Maternal and Neonatal Outcomes Associated With COVID-19 Infection in Pregnant Mothers Admitted in Tertiary Care Hospital in Central State of India.

In spite of various reports on perinatal outcomes of coronavirus disease 2019 (COVID-19) during pregnancies, the effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on unborn babies and pregnant mothers are still mysterious. The goal of our research is to examine the perceived fetomaternal outcomes of COVID-19 during pregnancy. A total of 396 pregnant women were admitted to the Department of Gynaecology and Obstetrics, Pt. JNM Medical College, Raipur, Chhattisgarh, India, during the period from July 20, 2020 to January 6, 2021. The presence of SARS-CoV-2 in different biological samples was recorded via positive quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) test results. All the newborns delivered from the infected pregnant mothers were tested as RT-PCR negative. Negative findings of RT-PCR for respiratory swabs of newborns, amniotic fluid, placental tissue, breast milk, vaginal swabs, and cord blood indicated no transmission of the virus from mother to baby. However, maternal outcomes, such as hospitalization (46.96%), preeclampsia (13.88%), pre-term birth (14.39%), prelabor rupture of membranes (PROM) before 34 weeks (3.78%), PROM before 37 weeks (2.77%), vaginal bleeding (4.29%), postpartum hemorrhage (2.52%), pregnancy-induced hypertension (1.51%), and neonatal outcomes such as low birth weight ≤1.5 kg (6.59) and 1.6-2.4 kg (39.34%), intrauterine deaths (IUD) (0.50%), fetal distress (22.33%), NICU admission (5.58%), meconium-stained liquor (14.46%), diarrhea (0.25%), and low APGAR score 4-6 at 1 min (20.54%), were observed. The results of the present study indicate that SARS-CoV-2-induced complications during pregnancy must be taken seriously. Intrauterine fetal deaths occurred at lower rates. There is no substantial proof of vertical perinatal transmission of the virus, as none of the neonates had tested positive for COVID-19.

Placental Histopathology in COVID-19-Positive Mothers.

The placenta is a captivating multifunctional organ of fetal origin and plays an essential role during pregnancy by intimately connecting mother and baby. This study explicates placental pathology and information about 25 placentas collected from the mothers infected with novel coronavirus (SARS-COV-2). So far, congenital transmission of SARS-CoV-2 seems to be remarkably uncommon in spite of many cases of COVID-19 during pregnancy. Out of the 25 placental tissue samples collected, none has shown gene expression of SARS-CoV-2 when confirmed by RT-PCR. At the same time, nasal and throat swab samples collected from newborns of SARS-CoV-2-positive mothers correspondingly tested negative by RT-PCR. The shielding properties of placental barriers against viral infections from mothers to newborns remains a mystery. Major histopathological findings have been recorded as choriodecidual tissue with necrosis, intramural fibrin deposition, chorionic villi with fibrosis, and calcification. Moreover, although recent findings are insufficient to prove direct placental transmission of COVID-19, the abundance of angiotensin-converting enzymes-2 (ACE-2) on the placental surface could potentially contribute to unpleasant outcomes during pregnancy as SARSCoV-2 gains access to human cells via ACE-2. Finally, the significance of these findings is vague and needs further study.

The Outcome of Pregnancy Among Tobacco Users in Tertiary Care Hospital of Chhattisgarh Province of India.

BACKGROUND: Tobacco use is responsible for numerous adverse pregnancy outcomes for females and their infants. The aim of this study was to explore the adverse outcome of tobacco use among pregnant females. METHOD:  A cross-sectional study was conducted on 1250 females in the third trimester of pregnancy from April to June 2022, which were exposed to tobacco use in the form of gudaku, tobacco chewing, gutka, or smoking. Complications and outcomes during and after pregnancy were recorded based on self-administered questionnaires. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) (IBM SPSS Statistics, Armonk, NY) software version 20.0 for categorical data, frequencies (n) and percentages (%) were calculated, and the chi-square test was used for determining intergroup differences. RESULTS:  Out of 1250 females, tobacco exposure was present among 429 (34.3%), and 821 (65.7%) had no tobacco exposure. Of 429, 36.10% of females complained about complications such as abortion (1.60%), antepartum hemorrhage (0.90%), congenital anomaly (0.20%), infertility (1.20%), intrauterine fetal death (IUFD) (0.50%), intrauterine growth restriction (IUGR) (0.90%), oligohydramnios (OLIGO) (3.30%), preterm labor (18.40%), premature rupture of membrane (6.30%), and anemia (2.80%), which were slightly higher than the females with no tobacco exposure. In tobacco users, obstructive complications were found to be significant with a p value of 0.0036. CONCLUSION: Our study concluded that tobacco use could have an adverse effect on their fetus and infants, as well as the pregnant females themselves. Policymakers need to ensure effective strategies that pregnant females, their partners, and close relatives need to have enough knowledge to avoid potential risks.

Single Loading Low Dose MgSo4 Regimen: A Simple, Safe and Effective Alternative to Pritchard's Regimen for Indian Women.

INTRODUCTION: Magnesium sulphate is the anticonvulsant of choice in prevention and control of eclamptic convulsions. Pritchard's regimen is the most popular time-tested regimen used. However, owing to concerns of toxicity, several low dose regimens have been introduced considering the lower body mass index of Asian women. AIM: To compare the efficacy and safety of a single loading low dose MgSo4 regimen with the Pritchard's regimen. MATERIALS AND METHODS: Seventy cases of eclampsia and imminent eclampsia were allocated to the control and study groups each. The former received the Pritchard's regimen while the latter was treated with single loading low dose of magnesium sulphate. Recurrent convulsion rates, maternal and perinatal outcomes of both regimens were evaluated and compared using unpaired t-test and Chi-square test for continuous and categorical variables, respectively. RESULTS: The mean serum magnesium levels were significantly lower in the study group at 30 minutes and 4 hours of initiation of therapy. The single loading low dose regimen was equally efficacious in prevention (96.6% vs 100%, p = 0.934) and control (97.6% vs 97.8%, p = 0.358) of eclamptic fits as compared to the Pritchard's regimen. The feto-maternal outcomes were also comparable. CONCLUSION: The single loading low dose MgSo4 regimen is an effective and safe alternative to the Pritchard's regimen, especially tailored to the small built Indian women.

Assessment of Serum Vascular Endothelial Growth Factor Levels in Pregnancy-Induced Hypertension Patients.

Objective. The objective of the study was to assess the serum vascular endothelial growth factor (VEGF) levels in peripheral blood of patients with pregnancy-induced hypertension (PIH) and find association between serum VEGF levels and PIH. Methods. Thirty-five PIH subjects, 35 normal pregnant females, and 20 normal healthy females were included in the study. Detailed history, clinical examination, and relevant biochemical parameters were assessed; serum VEGF levels were estimated using Double-antibody enzyme-linked immunosorbent assay. Results. The study groups were found to be age matched (p = 0.38). VEGF level in the pregnancy-induced hypertensive group (median = 109.19 (3.38 ± 619)) was significantly higher than the normal pregnant (median = 20.82 (1.7-619)) and control (median = 4.92 (1.13-13.07)) group and the difference between these three groups was significant (p < 0.0001). The 3 groups are found to be significantly different in terms of RBS (p = 0.01), urea (p < 0.0001), creatinine (p = 0.0005), AST (p = 0.0032), ALT (p = 0.0007), total protein (p = 0.0004), albumin (p < 0.0001), calcium (p = 0.001), and sodium (p = 0.02), while no statistically significant difference was found between total bilirubin (p = 0.167), direct bilirubin (p = 0.07), uric acid (p = 0.16), and potassium (p = 0.14). Conclusion. Significantly higher levels of serum VEGF were noted in PIH subjects compared to normal pregnant and control subjects.

Misoprostol vs mifepristone and misoprostol in second trimester termination of pregnancy.

OBJECTIVE: The present study was conducted with the aim to assess and comparatively evaluate the safety and efficacy of misoprostol alone and mifepristone with misoprostol for second trimester termination of pregnancy. METHODS AND MATERIALS: The study was conducted on 200 selected cases, divided in two groups of 100 cases each. In the study group mifepristone was given 200 mg 12 h before intravaginal insertion of 600 µg of misoprostol followed by 400 µg every 3 h up to a maximum of 5 doses or until the abortion occurs, whichever occurs early. In the control group only misoprostol was inserted in the same dose regime. The results were analyzed. RESULTS: The success rate in both regimens was 100%. Mean induction abortion interval from the insertion of the first misoprostol tablet was significantly shorter in the mifepristone pretreated group 6.72 ± 2.26 h as compared to 12.93 ± 3.4 h in the misoprostol alone group (P < 0.001). The mean blood loss was slightly higher in the control group. The mean dose of the misoprostol required was significantly less in the study group 1,186 ± 291.64 µg as against 1,736 ± 320.20 µg (P < 0.001). The side effects observed in both the groups were similar mainly nausea vomiting, fever, abdominal cramps. CONCLUSION: Pretreatment with mifepristone 12 h before intravaginal misoprostol significantly improves the induction abortion interval.