A Review Study on the Neonatal Outcomes of Pregnant Women with COVID-19.

COVID-19 is a fatal respiratory disease caused by a novel coronavirus that quickly became a pandemic. Pregnant women and neonates are two vulnerable groups in COVID-19 infections because the immune system weakens during pregnancy. The present review study was conducted to investigate the rate of vertical transmission in infants born to women with COVID-19 infections and to describe the characteristics of the affected infants. We conducted a search of the various scientific databases using relevant keywords. All English-language studies involving neonates born to women who had COVID-19 infections were included. The main outcomes were rates of vertical transmission and the characteristics of the affected newborns. Out of 13 selected studies, 103 newborns were involved. The rate of vertical transmission was 5.4%. Of the five infected newborns, four were full-term and one was preterm. All were born by Cesarean section. The clinical symptoms were vomiting, fever, lethargy, shortness of breath, and cyanosis. In four newborns, a chest x-ray showed evidence of pneumonia. The most common laboratory finding was leukocytosis and elevated creatine kinase levels. One newborn needed mechanical ventilation. All newborns recovered and were discharged. The findings of this review study showed that the prognosis of newborns of infected mothers was satisfactory, and clinical symptoms of infected neonates did not differ from adults and were nonspecific. Due to the low amount of data regarding this field, further studies with higher sample sizes are required for more definitive conclusions.

The 2019 Novel Coronavirus Disease in Pregnancy: A Systematic Review.

In December 2019, a respiratory disease caused by a coronavirus called SARS-CoV-2 (COVID-19) began in Wuhan, China, and quickly became a pandemic. In such situations, pregnant women are suspected of being among the vulnerable groups. The aim of this study was to report clinical symptoms, laboratory findings, and obstetrical complications, maternal, fetal, and neonatal complications of COVID-19 infection in pregnant women. We searched the Cochrane library, MEDLINE/PubMed, and Web of Sciences from their inception to April 5, 2020. Any study involving pregnant women with COVID-19 which evaluated the effect of the disease on pregnancy outcomes and fetal and neonatal complications was included in the study. The outcomes were the symptoms and laboratory findings, obstetrical complications, mode of delivery, and maternal, fetal, and neonatal complications. The search resulted in 69 titles and abstracts, which were narrowed down to 12 studies involving 68 women. The three most common symptoms of patients were fever, cough, and fatigue. The most common laboratory findings were an increase in C-reactive protein (CRP) and lymphopenia. The most common obstetrical complication was preterm labor (33.3%). No maternal deaths were reported. The Cesarean section rate was 83.3% and the vertical transition rate was 2.23%. The findings showed that the clinical symptoms and laboratory measures of pregnant women affected by COVID-19 did not differ from the general population. In general, the prognosis of mothers who suffered from COVID-19 and their newborns was satisfactory. However, there is a need for further rigorous studies to confirm these findings as the pandemic progresses.

A Systematic Review and Meta-Analysis of the Effect of Acupressure on Relieving the Labor Pain.

BACKGROUND: Numerous studies have been conducted on the effect of acupressure on labor pain, some of which have reported conflicting results. Thus, the present study was performed to critically review the previous studies related to the effect of acupressure administered during labor for relieving labor pain. MATERIALS AND METHODS: In this study, databases of the Cochrane Central Register of the Controlled Trials, PubMed/MEDLINE, Scopus, and Web of Science were searched from their establishment until November 5, 2019. All the Randomized Controlled Trials (RCTs) that had compared the use of acupressure with either placebo or nonintervention for relieving the labor pain were included in the study. Meta-analysis was performed using the Comprehensive Meta-Analysis (CMA) software Version 2. The random-effects model was used for pooling the effect sizes across the included studies. The p value <0.05 was considered as statistically significant. RESULTS: Totally, 5853 primary papers were identified in the search, which were narrowed down to 22 studies. The results of meta-analysis showed that the acupressure decreased the labor pain in the intervention group vs. control (-1.67 [-2.29 to -1.05], z = -5.25, p < 0. 001) (Q-value = 788.98, p < 0.001, I-squared = 96.83). No publication bias was found in the included studies (Egger's regression intercept = -1.02, p = 0.76). CONCLUSIONS: Although the findings of this meta-analysis showed that the acupressure significantly reduced the labor pain during the active phase of labor compared to the nonintervention or placebo; considering that the quality of the included studies was generally moderate, rigorous RCTs with better design and higher quality are needed to obtain definitive conclusions.

Effect of the Mixed Herbal Medicines Extract (Fennel, Chamomile, and Saffron) on Menopause Syndrome: a Randomized Controlled Clinical Trial.

Introduction: Menopause is the transition from the reproductive phase of a woman to the non-reproductive. It may impair quality of life. The study aims to determine the effectiveness of mixed herbal medicines on menopause symptoms Methods: A randomized, triple-blind, clinical trial and placebo-controlled study on 120 peri-menopausal women aged 45-65 years for 12 weeks. All participants took herbal extracts drops orally daily and randomly allocated into four groups: placebo (C), A (250 mg chamomile, 30 mg fennel, 15 mg saffron), B (1000 mg, 120 mg, 60 mg), and D (500 mg, 60 mg, 30 mg). Primary outcome was the mean change in scores of the menopause rating scale that evaluates 11 symptoms. Results: The median (IQR) physical score significantly reduced from 8.5(4) to 2(3), in psych score reduced from 12(4) to 2 (2) and in urogenital score reduced from 6.5(3) to 3(2) in group B. In group D physical score decreased from 12(6) to 8(4), in psychological score reduced from12 (3) to 8(4) and urogenital score reduced from 7.5 (3) to 8(3) at week 12. No significant differences in group A and C. With comparison the scores of physical, psych and urogenital domain of MRS questionnaire in 1th ,6th and 12th, no significant difference within group A and C were seen, but statistically significant difference was within group B (p<0.001) and D (p<0.001) in all weeks. The effect size was 0.92. Conclusion: A 12 weeks extracts treatment, there were significant improvement in physical, psychological and urogenital domains in group B.

No Differences in Hematological Parameters of Fasting and Non-Fasting Pregnant Women Three Months after Ramadan.

Introduction: Ramadan is a holy month in the Islamic calendar. Ramadan fasting is a religious obligation for all healthy adult Muslims. Many pregnant Muslim women choose to fast during Ramadan while others prefer not to do so. The aim of this study was to compare the basic hematological parameters of fasting and non-fasting pregnant women 3 months after Ramadan. Materials and methods: In this case-control study, 3 months after the end of Ramadan, the concentrations of basic hematological parameters in 200 healthy pregnant women with a previous history of fasting (n = 100) and non-fasting (n = 100) were measured. Results: The results showed that the fasters and non-fasters were similar in maternal age, gestational age, gravidity, pre-pregnancy weight, and maternal weight at enrollment. There were no statistically significant differences between the mean of hemoglobin (12.34 ± 1.15 g/dL vs 12.60 ± 1.11 g/dL, p = 0.10) and hematocrit (36.39 ± 2.79 % vs 36.27 ± 3.14 %, p = 0.77) in the fasting and non-fasting groups, respectively. In addition, no statistically significant differences were observed between the two groups when other hematological parameters were compared (p >0.05). Conclusion: Although the immediate effects of Ramadan fasting on hematological parameters are not known, this study concluded that partial fasting during Ramadan from a hematological point of view is of no concern for pregnant women 3 months after the end of Ramadan.

Meta-analysis of the effect of acupressure on duration of labor and mode of delivery.

BACKGROUND: Acupressure is increasing in popularity as an alternative treatment in obstetrics and gynecology. OBJECTIVES: To summarize and assess evidence regarding the effects of acupressure on duration of labor and mode of delivery. SEARCH STRATEGY: Four major databases and Google Scholar were searched using terms related to labor and acupressure, without language restrictions, up to November 2015. SELECTION CRITERIA: Randomized controlled trials were included if they examined the effect of acupressure at any acupoint during childbirth on duration of labor and/or mode of delivery. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data. The outcome measures were duration of labor and mode of delivery. Random-effects models were used to pool results. MAIN RESULTS: Thirteen studies were included in meta-analyses. Acupressure increased the chance of vaginal delivery when compared with placebo/no intervention (odds ratio [OR] 2.329, 95% confidence interval [CI] 1.348-4.024, P=0.002; risk difference [RD] 8.9%, 95% CI 2.7%-15.0%, P=0.005). Acupressure decreased the duration of the active phase by 1.310 hours (95% CI -1.738 to -0.882; P<0.001) and the second stage of labor by 5.808 minutes (95% CI -1.615 to -0.807; P<0.001). CONCLUSIONS: Acupressure could have a role in reducing the rate of cesarean delivery and decreasing the duration of labor in parturient women. However, there is a need for more reliable randomized controlled trials.