Management of Molar Pregnancy During COVID-19 Pandemic

Molar pregnancy is a group of diseases called gestational trophoblastic disease (GTD) that originates in the placenta and has the potential to invade the uterus and metastasize locally1, 2. During the past months, the novel coronavirus disease 2019 (COVID-19) has been responsible for the worldwide pandemic3.  Patients usually go to the hospital only if they need high emergency aid or have a high-risk condition in this quarantine situation. Hence, this situation can impact diagnosing and managing benign and malignant molar pregnancy, and the diagnosis might be delayed

Clinical, Laboratory, and Obstetrics Features of Novel Coronavirus Disease 2019 (COVID-19) during Pregnancy

Background: The novel coronavirus disease 2019 (COVID-19) remains a new entity; the data on its clinical features, complications, and adverse outcomes during pregnancy are still to be identified and described. Several studies have reported a series of COVID-19 infections in pregnancy, the maternal and the neonatal outcome from different ethnicities and geographical regions. Materials and Methods: This retrospective cross-sectional study was conducted in the obstetrics department of Mahdiyeh Hospital of Tehran, Iran, between February and April 2020. We included a series of 23 singleton pregnancies presenting to our department with fever and dry cough. All patients were tested for COVID-19 infection using nasopharyngeal swabs. Results: We included 23 singleton pregnant patients with a mean age of 28.1 ± 6.16 (ranging from 15 to 39) years and gestational age of 29.96±10.2 [ranging from 7 to 40] weeks. Of these patients, 7 (30.4%) tested positive for the SARS‑CoV‑2. Among the total patient population, 16 (69.5%) had elevated serum levels of C-reactive protein (CRP), 1 [4.3%] had lymphopenia, and 8 (34.7%) had elevated erythrocyte sedimentation rate (ESR). Only 2 (8.7%) patients had positive findings of chest CT-scan. Most newborns had acceptable Apgar and birth weight, and only 4 (17.4%) required NICU admission. Conclusion: The clinical characteristics of the COVID-19 infection in pregnant patients were comparable to those of non-pregnant patients. We did not record a high frequency of lymphopenia and leukopenia, probably due to leukocytosis during pregnancy. CRP was a sensitive marker for COVID-19 pneumonia in pregnant patients

Evaluation of the Knowledge, Attitude, and Practice of Pregnant Women in the COVID-19 Outbreak in Mahdiyeh Hospital

Background: As observed in severe acute respiratory syndrome (SARS) and Meddle-East respiratory syndrome (MERS) epidemics, pregnant women are more prone to complications and adverse outcomes of coronavirus infection. Coronavirus disease 2019 (COVID-19) is thought to significantly increase the risks to maternal and fetal health, while others believe that pregnant women have similar morbidity and mortality compared to the general population. Due to the severe prognosis of pregnant women with SARS-Coronavirus (CoV) or MERS-CoV, many concerns have been raised about the effects of SARS-CoV-2 on this sensitive group of patients. Materials and Methods: The present study was a cross-sectional descriptive study that was performed on all pregnant women referred to Mahdieh Hospital in Tehran, Iran, whose gestation period was during the coronavirus epidemic, by the available sampling method. Pregnant women answered the questions asked by the researcher and the answers were recorded in a pre-prepared structured standard questionnaire. Questionnaire questions included basic information, knowledge, attitude, practice, and obstacles. Results: A total of 284 people participated in this study with a mean age of 29.6 ± 12.2 years. The mean gestational age among the participants in this study was 28.5 ± 9.7 weeks. The knowledge, attitude, and practice of pregnant women referred to Mahdieh Hospital in Tehran were 74.05, 61.13, and 60.06, respectively. In terms of attitude, improving one's attitude towards herself will have the greatest effect on improving one's attitude. According to this finding, the attitude of individuals increases the level of knowledge about COVID-19. The amount of knowledge has a direct positive and significant effect on practice. Also, the attitude has a direct positive and significant effect on the practice. Conclusion: Given that the source of information for most of the participants in this study about COVID-19 was the media. Transmission of correct health information about the relationship between pregnancy and COVID-19, to this sensitive group, through the media could be appropriate. This is important because most participants feel they are at higher risk of developing the disease than non-pregnant people due to their pregnancy status

A Systematic Review of Elective Laser Therapy during Pregnancy: Laser Therapy During Pregnancy

Introduction: Currently, lasers are used to treat many diseases and their complications. However, the use of lasers in pregnant patients is still controversial.Methods: In this review, the application of lasers in the fields of urology, surgery, obstetrics, dermatology, and musculoskeletal disorders is evaluated. The following keywords were used to search through PubMed, Google Scholar, and Scopus: pregnancy, laser, urolithiasis, endovenous laser ablation (EVLA) or treatment, leg edema, varicose vein, venous insufficiencies, hair removal, pigmentation, telangiectasia, vascular lesions, Q switch laser, diode laser, holmium, holmium-YAG laser, erbium laser and Pulsed dye laser, low-level laser therapy, high-intensity laser therapy, pain, musculoskeletal disorders, twin to twin transfusion syndrome (TTTS), amnioreduction, and safety.Results: Totally, 147 articles were found, and their abstracts were evaluated; out of 53 articles extracted, 14 articles were about dermatology, 24 articles were about urology, 12 articles were about obstetrics and gynecology, 10 articles were about musculoskeletal disorders and three articles were related to surgery.Conclusion: Laser therapy can be used as a safe treatment for urolithiasis, skin diseases, TTTS, and varicose veins of the lower extremities. However, the use of laser therapy for musculoskeletal disorders during pregnancy is not recommended due to lack of evidence, and also we cannot recommend endovenous ablation. DOI: 10.34172/jlms.2021.5

Comparing the effect of gonadotropin-releasing hormone agonist and human chorionic gonadotropin on final oocytes for ovulation triggering among infertile women undergoing intrauterine insemination: An RCT

Background: The purpose of triggering in ovulation induction is to induce the final maturation of oocytes and their release from the ovary for fertilization. Objective: The aim of the present study was to compare the effectiveness of gonadotropin-releasing hormone (GnRH) agonist and human chorionic gonadotropin (HCG) on the final maturation of oocytes and pregnancy rates in intrauterine insemination (IUI) cycles. Materials and Methods: In this randomized clinical trial, 110 infertile women who were selected for IUI entered the study. Ovulation induction was performed. Group I received 0.1 mg GnRH agonist as triggering and group II received 10,000 IU of HCG. The serum Estradiol (E2), Luteinizing Hormone (LH), and Follicle-Stimulating Hormone (FSH) levels were measured at 12 and 36 hr after injection. Results: LH surge was detected in all patients. LH levels at 12 and 36 hr after triggering was higher in Group I and it washed out earlier than group II (p=0.00). The pregnancy rate was higher in Group I, but the difference was not statistically significant (26.9% vs. 20.8%, respectively p=0.46). Also, the incidence of ovarian hyperstimulation syndrome was not different between the two groups (p=0.11). There was a significant difference regarding the estradiol levels at 36 hours after triggering (p=0.00). Conclusion: Effects of GnRH on endogenous LH surge is sufficient for oocyte releasing and final follicular maturation. Pregnancy rates and ovarian hyperstimulation syndrome incidence were not different between the groups. We suggest that GnRH agonists might be used as an alternative option instead of HCG in IUI cycles

Coronavirus Pandemic and Mental Health During Pregnancy: COVID-19 And Pregnants’ Mental Health

Background: COVID-19 is an enveloped RNA virus, declared as a pandemic in 2020. The pandemic and the policies around it for controlling the infection have caused major psychological stress on the population, especially a high-risk group: the pregnant women. This study evaluates the anxiety and depression of pregnant women, in the first six months of COVID-19 pandemic in Iran.Methods: In this cross-sectional study, all pregnant women, visiting the obstetrics clinic of Mahdiyeh hospital, were enrolled in this study. Among them, women with no prior psychological disorder or use anti-anxiety or antidepressant drug were included in the study and were asked to complete the hospital anxiety and depression scale (HADS) questionnaire. Also, the demographic information, obstetrics history and past medical history of each patient were collected. Data were analyzed using SPSS software, version 22, using descriptive statistics (mean and standard deviation), t test, chi-square and Bonferroni post hoc tests. Significant levels were considered at P ≤ 0.05.Results: Overall, 465 pregnant women with a mean ± SD age of 26.75 ± 5.71 years were included in the study. The mean ± SD HADS score of the women was 12.00 ± 6.09 and 240 (51.6%) of the women had abnormal HADS score. Among the demographic properties, a significant association was seen between gravidity and HADS score (P < 0.05).Conclusion: COVID-19 can cause a considerable level of stress in women during their pregnancy, which can lead to adverse pregnancy outcomes. Among pregnant women, primigravida and multigravida (more than two previous pregnancy) ones were at higher risk of experiencing anxiety or depression

Coronavirus Pandemic and Mental Health During Pregnancy

Background: COVID-19 is an enveloped RNA virus, declared as a pandemic in 2020. The pandemic and the policies around it for controlling the infection have caused major psychological stress on the population, especially a high-risk group: the pregnant women. This study evaluates the anxiety and depression of pregnant women, in the first six months of COVID-19 pandemic in Iran. Methods: In this cross-sectional study, all pregnant women, visiting the obstetrics clinic of Mahdiyeh hospital, were enrolled in this study. Among them, women with no prior psychological disorder or use anti-anxiety or antidepressant drug were included in the study and were asked to complete the hospital anxiety and depression scale (HADS) questionnaire. Also, the demographic information, obstetrics history and past medical history of each patient were collected. Data were analyzed using SPSS software, version 22, using descriptive statistics (mean and standard deviation), t test, chisquare and Bonferroni post hoc tests. Significant levels were considered at P≤0.05. Results: Overall, 465 pregnant women with a mean±SD age of 26.75±5.71 years were included in the study. The mean±SD HADS score of the women was 12.00±6.09 and 240 (51.6%) of the women had abnormal HADS score. Among the demographic properties, a significant association was seen between gravidity and HADS score (P<0.05). Conclusion: COVID-19 can cause a considerable level of stress in women during their pregnancy, which can lead to adverse pregnancy outcomes. Among pregnant women, primigravida and multigravida (more than two previous pregnancy) ones were at higher risk of experiencing anxiety or depression

Removal of Cefixime from Wastewater Using a Superb nZVI/Copper Slag Nanocomposite : Optimization and Characterization

Nowadays, hospital wastewater contains a high concentration of toxic pharmaceutical contaminants, posing a significant threat to the environment, and human and animal life. Cefixime (CFX) is one such toxic contaminant that has a detrimental impact on both aquatic and terrestrial ecosystems. Therefore, it is essential to remove this compound using non-toxic and environmentally friendly procedures to ensure healthy drinking water. In this study, a low-cost and eco-friendly nano adsorbent (nZVI/copper slag) was synthesized and characterized using FESEM, XRD, EDX, FTIR, and zeta potential to remove CFX from wastewater. The Response Surface Methodology (RSM) was used to evaluate the effects of experimental factors including adsorbent dosage (2–10 g/L), pollutant concentration (10–30 mg/L), pH (2–10), and contact time (10–50 min) for efficient CFX elimination. The optimal conditions (adsorbent dosage: 7.79 g/L, pollutant concentration: 19.42 mg/L, pH: 4.59, and reaction time: 36.17 min) resulted in 98.71% CFX removal. The adsorption isotherm and kinetics data showed that the pseudo-second-order kinetics and Langmuir isotherm models were appropriate for CFX elimination. Furthermore, the nano adsorbent demonstrated 90% CFX elimination after up to six repeated cycles in regeneration and reusability testing. Finally, the nZVI/CS nano adsorbent can be an effective and promising solution for removing CFX from wastewater.Applied Science, Faculty ofNon UBCEngineering, School of (Okanagan)ReviewedFacultyGraduat