Pregnancy with COVID-19: feto-maternal outcome from a tertiary care hospital, Bangladesh

Background: The objective was to determine the maternal and fetal outcomes of pregnant women with COVID-19 infection in the southeast part of Bangladesh.Methods: A prospective observational study was conducted at Chittagong Medical College Hospital (CMCH), Bangladesh, for one year. Pregnant women were divided into suspected and confirmed groups based on the clinical features of COVID-19 and the results of RT-PCR (SARS-CoV2). Outcome measures were maternal death, ICU admission, mechanical ventilation, and stillbirth/neonatal death. The Mann-Whitney U test was applied for between-group comparisons. Binary logistic regression analysis was done for factors affecting feto-maternal outcomes. Results were presented as odds ratios (OR) and 95% confidence intervals (CI).Results: A total of 144 pregnant women (n=144) were included in the study, divided into confirmed (n=71) and suspected (n=73). Complications were more in the confirmed group (p=0.315). Caesarean section was 69% and 64.4% in the confirmed and suspected groups, respectively (p=0.556). Eight women (5.55%) needed ICU admission, five (3.5%) required mechanical ventilation, and five (3.5%) women expired. Fetal distress was seen in 15 (10.41%) pregnancies. Stillbirth or neonatal death and the need for NICU admission were higher for suspected than in confirmed cases. Pregnancies with suspected COVID-19 had 3.91 times (OR: 3.913, 95% CI: 1.398-10.954) higher poor feto-maternal outcome. Unbooked status, COVID-19 test negativity, and use of antivirals were associated with poor feto-maternal outcomes.Conclusions: Pregnancies with COVID-19 were prone to poor feto-maternal outcomes. The study pointed to an improvement in the ANC of pregnant women with COVID-19 in a public hospital like Bangladesh

Efficacy of the Swede score in prediction of high-grade lesions of cervix

Background: Cervical cancer is a preventable lesion that can be identified by stepwise screening methods. Visual inspection of the cervix with acetic acid, Lugol’s iodine, pap smear, and HPV are the primary screening methods. This study aims to evaluate the efficacy of the Swede score in predicting high-grade lesions of the cervix among patients attending a colposcopy clinic. Methods: This observational cross-sectional study was performed in a colposcopy clinic under the department of obstetrics and gynaecology at CMCH. All referral patients to the colposcopy clinic were the study population. Women aged between 25-65 years was the study subject. Results: Majority (47.5%) of the patient’s Swede score was 4 and 20.1of % of patients had scores of 5-6 and only 1.3% of patients had scores ≥7%. 63 (79%) patients had low grade/normal/ cervical intraepithelial lesion (CIN) 1, 16 (20%) patients had high grade/non-invasive cancer/CIN 2 and only 1 patient had high grade/suspected invasive cancer/CIN 3. A score of 6 had a specificity of 100% for CIN 2 with a sensitivity of 30% positive and negative predictive value (PPV=100%; NPV=90.9%). Lowering the score to 5 for predicting CIN 2 improved the sensitivity at the expense of specificity (sensitivity=60%; specificity=90%; PPV= 94%; NPV=46.2%).Conclusions: Swede scoring system is consistent and reproducible, has a simple structure, and thus contributes to preventing cervical cancer. Swede score of 6 or more has 100% specificity; this scoring method is a preferred method for the treatment of high-grade CIN.

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Frequency of Burnout among participants (n = 168).

Frequency of Burnout among participants (n = 168).</p

MBI subscale scores among the participants (n = 168).

MBI subscale scores among the participants (n = 168).</p

Participants’ level of emotional exhaustion, depersonalisation, and reduced personal achievement by demographic and job-related characteristics (n = 168).

Participants’ level of emotional exhaustion, depersonalisation, and reduced personal achievement by demographic and job-related characteristics (n = 168).</p

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Post-hoc analysis.

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