Accuracy of screening methods of COVID-19 in pregnancy: a cohort study.

BACKGROUND: All pregnant women in labor should be universally screened for Coronavirus Disease 2019 (COVID-19) during pandemic periods using reverse transcriptase polymerase chain reaction (RT-PCR) test. In many low-middle income countries, screening method was developed as an initial examination because of limited availability of RT-PCR tests. This study aims to evaluate the screening methods of COVID-19 accuracy in pregnant women. METHODS: We recruited all pregnant women with suspicion of COVID-19 from April to August 2020 at Airlangga University Hospital, Surabaya, Indonesia. The participant was divided into two groups based on RT-PCR results: COVID-19 and non-COVID-19 group. The proportion of positive signs and symptoms, rapid antibody test, abnormal findings in chest X-ray, and neutrophil to lymphocyte ratio (NLR) value were then compared between both groups. The sensitivity, specificity, positive predictive value (PPV), negative predictive values (NPV), and diagnostic accuracy (DOR) were calculated. RESULTS: A total 141 pregnant women with suspected COVID-19 cases were recruited for this study. This consist of 62 COVID-19 cases (43.9%) and 79 non-COVID-19 pregnant women (56.1%). The sensitivity, specificity, PPV, NPV, and diagnostic accuracy of each parameter are as follow: clinical sign and symptoms (24.19%, 75.95%, 3.92%, 96.11%, 65.87%), rapid antibody test (72.73%, 35.06%, 4.35%, 96.94%, 36.53%), chest X-ray (40.68%, 59.45%, 3.92%, 96.11%, 58.76%), and NLR >5.8 (41.38%, 72%, 5.66%, 96.80%, 70.81%). CONCLUSIONS: The use of combined screening methods can classify pregnant women with high-risk COVID-19 before definitively diagnosed with RT-PCR. This practice will help to reduce RT-PCR need in a limited resources country.

Clinical manifestations and pregnancy outcomes of COVID-19 in indonesian referral hospital in central pandemic area.

OBJECTIVE: s Data on the clinical manifestations and pregnancy outcomes of pregnant women with COVID-19 are limited, particularly in developing countries. The aim of this study was to analyze the clinical manifestations and pregnancy outcomes in COVID-19 maternal cases in a large referral hospital in Indonesia. METHODS: This study used a prospective cohort design and included all pregnant women with suspected COVID-19. Subjects were divided into COVID-19 and non-COVID-19 groups based on the results of real-time polymerase chain reaction (RT-PCR) for severe acute respiratory syndrome coronavirus 2. Clinical characteristics, laboratory results, and pregnancy outcomes were compared between the two groups. RESULTS: Of the 141 suspected maternal cases, 62 cases were COVID-19-confirmed (43.9%), while 79 suspected cases were negative (56.1%). The clinical manifestations and laboratory findings between the two groups were not significantly different (P>0.05). However, the maternal mortality directly caused by COVID-19 was significantly higher than that in the non-COVID-19 group (8.3% vs. 1.3%; P=0.044; odd ratio, 6.91; 95% confidence interval, 0.79-60.81). CONCLUSION: The clinical manifestations and laboratory results of suspected pregnant women with positive and negative RT-PCR COVID-19 results were similar. However, within the Indonesian setting, COVID-19 significantly increases the risk of maternal death through both direct and indirect factors.

Death of 43 Indonesian women with ovarian cancer: A case series.

BACKGROUND: Ovarian cancer is a gynecological cancer with a higher mortality than other gynecological cancers. CASE REPORT: There were 43 cases of Indonesian women who died of ovarian cancer in 2015-2017. Patients were first diagnosed at the age of 40-59 years (65.11%), of which had normal BMI (62.72%) and mostly in stage III (39.53%). The histology was 88.3% epithelial ovarian cancer with the most subtypes of mucinous carcinoma (25.5%). The majority were referral patients (62.7%), but due to its malignancy, many died before receiving ovarian cancer treatment (40.74%). Of the 43 patients, 17 patients received chemotherapy, and 10 patients received a combination of surgical therapy and chemotherapy. Most of the deaths were caused by primary disease (69.77%). Patients with stages III and IV, as well as patients receiving surgery or chemotherapy alone had shorter survival times. CONCLUSION: Most ovarian cancer patients are first diagnosed at stage III with the mucinous carcinoma subtype. Most deaths are caused by primary ovarian cancer. The therapy that provides the longest survival is a combination of surgery and chemotherapy.

A potential therapy of human umbilical cord mesenchymal stem cells for bone regeneration on osteoporotic mandibular bone.

OBJECTIVE: The aim of this study is to prove that human umbilical cord mesenchymal stem cell (hUCMSC) therapy on mandibular osteoporotic model is able to increase transforming growth factor-beta-1 (TGF)-ß1 expression, Runx2, and osteoblasts. MATERIALS AND METHODS: This research is true experimental posttest control group design. Thirty female Wistar rats were divided into 6 groups randomly, which consisted of sham surgery for control (T1), ovariectomy as osteoporotic group (T2), osteoporotic group injected with gelatine for 4 weeks (T3), 8 weeks (T4) injected with hUCMSC-gelatine for 4 weeks (T5) and 8 weeks (T6). All mice were presented for immunohistochemistry examination for TGF-ß1, Runx2, and histology for osteoblasts. RESULTS: The lowest level of osteoblast was osteoporotic group injected with gelatine in 4 weeks compared to other groups. There were increases of TGF-ß1, Runx2, and osteoblasts from osteoporotic group compared to osteoporotic post-hUCMSC-gelatine injection group. CONCLUSION: The hUCMSC has a high osteogenic effect and increases the osteoporotic mandibular bone regeneration on the animal model that is showed by the increase of the level of TGF-ß1, Runx2, and osteoblasts.