Pregnant woman infected with SARS-COV-2 – diagnosis and treatment

Introduction: COVID-19 is an infection caused by the new SARS-CoV-2 virus. In pregnant women with COVID-19, compared to non-pregnant women, there is an increased risk of a severe course of the infection. Pregnant women are more often hospitalized in the Intensive Care Unit and require mechanical ventilation. In the course of COVID-19 infection, pregnant women have a greater risk of miscarriage, premature birth or having a baby with low birth weight, compared to their healthy pregnancy peers. The aim of the study: To present, based on the available literature, the principles of management of a pregnant woman infected with SARS-CoV-2 virus. State of knowledge: The evidence of infection is the detection of the virus in the clinical specimen confirmed by PCR. Chest computer tomography can be useful in diagnosis, especially when the PCR test result is negative. Particular attention should be paid to pharmacological treatment, which should be both effective and safe for the fetus. Certain antiviral and anti-inflammatory drugs as well as anticoagulants drugs are used in COVID-19 therapy. Oxygen and fluid therapy is also important. The condition of the fetus should be monitored regularly. It is recommended to measure the fetal heart rate, perform cardiotocography, pregnancy ultrasound and assess the volume of amniotic fluid. The decision about the time and method of delivery should be made individually on the basis of obstetric indications and the maternal-fetal condition. Summary: The therapy of a pregnant patient infected with SARS-CoV-2 should be adjusted individually depending on the woman's health condition. In therapeutic interventions, the welfare of both the mother and the fetus should be taken into account

The role of obstetricians and neonatologists in childcare in the time of the COVID-19 pandemic

Introduction: The COVID-19 pandemic has caused numerous changes to the healthcare system, including care for the newborns. Aim of the study: The aim of the study was to create a clear set of recommendations used in the care of a newborn during the SARS-CoV-2 pandemic. State of knowledge: Despite the low risk of infection of the newborn in utero or during vaginal delivery, in rare cases there is a possibility of vertical transmission of the SARS-CoV-2 virus. Every newborn baby whose mother has been diagnosed with COVID-19 disease should be screened for infection. Suspected neonates should be isolated from healthy children and kept in quarantine until the test result is obtained. It is essential to constantly monitor your baby's health and be alert to any possible signs of infection. Medical personnel should ensure adequate protection when handling an infected newborn. A healthy infant whose mother is SARS-Cov-2 positive may be discharged home provided it is looked after by a healthy caregiver. Summary: New patterns of management in maternity and neonatal departments are associated with changes that may have a significant impact on the mother-child relationship. When making decisions aimed at reducing the spread of SARS-CoV-2 infection, it is necessary to seek solutions taking into account the needs of this particular group of patients

COVID-19 vaccination in pregnant and lactating women

Introduction: The COVID-19 pandemic significantly changed the lifestyle of pregnant women. Pregnant women with COVID-19 are more likely to suffer from severe disease, as well as unfavorable pregnancy and childbirth. Currently, there is no causal treatment for this disease available, so attention should be paid to preventing infection with vaccines. Aim of the study: A review of the literature on the influence of COVID-19 vaccines on the course of pregnancy and summary of recommendations regarding the use of COVID-19 vaccines during pregnancy and breastfeeding.  State of knwoledge: Three types of COVID-19 vaccines are most commonly used: mRNA vaccines, vector vaccines as well as subunit vaccines. In preclinical developmental and reproductive toxicity studies in animal models, there were no alarming safety signals, and observations of vaccinated pregnant women did not reveal any complications with respect to the course of pregnancy and development of the fetus. No cases of neonatal death have been reported in the first 28 days after birth. Most of the side effects following vaccination, such as injection site pain or tenderness, fatigue, fever or muscle pain, were moderate and resolved within 24 hours. The current research results confirm a positive immune response in pregnant women. Moreover, it is important that the presence of antibodies in the umbilical cord blood makes it possible to protect and reduce the risk of SARS-CoV-2 infection of the newborn. Summary: All pregnant women, irrespective of trimester, and breastfeeding mothers are advised to administer a booster dose of the COVID-19 vaccine within an appropriate period of time after the primary vaccination schedule

Study of the role of L-arginine in the diagnosis of pregnancy-induced hypertension

Background Pregnancy-induced hypertension (PIH) is a significant health issue in pregnancy, complicating 7–10% of pregnancies. L-arginine is an important mediator of vasodilation with a potential preventative role in pregnancy-related hypertensive diseases. Aim of the study The aim of the present study was to assess the differences in plasma L-arginine concentrations in physiological pregnancies and pregnancies complicated with hypertension in the third trimester. Material and methods Plasma concentration of L-arginine was determined by ion-exchange chromatography in 210 pregnant women (25–41 weeks of gestation). Plasma L-arginine concentration was expressed in μmol/cm3. Results The mean L-arginine concentration was significantly higher in physiological pregnancy (0.102) than in the PIH group (0.034). The analysis of plasma L-arginine concentration in the subgroups of third trimester showed that L-arginine concentration in the PIH group decreased with increasing stage of pregnancy (25–34 hbd — 0.051; 35–38 hbd — 0.03; 39–41 hbd — 0.02). L-arginine concentration in physiological pregnancies was the same in all subgroups (0.1). Conclusions L-arginine may have a role in the prevention and treatment of pregnancy-induced hypertension. Further well-designed and adequately powered research is warranted.Background Pregnancy-induced hypertension (PIH) is a significant health issue in pregnancy, complicating 7–10% of pregnancies. L-arginine is an important mediator of vasodilation with a potential preventative role in pregnancy-related hypertensive diseases. Aim of the study The aim of the present study was to assess the differences in plasma L-arginine concentrations in physiological pregnancies and pregnancies complicated with hypertension in the third trimester. Material and methods Plasma concentration of L-arginine was determined by ion-exchange chromatography in 210 pregnant women (25–41 weeks of gestation). Plasma L-arginine concentration was expressed in μmol/cm3. Results The mean L-arginine concentration was significantly higher in physiological pregnancy (0.102) than in the PIH group (0.034). The analysis of plasma L-arginine concentration in the subgroups of third trimester showed that L-arginine concentration in the PIH group decreased with increasing stage of pregnancy (25–34 hbd — 0.051; 35–38 hbd — 0.03; 39–41 hbd — 0.02). L-arginine concentration in physiological pregnancies was the same in all subgroups (0.1). Conclusions L-arginine may have a role in the prevention and treatment of pregnancy-induced hypertension. Further well-designed and adequately powered research is warranted

Influence of Dispersed Reinforcement on Mechanical Properties of Stabilized Soil

Stabilized soils are commonly used as part of pavement construction in highway engineering. The everyday use of this material makes it necessary to classify it. One of the basic methods of determining the mechanical properties of a material is the unconfined compressive strength (UCS) test, from which the material elasticity can be determined. The scope of the research included the design and making of soil mixtures stabilized with polypropylene fibers modified cement. This paper presents the effect of the amount of dispersed reinforcement on the maximum compressive strength, the secant modulus at half the ultimate stress (E50), the secant modulus at the ultimate stress (Es), and the tangent modulus (Et). The materials chapter characterizes the soil, cement, and dispersed reinforcement used. The test methods section describes the tests performed and the procedure for interpreting the results. The results section describes the relationship between elastic modulus and compressive strength. The discussion section compares the obtained results with the works of other authors. The work is concluded with a summary containing the most important conclusions resulting from the work

Influence of Load Frequency on Cohesive Soil Respond

The mechanism of cohesive soils response to cycling loading is less investigated compared to cohesionless soils. Multiple load-unload cycles cause significant changes in the structure of cohesive soils, which result in complex behaviour under the given load. The aim of the paper was to investigate and study the influence of load frequency on cohesive soil reaction. In order to obtain results, tests were conducted using the cyclic triaxial apparatus. Three cyclic tests were carried out, each for different frequency −0.5 Hz, 1.0 Hz, 2.0 Hz and one static triaxial test. The maximal value of deviator stress qmax, used in the cyclic tests, was set to 40 kPa. Afterwards samples were unloaded to qmin = 30 kPa. Cyclic loading triaxial tests were performed in a consolidated-undrained (CU) one-way loading manner, a sinusoidal waves were used. After the cycling loading was completed, a static triaxial shear test was conducted. Changes in the cohesive soil responses depending on cycling load frequency were presented in the paper. Differences in the accumulation of plastic strains were noticed, as well as changes of degradation index values, resilient degradation index values and differences in the excess pore water pressure development

Influence of Pre-Pregnancy Obesity on Carbohydrate and Lipid Metabolism with Selected Adipokines in the Maternal and Fetal Compartment

A higher body mass index (BMI) before pregnancy is associated with an increased risk of maternal and perinatal complications. This study aimed to analyze selected parameters of carbohydrate and lipid metabolism, including adipokines, in obese pre-pregnant women, and their influence on the birth weight of newborns. Materials and Methods: The study group (O) consisted of 34 pregnant women with higher BMI (obese) before pregnancy. The control group (C) was 27 pregnant women with target BMI and physiological pregnancy. The BMI index: body weight [kg]/(height [m]2 was assessed on the first obstetrical visit. The research material was the serum of pregnant women collected in the third trimester of pregnancy and umbilical cord blood collected immediately after delivery. Selected parameters of carbohydrate and lipid metabolism and adipokines were determined. Results: There were no statistically significant differences between the study group and the control group concerning the concentrations of insulin, glucose, VLDL, adiponectin, TNF-α, HOMA-IR, as well as LDH and cholesterol in maternal blood serum and umbilical cord blood serum. Total cholesterol and HDL in both maternal blood serum and umbilical cord blood were statistically significantly lower than those in the control group. The concentration of triglycerides (TG) and resistin in the blood serum of obese mothers were higher than those in the control group (p < 0.05). However, no statistically significant differences were found between the two groups regarding the concentrations of TG and resistin in the umbilical cord blood. The concentration of LDL cholesterol in the umbilical blood serum in the obese group was statistically significantly lower than that in the control group. The concentration of leptin in maternal blood serum and umbilical cord blood serum in the study group was statistically significantly higher than that in the control group. Conclusions: Pregestational obesity does not substantially affect the basic parameters of carbohydrate metabolism in pregnant women, but it disturbs the lipid profile, which is manifested by a significant increase in triglycerides and a decrease in the level of HDL cholesterol in the serum. Preexisting obesity increases the concentration of leptin and resistin in the serum of pregnant women, which may be caused by the increased volume of adipose tissue. The concentrations of leptin and resistin in the blood of pregnant women correlate positively, and the concentrations of adiponectin and TNF-α negatively correlate with pre-pregnancy BMI values. There is a positive correlation between the concentration of leptin in the serum of umbilical cord blood and the birth weight of the newborn, which suggests that this parameter contributes to the pathomechanism of macrosomia

Antioxidative, Anti-Inflammatory, Anti-Obesogenic, and Antidiabetic Properties of Tea Polyphenols&mdash;The Positive Impact of Regular Tea Consumption as an Element of Prophylaxis and Pharmacotherapy Support in Endometrial Cancer

Endometrial cancer (EC) is second only to cervical carcinoma among the most commonly diagnosed malignant tumours of the female reproductive system. The available literature provides evidence for the involvement of 32 genes in the hereditary incidence of EC. The physiological markers of EC and coexisting diet-dependent maladies include antioxidative system disorders but also progressing inflammation; hence, the main forms of prophylaxis and pharmacotherapy ought to include a diet rich in substances aiding the organism&rsquo;s response to this type of disorder, with a particular focus on ones suitable for lifelong consumption. Tea polyphenols satisfy those requirements due to their proven antioxidative, anti-inflammatory, anti-obesogenic, and antidiabetic properties. Practitioners ought to consider promoting tea consumption among individuals genetically predisposed for EC, particularly given its low cost, accessibility, confirmed health benefits, and above all, suitability for long-term consumption regardless of the patient&rsquo;s age. The aim of this paper is to analyse the potential usability of tea as an element of prophylaxis and pharmacotherapy support in EC patients. The analysis is based on information available from worldwide literature published in the last 15 years

Sonographic Assessment of Complex Ultrasound Morphology Adnexal Tumors in Pregnant Women with the Use of IOTA Simple Rules Risk and ADNEX Scoring Systems

Background: To evaluate the accuracy of subjective assessment (SA), the International Ovarian Tumor Analysis (IOTA) group Simple Rules Risk (SRR) and the Assessment of Different NEoplasias in the adneXa (ADNEX) model for the preoperative differentiation of adnexal masses in pregnant women. Methods: The study population comprised 36 pregnant women (median age: 28.5 years old, range: 20–42 years old) with a mean gestation age of 13.5 (range: 8–31) weeks at diagnosis. Tumors were prospectively classified by local sonographers as probably benign or probably malignant using SA. Final tumor histological diagnosis was used as the reference standard in all cases. Logistic regression SRR and ADNEX models were used to obtain a risk score for every case. Serum CA125 and human epidydimis protein 4 (HE4) concentrations were also retrieved and the Risk of Ovarian Malignancy Algorithm (ROMA) value was calculated. The calculated predictive values included positive and negative likelihood ratios of ultrasound and biochemical tests. Results: Final histology confirmed 27 benign and 9 malignant (including 2 borderline) masses. The highest sensitivity (89%) and specificity (70%) were found for the subjective tumor assessment. Although no malignancy was classified as benign using the SRR criteria (sensitivity = 100%), the specificity of this scoring system was only 37%. At the cut-off risk level of >20%, the ADNEX model had a sensitivity of 78% and a specificity of 70%. Serum levels of CA125, HE4 and the ROMA risk model correctly identified adnexal malignant tumors with a sensitivity of 67%, 25% and 25%, respectively. Corresponding specificities were 72%, 100% and 100%, respectively. The highest positive and negative likelihood ratios were found for SA (LR+ = 3.0 and LR− = 0.16, respectively). Overall diagnostic accuracy of all predictive methods used in this study were similar (range: 70–75%) except for SRR (53%). Conclusion: Subjective assessment remains the best predictive method in complex adnexal masses found at prenatal ultrasound in pregnant women. For less experienced sonographers, both the SRR and ADNEX scoring systems may be also used for the characterization of such tumors, while serum tumor markers CA125 and HE4, along with the ROMA algorithm appear to be less accurate

Sonographic Assessment of Complex Ultrasound Morphology Adnexal Tumors in Pregnant Women with the Use of IOTA Simple Rules Risk and ADNEX Scoring Systems

Background: To evaluate the accuracy of subjective assessment (SA), the International Ovarian Tumor Analysis (IOTA) group Simple Rules Risk (SRR) and the Assessment of Different NEoplasias in the adneXa (ADNEX) model for the preoperative differentiation of adnexal masses in pregnant women. Methods: The study population comprised 36 pregnant women (median age: 28.5 years old, range: 20–42 years old) with a mean gestation age of 13.5 (range: 8–31) weeks at diagnosis. Tumors were prospectively classified by local sonographers as probably benign or probably malignant using SA. Final tumor histological diagnosis was used as the reference standard in all cases. Logistic regression SRR and ADNEX models were used to obtain a risk score for every case. Serum CA125 and human epidydimis protein 4 (HE4) concentrations were also retrieved and the Risk of Ovarian Malignancy Algorithm (ROMA) value was calculated. The calculated predictive values included positive and negative likelihood ratios of ultrasound and biochemical tests. Results: Final histology confirmed 27 benign and 9 malignant (including 2 borderline) masses. The highest sensitivity (89%) and specificity (70%) were found for the subjective tumor assessment. Although no malignancy was classified as benign using the SRR criteria (sensitivity = 100%), the specificity of this scoring system was only 37%. At the cut-off risk level of &gt;20%, the ADNEX model had a sensitivity of 78% and a specificity of 70%. Serum levels of CA125, HE4 and the ROMA risk model correctly identified adnexal malignant tumors with a sensitivity of 67%, 25% and 25%, respectively. Corresponding specificities were 72%, 100% and 100%, respectively. The highest positive and negative likelihood ratios were found for SA (LR+ = 3.0 and LR− = 0.16, respectively). Overall diagnostic accuracy of all predictive methods used in this study were similar (range: 70–75%) except for SRR (53%). Conclusion: Subjective assessment remains the best predictive method in complex adnexal masses found at prenatal ultrasound in pregnant women. For less experienced sonographers, both the SRR and ADNEX scoring systems may be also used for the characterization of such tumors, while serum tumor markers CA125 and HE4, along with the ROMA algorithm appear to be less accurate