-2 infection may impact on common pregnancy complications as well. Healthy pregnant women are likely to be more susceptible to viral infection and therefore are at higher risk of developing severe COVID-19 because of adaptive changes in their immune and respiratory systems, their altered endothelial cell functions, and modified coagulation responses. However, studies show that most pregnant women diagnosed with COVID-19 developed mild-to-moderate symptoms and only a few of them have required critical care facilities. In contrast with preeclampsia, preeclampsia-like syndrome can resolve spontaneously following recovery from severe pneumonia and may not be an obstetric indication for delivery. Preeclampsia-like syndrome is one symptom of COVID-19, but its cause is different from obstetric preeclampsia and therefore not connected with placental failure. Vertical transmission of SARS-CoV-2 infection is rare but can probably occur. No evidence has been found that COVID-19 developed during pregnancy leads to unfavourable outcomes in the fetus. Most health authorities indicate that standard procedures should be used when managing pregnancy complications in asymptomatic women with confirmed SARS-CoV-2. Vaccines should not be withheld from pregnant and lactating individuals who otherwise meet the vaccination criteria.

C-reactive protein as the indicator of severity in ovarian hyperstimulation syndrome.

BACKGROUND: To establish correlations between laboratory findings and clinical symptoms of moderate and severe ovarian hyperstimulation syndrome (OHSS). DESIGN: A retrospective study. SETTING: Department of obstetrics and gynecology, public clinical hospital. PATIENTS: Nineteen women admitted to the public hospital with a diagnosis of OHSS. The procedure of controlled ovarian stimulation (COH) was performed in the private assisted reproductive technology centre. METHODS: Blood samples were collected, ultrasound examination of ovaries, abdominal circumference measurement were performed, intravenous crystalloids, plasma expanders such colloids and albumin were given. Correlations between mean laboratory results (haematocrit, c-reactive protein (CRP), white blood count, serum protein, serum albumin), ovarian size in ultrasound examination, abdominal circumference, and amount of albumin and hydroxyethyl starch transfused to the patient were assessed. RESULTS: Significant correlation was observed between CRP concentration and abdominal circumference measured when the patient was admitted to the department, between CRP concentration and ovarian size measured during ultrasound examination at admission and between CRP concentration and body weight. CONCLUSIONS: CRP can be a potential candidate to an indicator of OHSS severity.