Impact of pandemic restrictions on antenatal complications at a tertiary care center

Background: The ongoing pandemic has drastically affected the heath care sector, especially the tertiary care centers taking the major burden of patients. Apart from COVID-19 positive patients there has also been an increase in Covid 19 negative patients due to other private hospitals being closed. We have conducted an analysis at a tertiary care centre comparing the patient data in 3 months that is from 23rd March 2020 to 22nd June 2020 and the same time period last year 2019. The antenatal and postnatal complications and mode of delivery were analysed.Methods: A total of 1837 cases were compared. Patients were divided into 2 groups case and controls.Control group comprised of 780 patients admitted between 23rd March 2019 to 22nd June 2019. Case group consisted of 1057 patients admitted between 23rd March 2020 to 22nd June 2020. Patient were matched for age, parity, socioeconomic and demographic dataResults: Our results showed that there was no statistically significant increase in antenatal complications despite there being an increase in the total number of patients during the same time period. There was however a significant increase in unregistered cases p<0.0001. There was also a statistically significant increase in the total number of lscs and normal deliveries (p=0.03).Conclusions: Our analysis concludes that despite there being an increase in the total number of cases compared to the previous year there was no statistically significant increase in complications.There was however a significant increase in unregistered cases which may be due to increased referrals from PHCs. The increase in work load perceived by the doctors may possible be due to stress and the added burden of managing COVID-19 positive patients

An experience with COVID-19 positive pregnant patients at a tertiary care center

Background: The Covid-19 pandemic is a global phenomenon. The lockdown imposed by the central and state governments, has also led to restriction of movement of patients thus reducing their access to antenatal care. Our hospital was officially declared as a Covid-19 centre as per government directives. The hospital has been managing Covid-19 positive patients as per guidelines. We here present the data of management of COVID-19 positive pregnant patients.Methods: A retrospective study. All COVID positive patients admitted to the obstetric unit of the hospital from 23 March 2020 to November 2020 were analysed. A total of 96 COVID positive patients were analysed. The patients were analysed for antenatal complications, complications during delivery, mode of delivery and neonatal complications.Results: There was only one patient with major complications associated with COVID. Most of the patients were either asymptomatic or had mild symptoms. There was only one maternal mortality. 23 out of the 89 antenatal cases required emergency caesarean section. The caesarean section rate was higher in COVID positive patients though the caesarean sections were done for obstetric indications only. Three neonates tested positive for the virus. 2 of the neonate required NICU admission.Conclusions: COVID-19 is a completely unprecedented situation. The aim of this study was to demonstrate that the effect of COVID-19 on pregnant women is minimal. There were only 2 patients with major complications. The COVID positive pregnant patients can be managed effectively with proper personal protective equipment and adherence to guidelines

Undrained Shear Strength of Frozen Unsaturated Silts

This study focuses on investigation of the undrained shear strength of unsaturated frozen silts prepared at varying initial thermal and hydraulic conditions. The initial degree of saturation controls ice and unfrozen water contents at temperatures below depression point. The strength properties of frozen soils are highly influenced by ice and water contents which is highly coupled with thermal state of the soils. To evaluate the strength properties of frozen silts, a series of direct simple shear experiments were performed using Bonny silt prepared at different initial degrees of saturation under monotonic shear loading. Compacted silt samples at varying degrees of saturation were subjected to artificial freezing before shear loading and stress-strain curves were recorded during loading. Identical samples were prepared and sheared at room temperatures for comparison. The stress-strain behavior of frozen silts was observed to be significantly different than those of obtained at room temperatures where on an average the shear strength of the saturated frozen soils was higher by 150% in comparison to the shear strength of the same soil in saturated unfrozen condition. The undrained shear strengths for frozen soils were also observed to be affected by initial degree of saturation where the strength was observed to increase by 142 % when the initial degree of saturation was increased from 0.51 to 1.00. The results obtained from this study will be used in ongoing investigations of capacity of deep foundations in warming permafrost