Comparative effect of calcium supplementation on the incidence of pre-eclampsia and eclampsia among primigravid women
Published on: 17th December, 2019
OCLC Number/Unique Identifier: 9272372141
Background: Pre-eclampsia is a frequent and serious pregnancy complication contributing for the increasing maternal morbi-mortality rates. This study was designed to evaluate the effect of calcium supplementation during pregnancy, on the incidence of pre-eclampsia and eclampsia among primigravid women.
Method: In a hospital-based, opened, randomized and controlled clinical trial carried out in the city of Yaounde, 70 women were randomized to either 1.5 g daily calcium supplements (n = 35) or vitamins at the same time (n = 35) from 20 weeks gestation till delivery. Were included all singleton healthy, primigravid women who offered their signed inform consent and were excluded, all women with any chronic condition. Primary outcomes were pre-eclampsia and eclampsia.
Results: No significant difference was observed between the two study groups with respect to the baseline characteristics obtained at enrollment. We recorded a sevenfold decrease in the incidence of preeclampsia in the calcium group (RR = 0.26, CI 0.06 – 0.44, p = 0.024). The onset of pre-eclampsia was delayed 3 weeks in the calcium group. Meanwhile the mean diastolic blood pressure at delivery was of no significant difference (p = 0.126), the mean systolic blood pressure at delivery however, presented a significant difference between both groups (p = 0.009).
Conclusion: A 1.5 g daily calcium supplementation of healthy normotensive primigravid women during pregnancy seems to be effective in reducing the incidence of pre-eclampsia.
Snake envenomation during pregnancy
Published on: 23rd December, 2019
OCLC Number/Unique Identifier: 9272371188
Background: We report our experience with management and treatment of pregnant women who were admitted at our institution for snake envenomation.
Methosd: We reviewed the charts and recorded the management, treatment, and outcome of 51 pregnant women admitted to our high-risk obstetric service with a diagnosis of snakebite.
Results: One patient experienced spontaneous abortion, 2 had intrauterine fetal death due to placental abruption, 2 delivered malformed babies, 1 had premature birth of twins with low birthweight. There were no maternal deaths.
Conclusion: Snake-venom poisoning in pregnancy is a complex medical emergency that involves complications at the site of the bite and may also involve dysfunction of multiple organ systems in both mother and fetus.
Oral Clindamycin and Metronidazole in the treatment of bacterial vaginosis in pregnant black women: Comparison of efficacy and pregnancy outcome
Published on: 10th January, 2020
OCLC Number/Unique Identifier: 9272372469
Bacterial vaginosis (BV) is associated with adverse pregnancy outcomes with various treatment options.
Objective: To compare the efficacy and effect on pregnancy outcome of Metronidazole and Clindamycin in women with bacterial vaginosis in Port Harcourt, Nigeria.
Methodology: Randomized controlled study of 136 pregnant women diagnosed with BV at the University of Port Harcourt Teaching Hospital. A structured proforma was used to obtain socio-demographic characteristics and other relevant data. Treatment was with either oral Metronidazole or oral Clindamycin for seven days. A secondary test and evaluation of the effect on adverse pregnancy outcomes were determined. Data analysis was done using the SPSS statistical package version 22.0
Results: BV prevalence was 23%, with similar cure rates with both medications. The failure rates of clindamycin and metronidazole were 10.4% and 13% respectively (p = 0.639). The mean gestational age at delivery in the metronidazole treated group was 38.67 weeks ± 1.69 compared to 38.68 weeks ± 1.64 in the oral clindamycin group (p = 0.96). Pre-labour rupture of membranes and preterm delivery rates with both medications were similar (p = 0.73; OR 1.3; 95% CI 0.3-4.9) and (p = 0.73; OR 1.3; 95% CI 0.3-4.9) respectively.
Conclusion: Both medications have comparable efficacy and similar pregnancy outcomes in the treatment of bacterial vaginosis in low-risk asymptomatic pregnant Nigerian women and thus can be used interchangeably.
Effectiveness of prenatal intensive counselling on knowledge, attitude and acceptance of post placental intrauterine contraceptive device among mothers
Published on: 27th March, 2020
OCLC Number/Unique Identifier: 8573348290
Introduction: Contraception is a method or device used to prevent pregnancy. In the first year of postpartum period around 65% of women are having unmet need of family planning. Post Placental Intrauterine Contraceptive Device is not only advantageous to the women and couples; even the service providers benefit from PPIUCD. PPIUCD insertion on the same delivery table saves time and separate clinical procedure is not required.
Methodology: The Quantitiative Pre-Experimental One Group Pre and Post Test research design was used. 70 Antenatal mothers were selected by using Purposive Sampling Technique who fulfilled the inclusion criteria and who were available during the period of data collection at selected hospital, Puducherrry. Data was collected by using Structured Interview Schedule.
Result: The Pre test mean score of Knowledge was 9.98 ± 2.38 and Post Test mean score of Knowledge was 14.91 ± 1.15. The calculated paired‘t’ value was (-20.82) found to be statistically significant at p < 0.001 level. The Pretest mean score of Attitude was 34.67 ± 5.67 and Post test mean score of Attitude was 44.27 ± 4.70. The calculated paired‘t’ value was (-17.25) found to be statistically significant at p < 0.001 level. The Pretest mean score of Acceptance was 0.11 ± 0.320 and Post Test mean score of Acceptance was 0.29 ± 0.455. The paired‘t’ value of t = -3.778 found to be statistically significant at p < 0.001 level. The Demographic and Obstetrical Variables like age at marriage, previous childbirth and decision maker of family about family planning have shown significant association with Post Test level of Knowledge, Attitude and Acceptance of PPIUCD at p < 0.05 and p < 0.001.
Conclusion: The researcher concluded that Prenatal Intensive Counselling increases the mother’s Knowledge, Attitude and Acceptance of PPIUCD. So Prenatal Intensive Counselling on PPIUCD can be given to Antenatal Mothers during their antenatal visits to meet the unmet needs of family planning.
Trial of labor after cesarean outcomes with excessive gestational weight gain
Published on: 6th May, 2020
OCLC Number/Unique Identifier: 8601973455
The success of vaginal birth after cesarean section (VBAC) has been correlated with a variety of maternal characteristics such as age, ethnicity, and body mass index (BMI, calculated as weight in kilograms divided by height in meters squared). The patient’s BMI just prior to delivery has been shown to be a better prognostic indicator of success than pre-pregnancy BMI. Gestational weight gain was previously associated with a decreased rate of successful VBAC. More recent research has not supported such an association. The objective of our study was to further validate these findings with a larger population.
We performed a retrospective cohort study of women undergoing trial of labor after cesarean (TOLAC) at our institution from January 2010 to December 2019. Women were divided into three groups based on weight gain in pregnancy as compared to the American College of Obstetrics and Gynecology (ACOG) recommendations (i.e. < 25 pounds (lbs), 25-35 lbs, > 35 lbs). We further subdivided the pregnancies between term and preterm deliveries. The primary outcome was a successful VBAC. Of 1087 patients attempting a TOLAC, 772 (71%) were successful and 315 (29%) failed VBAC. When grouped according to ACOG weight gain recommendations, 303 (31%) women were below ACOG guidelines, 318 (33%) met guidelines, and 339 (35%) exceeded guidelines. There was no difference in the rate of VBAC success among the three groups. When counseling patients, providers should still promote healthy dietary habits but should not correlate excess weight gain with chance of TOLAC success.
Determinants of neonatal near miss among neonates admitted to Ambo University Referral Hospital and Ambo General Hospital, Ethiopia, 2019
Published on: 24th June, 2020
OCLC Number/Unique Identifier: 8625640828
Background: Neonatal Near-miss is defined as complications of neonates so severe as to be imminently life-threatening but survived due to chance or treatment. The number of neonates who survived morbidities were approximately 3 to 6 times greater than those who died. There was little evidence about neonatal near miss in Ethiopia. This study attempted to identify the determinants of neonatal near miss among neonates admitted to the Ambo University Referral Hospital and Ambo General Hospital.
Methods: Hospital-based quantitative unmatched case-control study was conducted at the Ambo University Referral Hospital and Ambo General Hospital from March 1 to 28, 2019. The respondents, 134 cases and 268 controls were recruited by simple random technique. Data were coded, entered and cleaned in EpiInfo version 7 and exported to SPSS. Both Bivariable and multivariable logistic regression was computed at 95% CI and the final model was checked by Hosmer and Lemeshow goodness -of-fit test. Multi collinearity and cofounders were not detected.
Result: Multivariate analysis showed that distance more than 15km away from health facilities [AOR=2.11, 95% CI: (1.09, 4.095)], Unwanted, and unplanned current pregnancy [AOR=3.71, 95% CI: (1.28, 10.79)], less than four Antenatal care visit [AOR=6.55, 95% CI: (3.07, 13.98)], Instrumental delivery [AOR=4.62, 95% CI: (1.78, 11.98)] were positively associated with Neonatal Near Miss. Whereas Term Neonates [AOR= 87%, 95% CI: (0.05, 0.32)], and Normal birth weight [AOR=91%, 95% CI: (0.03, 0.28)] were negatively associated with Neonatal Near Miss.
Conclusion: Distance from health facilities, Antenatal care visit, current pregnancy type, birth weight, gestational age and mode of delivery were determinants of Neonatal Near Miss. Therefore, providing adequate Antenatal services, health education and training is needed to improve neonatal health.
COVID-19 in pregnancy: Our experience at a tertiary maternity unit in France
Published on: 24th June, 2020
OCLC Number/Unique Identifier: 8625644678
Objectives: Our main objectives are to reveal the pregnancy and neonatal impacts of COVID-19 infection and to compare it to the results that are reported in the literature.
Methods and materials: The characteristics of the admitted pregnant patients COVID-19 positive with their initial presentation, course at the hospital, and short term follow-up are exposed. Correlation of the age and gestational age with the severity of the disease was calculated.
Results: Thirty five COVID-19 positive pregnant patients presented between the beginning of March and the end of April 2020. From 5 weeks till 41 weeks of gestation, all trimesters were included. The mean of age is 32 and the BMI equal 28.2. Associated comorbidities included not only diabetes and hypertension but also PCOS. The symptomatology was considered mild in most of the cases. The distribution of the symptoms included cough in 86%. 10 out of 35 delivered and cesarean was performed in 50% of the cases. The mean length of stay is 6 days. Neither maternal nor neonatal deaths occurred. There is a significant correlation between the age of the patient and the severity of the disease but this is not the case with gestational age.
Conclusion: Our results were comparable to the literature in terms of initial presentation, associated comorbidities and the length of stay. Despite the fact that the cesarean rate was high, it was far below that of the literature. More data is still needed about COVID-19 in pregnancy.
Evaluation of Single Bilateral Intratesticular Injection of Cetrimide for Nonsurgical Sterilization of Adult Male Albino Mice
Published on: 27th July, 2020
OCLC Number/Unique Identifier: 8650662346
Nonsurgical fertility control is increasingly advocated as more cost-effective than surgical sterilization to manage stray animal populations in a different part of the world. An experimental study was conducted from December 2018 to April 2019 at Mekelle University to evaluate the effect of single bilateral intratesticular injection of cetrimide 2% in adult albino mice. A total of 20 clinically healthy albino mice selected based on their age and sex and were divided randomly into five groups and evaluation was conducted for 30 days after intratesticular injection of cetrimide solution 2% at the dose rate of 5, 10, 15 and 20 mg per testis and for control 0.1 mL normal saline per testis per 100 g body weight were given. All albino mice were evaluated for 30 days at a fixed interval. Change in body weight, scrotal width, sexual behavior, and fertility performance was also assessed. On day 30, all albino mice were sacrificed for histopathological study. Means ± Standard deviation of the mean, one-way, and a mixed model ANOVA (for repeated measures) was used to summarize the data, determine the effects of group and time on bodyweight and scrotal width. The significant increase in body weight (p - 0.001) and significant reduction of scrotal width (p - 0.001) were noted in all cetrimide treated in comparison to control groups. In addition, there was a significant (p < 0.05) reduction of scrotal width in albino mice after intratesticular injection of cetrimide on day 1, 10, 15, 20, 25, and 30 with respect to their experimental groups. Testicular histology revealed that there were multinucleated giant cells in seminiferous tubules, derangement of tubular architecture along with infiltration of leucocytes and appearance of fibrous tissue were seen on testicular sections at a dose rate of 15 and 20 mg. Similarly, a significant change in the sexual behavior of the treated males and no pregnancy was detected on female albino mice after 21 days post-coital at 10, 15, or 20 mg cetrimide-treated males. In conclusion, a single bilateral intratesticular injection of cetrimide 2% at a dose of 15 and 20 mg might provide an effective way of sterilization and may be considered as an alternative to surgical castration in male animals. Besides, further assessment should be done in the future to identify the mechanism of infertility.
Hemorrhagic shock due to irreducible uterine torsion in a third trimester twin pregnancy: A case report
Published on: 7th July, 2020
OCLC Number/Unique Identifier: 8628624184
Uterine torsion is a rare life-threatening event that happens at any age or any gestational age. By definition, it consists of a rotation of more than 45 degrees around the long axis of the uterus. The reported cases have variable presentations. The uterine torsion can happen without any sequelae either for the fetus or the mother. However, fetal and maternal mortalities were also reported in such a case.
We hereby, report the case of a 29-year-old female patient, with previous four Normal Vaginal Deliveries, pregnant with twins, presenting at 36 weeks gestation with an irreducible uterine torsion at the third trimester of her pregnancy complicated by maternal and fetal deaths.
We concluded that the prognosis is improved as long as the management is done rapidly. More data is needed to know about the genetic predilection and the characteristics of imaging workup for a rapid preoperative diagnosis of this condition.
A case series review of patients with Thrombocytopenia and Absent-Radii syndrome (TARS) and their management during pregnancy
Published on: 12th August, 2020
OCLC Number/Unique Identifier: 8667871373
Bleeding diatheses due to platelet-related disorders can present challenges to treating clinicians especially in the context of peri- and post-partum patients in the obstetric setting. TARS is an inherited disorder characterised by reduced bone marrow platelet production, skeletal deformities affecting radii and other limbs; cardiac, renal, and other heterogeneous anomalies may occur. It is caused by co-inheritance of a microdeletion and a nucleotide polymorphism in the RBM8A gene on chromosome 1.
Bleeding phenotype is more severe than platelet numbers might predict especially in infants but improves with age. There is minimal literature regarding impact in pregnancy and puerperium.
We describe management of three pregnancies in the haematology-obstetrics clinic. As platelet counts normally decrease through pregnancy, close monitoring is required in TAR syndrome. No major bleeding was seen antenatally but two required platelet transfusion during labour. No other treatment definitely improves bleeding, although case reports of steroids claim variable success.
Tranexamic acid may be helpful, and thrombopoietin agonists represent a potential future option.
The influence of HBV or HCV infections on the pregnancy course
Published on: 14th August, 2020
OCLC Number/Unique Identifier: 8667859611
The incidence of HBV infections among the pregnant in Europe falls within the range of 1% - 7%, whereas it is 1.7% - 4.3% for HCV.
The aim was to assess the course of pregnancy among women infected with HBV or HCV, and the condition of neonates in the fifth minute after the birth.
The study included 157 pregnant individuals infected with HBV, 53 infected with HCV, and 330 healthy pregnant women. None of the women infected with HBV and HCV as well as from the control group were infected with HIV, and none of them took intoxicants.
Weight of neonates delivered by healthy women was higher as compared with children born by women infected with HBV or HCV (3,517 vs. 3,347 and 3,366). The Apgar score of neonates delivered by women with HBV and HCV infections was lower as compared with the children born by healthy women (9.4 vs. 9.3 vs. 9.7; p < 0.05). Premature births occurred more often in HBV and HCV-infected women than in the control group (14.6% and 24.5% vs. 6.96%; p < 0.05). Miscarriages were significantly more common among the pregnant with HCV infections as compared with the pregnant who were healthy (9.4% vs. 1.8%; p < 0.05). In comparison with the healthy individuals, this group of patients experienced pruritus (10.5% vs. 4.2%; p < 0.05), oedemas (9.4% vs. 2.4%; p < 0.05), and hypertension (9.4% vs. 1.5%; p < 0.05) more often.
An increase in HBV loads was observed between the 6th and 28th – 32nd week of pregnancy among the infected with HBV, and then, a decrease was observed in the 6th months after the delivery.
The pregnant infected with HBV without HBsAg (-) and the infected with HCV are subject to common incidence of premature births. Women infected with HCV often experience oedemas, hypertension, and pruritus.
Pregnancy complicated with deficiency of antithrombin: Review of current literature
Published on: 31st August, 2020
OCLC Number/Unique Identifier: 8667872114
Antithrombin deficiency, although the rarest thrombophilia, carries the highest risk of thromboembolism. This risk is increased especially for pregnant women due to physiological coagulation changes in pregnancy. Therefore, in cases of positive personal and/or family history of thromboembolic events as well as recurrent pregnancy loss women should be tested for antithrombin deficiency. Antithrombin deficiency is caused by numerous mutations of serpin peptidase inhibitor clade C 1 gene (SERPINC) and is classified according to antithrombin plasma activity and antigen levels into Type I (quantitative defect) and Type II (qualitative defect). Complications during pregnancy can be divided into those regarding the mother and those concerning the fetus. The main clinical manifestation of antithrombin deficiency regarding the mother is thromboembolism occurring spontaneously or recurrently during pregnancy. Numerous major gestational complications such as miscarriage, intrauterine growth restriction or fetal death, placental abruption, preeclampsia and hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome can be linked to antithrombin deficiency. Close monitoring with early and adequate prophylaxis and treatment nowadays can mostly assure the positive pregnancy outcome for both mother and child. Prophylaxis/therapy with both low molecular weight heparin and antithrombin concentrate should start as soon as pregnancy is planned or at least as early as possible in pregnancy and continue until the end of the puerperium.
Pregnancy and childbirth in women aged 40 and over at befelatanana maternity, Madagascar
Published on: 24th December, 2019
OCLC Number/Unique Identifier: 8501548256
Objective: Pregnancy after age 40 remains a concern as it exposes to particular obstetrical complications. Our study aims to determine the risks of complications related to pregnancy and childbirth of women aged 40 and over.
Study design: We carried out a cross-sectional analytical study of a historical cohort comparing the progress and the outcome of pregnancy in women 40 years of age and over to those aged 20 and 35 who gave birth at the University Hospital of Obstetrics and Gynecology in Befelatanana, from 1st January 2010 to 31 December 2013.
Results: The prevalence of childbirth among 40 years old and over was 0.61%. They were multiparous and large multiparous in 88% of the cases. The analysis showed that parturients aged 40 years and older were at significant risk for caesarean section, with three times the risk of emergency caesarean section. The frequency of this emergency caesarean section increased with parity ((RR = 3.04 [2.15-4.30], p = 10-10). Among their neonates, 23.42% were hypotrophic, 22.86% premature, 12% asphyxiated at birth, 13.14% admitted to neonatal resuscitation and 5.71% died in utero, but without significant difference with the group unexposed. Perinatal death was 7.43% in women aged 40 and over vs. 4% in 20 to 35 year olds ((RR = 1.85 [0,89-3,86]; p 0.052).
Conclusion: We found that pregnancies after 40 years were not exposed to pregnancy-related pathologies or specific fetal complications. The use of an emergency cesarean is, however, frequent.
Universal testing for severe acute respiratory syndrome coronavirus 2 upon admission to three labor and delivery units in Santa Clara County, CA
Published on: 31st August, 2020
OCLC Number/Unique Identifier: 8667870286
Objective: To determine the prevalence of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in labor and delivery units in one of the epicentres of the West Coast.
Study Design: This was a retrospective chart review of patients admitted to labor and delivery from April 15, 2020-May 15, 2020 after implementation of a universal testing policy on Labor and Delivery.
Results: The prevalence of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the admitted labor and delivery population was 2.5%, of whom 87.5% were asymptomatic.
Conclusion: We present additional data on the prevalence of asymptomatic SARS-CoV-2 in pregnant patients on the West Coast, which is much lower compared to other locales, possibly as a result of aggressive ‘shelter in place’ policy. Universal screening is insufficient to detect asymptomatic SARS-CoV-2 and thus rapid, universal testing should be prioritized for labor and delivery units for the protection of patients and staff, and to better allocate appropriate resources.
Key points:
1. 2.5% of 320 patients tested positive for SARS-CoV-2.
2. 87.5% of positive patients were asymptomatic.
3. Universal testing on labor and delivery is necessary.
4. ‘Shelter-in-place’ policies reduced SARS-CoV-2.
Viral meningitis in pregnancy: A case report
Published on: 13th October, 2020
OCLC Number/Unique Identifier: 8691250730
Ms X is a 34 year old para 1 woman who presented at 26+5 weeks’ gestation with fever, neurological symptoms and history of a viral illness. She was treated empirically for bacterial meningitis and transferred to a tertiary maternity hospital. Cerebrospinal fluid (CSF) polymerase chain reaction (PCR) was positive for enteroviral ribonucleic acid (RNA), confirming viral meningitis. Ms X improved clinically and was discharged after six days. A high index of suspicion is required for diagnosis of meningitis in pregnancy. Thorough history, examination and workup is vital for timely treatment. Prognosis in viral meningitis is excellent with no clear adverse fetal or neonatal outcomes.
Endometrial thickness and frozen thaw embryo transfer: A prospective study
Published on: 14th October, 2020
OCLC Number/Unique Identifier: 8691248908
Aim and objectives: Endometrial Window of Implantation (WOI) is open in the midsecretory phase wherein the markers of invasion and cell adhesion are manifested .The primary objective was to find out the predictive value of Endometrial thickness and profile as a prognostic factors for embryo transfers during ART.
Materials and Methods: Endometrial thickness assessment was performed with grey scale ultrasound on the day of transfer just before thawing the embryos in patients undergoing Frozen embryo transfer cycle after endometrial preparation.
Results: The mean age and standard deviation of study population was is 33.26+5.95.Out of 69 patients there was clinical pregnancy in 33 patients , miscarriage in 10 patients and ongoing pregnacy in 23 patients. So the implantation rate was 47.83% (33/69), early miscarriage rate (pregnancy ending before 12 weeks) was 14.49%(10/69) and the ongoing pregnancy rate was 33.33% (23/69). Endometrial thickness < 6 mm had comparable implantation rates but low ongoing pregnancy rates.
Conclusion: The ultrasound morphological and vascular grading of endometrial thickness and vascularity is useful to synchronise Day 5 embryo transfer and window and implantation thereby minimizing the loss of good embryos in nonreceptive endometrium.
Experiment of a novel four-spherical intrauterine contraceptive device with nickel-titanium
Published on: 20th October, 2020
OCLC Number/Unique Identifier: 8691260293
The aim of this study was to develop a novel four-spherical intrauterine contraceptive device (4-SIUD) with nickel-titanium (Ni-Ti) for human, and to evaluate the contraceptive effect. The 4-SIUD composed of 4 mesh spheres and 5 support arms. The shape of 4-SIUD was like a “T”. The height (H), upper width (D) and thickness of the 4-SIUD for macaques were 0.8 cm, 0.5 cm and 0.3 cm, and for human were 4.5 cm, 4.0 cm and 0.8 cm, respectively. The 4-SIUD was inserted into 5 macaques and pregnancy was not observed at 12 months. Three women used the 4-SIUD for 12 months, uterine perforations, expulsion, pain, and pelvic inflammatory did not occur. The results suggested that the 4-SIUD is appropriate for rhesus macaques and human use, and has a good contraceptive effect.
Overview on current approach on recurrent miscarriage and threatened miscarriage
Published on: 30th November, 2020
OCLC Number/Unique Identifier: 8875583329
Miscarriage is a frequent outcome of pregnancy, with major emotional implications to the couple experiencing such an event. Threatened miscarriage is the commonest complication of early pregnancy and affects about 20% of pregnancies. It presents with vaginal bleeding with or without abdominal cramps. On the other hand recurrent miscarriages are post implantation failures in natural conception. Increasing age of women, smoking, obesity or polycystic ovary syndrome (PCOS) and a previous history of miscarriage are risk factors for threatened miscarriage. The pathophysiology has been associated with changes in levels of cytokines or maternal immune dysfunction. Clinical history and examination, maternal serum biochemistry and ultrasound findings are important to determine the treatment options and provide valuable information for the prognosis. Many surgical and non-surgical interventions are used in the management of threatened and recurrent miscarriages. In this review, we present available evidence-based guidance on the incidence, pathophysiology, investigation and clinical management of recurrent miscarriage and threatened miscarriage, focusing mainly on the first trimester of pregnancy and primary healthcare settings. The review is structured to be clinically relevant. We have critically appraised the evidence to produce a concise answer for clinical practice.
Clinical characteristics, management, maternal and neonatal outcome among seven severe and critically ill pregnant women with COVID-19 pneumonia
Published on: 30th November, 2020
OCLC Number/Unique Identifier: 8812298810
Pneumonia caused by the Novel coronavirus disease 2019 (COVID-19) is a highly infectious disease and the ongoing outbreak has been declared as a Pandemic by the World health organization. Pneumonia is a serious disease in pregnancy and requires prompt attention. Viral pneumonia has higher morbidity and mortality compared to bacterial pneumonia in pregnancy. All efforts are well exerted to understand the newly emerged disease features but still some areas are gray.
The treatment is primarily supportive with antivirals, steroids, anticoagulation and antibiotics for secondary bacterial infection. Severe cases require intensive care monitoring with oxygen support, mechanical ventilation. Investigational therapies include convalescent plasma, cytokine release inhibitors and other immunomodulatory agents like interferons. The mortality appears driven by the presence of severe Adult Respiratory Syndrome (ARDS) and organs failure.
COVID pandemic is a challenging and stressful socio-economic situation with widespread fear of infection, disease and death. In the specialty of obstetrics and gynecology, studies are being conducted to ascertain the manifestation of disease in pregnant women and the fetal outcome.
The aim of our case series is to describe the demographics, clinical characteristics, laboratory and radiological findings, feto- maternal outcome of severe and critical COVID pneumonia in pregnant women in Latifa Hospital.
Unilateral pleural effusion as the sole presentation of ovarian hyperstimulation syndrome (OHSS)
Published on: 3rd December, 2020
OCLC Number/Unique Identifier: 8875582680
A 44-year-old G4P2+1 presented to the emergency department on the 10th day following embryo transfer (with two fresh, day 5, blastocysts transferred in a hospital abroad) with the complaints of difficulty breathing, chest discomfort and cough for one day. These symptoms increased on lying on her side and were not related to exertion. She also mentioned having had abdominal discomfort over the preceding few days. On taking a past history, the patient revealed that all her prior pregnancies were the result of IVF treatment and she suffered OHSS with each. Her first pregnancy was a triplet gestation through IVF and complicated by OHSS; followed by her second pregnancy which was an IVF twin gestation also complicated by OHSS with ascites requiring paracentesis. With her third IVF treatment she conceived, had OHSS and miscarried spontaneously. However, these IVF treatments and pregnancies were all managed abroad and no medical records were available.
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