SARS-CoV-2 in pregnancy: characteristics and outcomes of hospitalized and non-hospitalized women due to COVID-19.

BACKGROUND: There is little evidence about how novel coronavirus (SARS-CoV-2) affects pregnant women and their newborns. Comparisons with other members of the coronavirus family responsible for severe acute respiratory syndrome (SARS) have been done to predict maternal and neonatal outcomes; however, more information is required to establish clinical patterns, disease evolution and pregnancy prognosis in this group of patients. METHODS: This paper is reporting a series of 91 women diagnosed with SARS-CoV-2 infection during pregnancy and puerperium. The analysis showed that 40 patients developed pneumonia, bilateral in most cases, with a 46.2% rate of hospitalization and 4 patients requiring intensive care unit (ICU) admission. In confront with previous publications, we have found a higher rate of coronavirus disease (COVID-19) severe forms, even when compared to non-pregnant women with the same baseline characteristics. We have analyzed the demographic characteristics, pregnancy-related conditions and presenting symptoms to identify features that could determine which patients will need hospitalization because of COVID-19 (Group 1-G1) and those who not (Group 2-G2). We have found that obesity and Latin-American origin behave as risk factors: OR: 4.3; 95% CI: 1.4-13.2, and OR: 2.6; 95% CI: 1.1 - 6.2, respectively. Among the 23 patients that delivered with active SARS-CoV-2, the overall rate of cesarean section (CS) and preterm birth were 52.2% and 34.8%, respectively, but we observed that the rate of CS was even higher in G1 compared to G2: 81.8% versus 25%, p = .012. However, prematurity was equally distributed in both groups and only one preterm delivery was determined by poor maternal condition. There were no deaths among the patients neither their newborns. CONCLUSION: In conclusion, the results of our cohort reveal that SARSC-CoV-2 infection may not behave as mild as suggested during pregnancy, especially when factors as obesity or Latin-American origin are present. No evidence of late vertical transmission was noticed but prematurity and high CS rate were common findings, although it is difficult to establish any causality between these conditions and COVID-19. Further evidence is required to establish if pregnancy itself can lead to severe forms of COVID-19 disease and whether risk factors for the general population are applicable to obstetric patients. Until larger studies are available, pregnant women should be monitored carefully to anticipate severe complications.

Puerperal curettage after cesarean section delivery.

OBJECTIVE: To analyze the clinical situations that leads us to carry out curettage after cesarean section, the ultrasound prior surgery, intraoperative, and pathological findings. METHODS: A retrospective study of all cases of postpartum curettage after cesarean section in a level 3 maternity unit. RESULTS: There were 42 curettages to women with cesarean sections (1.6% of all cesarean sections). The indications for curettage were: fever: 21, methrorraghia: 11, and residual trophoblastic tissue: 10. In the previous ultrasound, all indicated curettages for retained trophoblastic tissue showed it, and in a lower proportion those indicated for fever (66.6%) or methrorraghia (22.2%). A total of fourteen curettages (35%) were performed without suspect image of retained tissue, and in all cases the surgeon described to obtain small amount of tissue. From material submitted to pathologic evaluation trophoblastic tissue was found in 64.7%, and there were no differences as curettage indication. CONCLUSIONS: When the previous ultrasound do not showed retained tissue, the surgeon did not remove retained material. When extracted there were always in small amounts. Therefore, it could be concluded that after cesarean section the curettage should be indicated only in the presence of evident ultrasound image of retained products.

Agresión y dependencia en un grupo de niños asmáticos y un grupo testigo / Dependence and aggression in boys asthmatics and one control group

Con el interés de conocer los factores que influyen en la psicodinamia del niño asmático y no asmático se estudió una muestra de 60 sujetos: un grupo compuesto por 30 niños con diagnóstico de asma bronquial y que pertenecian a la consulta externa del Instituto Nacional de Pediatría; Instituto Nacional de Enfermedades Respiratorias y Hospital Central Sur de Alta Concentración de PEMEX. Otro grupo de 30 niños sin diagnóstico de asma de escuelas primarias de la Secretaría de Educación Pública. A ambos grupos de les aplicó la prueba de apercepción temática versión humana (CAT-H) y su suplemento (CAT-S). El análisis de datos, se realizó de forma cuantitativa y cualitativa; para la primera se utilizó la escala nominal, con objeto de aplicar la chi cuadrada (X²); obteniéndose así las frecuencias de los puntajes de las pruebas aplicadas en los grupos. A partir de las frases utilizadas por los sujetos en sus historias de desarrolló el análisis cualitativo. Finalmente, se observó que no existen diferencias estadísticamente significativas en el factor dependencia (p .05), lo cual sugiere que el niño asmático es un niño con falta de seguridad en sí mismo, con tendencia a buscar la ayuda de los demás