Investigation of sars-cov-2 ability to pass through the placenta

Context: Recently, a new coronavirus (SARS-CoV-2) as the cause of COVID-19 has made a global health crisis and a great challenge. Pregnant women and fetuses are among the high-risk groups for COVID-19. In this review, we summarize studies regarding SARS-CoV-2 virus-placenta interactions at the maternal-fetal interface by demonstrating the pathogenicity of the virus and defense methods of the placenta. Evidence Acquisition: In the present study, a search was done in domestic and international databases including Google Scholar, Web of Science, PubMed, and Scopus using specific keywords (“Coronavirus” OR “COVID-19” OR “SARS-CoV-2”) AND (“Fetus” OR “Pla-centa”) AND (“Pregnancy”), limited until August 2020. Finally, we reviewed 250 articles. Results: Generally, the pathogenicity and the life cycle of SARS-CoV-2 and virus entry and replication methods allow the virus to pass through the placenta, although there are hormonal and immune barriers in the placenta against SARS-CoV-2, such as placental type interferons. Conclusions: The SARS-CoV-2 can pass through the placenta, but there are defense methods against it. © 2021, Author(s)

Urinary incontinence related to perineal muscle strength in the first trimester of pregnancy: cross-sectional study

Objective To analyze pelvic floor muscle strength (PFMS), urinary continence and quality of life related to urinary incontinence (UI) of women in the first trimester of pregnancy. Method Cross-sectional study with a sample of 500 women who started prenatal care in a complementary healthcare facility in Guarulhos, state of São Paulo, from 2012 and 2013. Pelvic floor muscle strength was evaluated through perineometry. The pregnant women who presented UI answered the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). Results It was found that maternal age (OR=1.06; CI95% 1.02-1.11) and prior UI (OR=15.12; 95%CI 8.19-27.92) are the variables that, in tandem, best explain the occurrence of UI at the beginning of pregnancy. The mean score on the ICIQ-SF was 8.2 (SD=3.9), considered a moderate impact on quality of life. Conclusion Older pregnant women with prior UI are more likely to have UI in the first trimester of pregnancy.
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The diagnosis of early fetal cardiac changes of the gestational diabetic mothers: Presenting the preload index

Objectives: To evaluate fetal cardiac changes in gestational diabetic mothers, compared to healthy ones by means of different indices and to determine which index can first represent the alterations. Methods: The study was conducted as an observational cross-sectional study, including 25 pregnant women with gestational diabetes as the cases and 50 healthy pregnant women as the controls. The preload index, left and right side myocardial performance index (MPI), Interventricular septal hypertrophy, the left and right side cardiac output were assessed in all the patients. Results: The gestational ages were 31.65 ± 8.02 and 31.64 ± 5.37 weeks in case and control group respectively, without any significant difference. Both of the left and right ventricular MPI did not differ statistically between the case and controls. The cases had a greater Interventricular septal hypertrophy but the cardiac output was similar. The preload index was higher in the fetuses of the gestational diabetic mothers. Conclusions: In our study, the MPI did not show any difference between the fetuses of the gestational diabetic mothers and non-diabetic ones; but, fetuses of gestational diabetic mothers had a greater value of PLI, representing early diastolic function changes in right heart even before the overt heart failure occurred. This could be a sign of vasculopathy in gestational diabetic mothers. Copyright © 2019, Author(s)

Percutaneous transluminal mitral commissurotomy in pregnant women with severe mitral stenosis

Background: Mitral stenosis tends to worsen during pregnancy because of the increase in the cardiac output and the heart rate. In nonresponders to medical therapy, percutaneous transluminal mitral commissurotomy (PTMC) may be performed when there is a suitable valvular anatomy. In this study, we aimed to investigate the clinical and fetal outcomes of pregnant women with mitral stenosis who underwent PTMC. Methods: Thirty-one patients undergoing PTMC during pregnancy were enrolled in this study. The mitral valve area (MVA), the transmitral valve mean gradient (MVMG), and the severity of mitral regurgitation were assessed pre- and postprocedurally by transthoracic and transesophageal echocardiography. The radiation time was measured during the procedure. The patients were followed up during pregnancy, and the neonates were monitored for weight, height, the head circumference, the birth Apgar score, and the adverse effects of radiation for at least 12 months. Results: PTMC was successfully performed on 29 (93.5) patients. No maternal death or pulmonary edema was reported. The mean MVA significantly increased (from 0.73±0.17 cm2to 1.28±0.24 cm2; P&lt;0.001), and the mean MVMG significantly decreased (from 19.62±5.91 mmHg to 8.90±4.73 mmHg; P&lt;0.001) after the procedure. A significant decrease in the systolic pulmonary artery pressure was also detected. Mitral regurgitation did not increase in severity in 16 (51.6) patients. There was no significant relationship between the Apgar score, weight, height, and the head circumference at birth and at the radiation time. Conclusion: In our series, PTMC during pregnancy was a safe and effective procedure. Lowering the radiation time with low frame-count techniques confers a significant decrease in radiation-related complications. © 2019, Tehran Heart Center. All Rights Reserved

VIRULENCE FACTORS, ANTIMICROBIAL SUSCEPTIBILITY AND MOLECULAR CHARACTERIZATION OF STREPTOCOCCUS AGALACTIAE ISOLATED FROM PREGNANT WOMEN

Forty-one Streptococcus agalactiae isolates collected from pregnant women at 35-37 weeks of gestation were analysed for their capsular types, antimicrobial resistance determinants, distribution of virulence factors and genetic relatedness using PCR and multiplex PCR. Capsular type III was predominant (65.8), followed by capsular type II (14.6), Ib (7.3), and V(4.9). All isolates were susceptible to penicillin, vancomycin, linezolid and quinupristin-dalfopristin. Resistance to tetracycline, erythromycin and clindamycin were found in 97.6, 24.4, and 14.6 of isolates, respectively. The most common antimicrobial resistance gene was tetM found in 97.6 of the isolates followed by ermTR and ermB found in 12 and 7.3 of isolates, respectively. The most common virulence gene was hly (100), followed by scpB (97.6), bca (97.6), rib (53.65) and bac (4.9). The insertion sequence IS1548 was found in 63.4 of isolates. By multi locus variable number of tandem repeat analysis (MLVA) typing, 30 different allelic profiles or MLVA types (MTs) were identified. The most frequent was the MT1 (5/41, 12.2) and followed by MT2 (4/41, 9.75). Our data revealed that population structure of these isolates is highly diverse and indicates different MLVA types

Sexual satisfaction after child birth: vaginal versus elective cesarean delivery

&quot;nBackground: The perception of impairment of sexual function after childbirth in vaginal delivery (as a complication) makes pregnant women to request elective cesarean section. But this conception is more related to culture. Therefore we studied women&apos;s sexual health after childbirth to assess whether women who underwent cesarean section experienced better sexual health in the postnatal period than women with vaginal births. &quot;nMethods: A cohort study was conducted on 303 primiparous women who had delivered vaginaly and 315 primiparous delivered by elective cesarean section in seven private hospitals in Tehran, employing data of demographic characteristics like age, education, BMI, obstetric history (weight gain in pregnancy, history of pelvic pain and vaginal discharge), stress incontinence history (prepregnancy and during pregnancy) and effect of delivery on sexual satisfaction in several follow-ups until 12 months after delivery. &quot;nResults: Sexual satisfaction after delivery in vaginal group was significantly more than cesarean group. (76% vs 60%, p&amp;lt;0.0001). There was no relation between pelvic pain &amp;amp; delivery type (in several follow- up). &quot;nConclusions: Instead of social conception of have more sexual satisfaction after cesarean delivery, outcomes from this study provide no basis for advocating cesarean section as a way to protect women&apos;s sexual function after childbirth. Therefore Request of cesarean section by mother for having more sexual satisfaction after childbirth is not logic

The Effects of Omega-3 Fatty Acids Supplementation on Gene Expression Involved in the Insulin and Lipid Signaling Pathway in Patients with Polycystic Ovary Syndrome

Limited data are available evaluating the effects of omega-3 fatty acids supplementation on gene expression involved in the insulin and lipid-signaling pathway in women with polycystic ovary syndrome (PCOS). This study was conducted to evaluate the effects of omega-3 fatty acids supplementation on gene expression involved in the insulin and lipid signaling pathway in women with PCOS. This randomized double blind, placebo-controlled trial was done among 60 women aged 18–40 years old and diagnosed with PCOS according to the Rotterdam criteria. Participants were randomly assigned into 2 groups to receive either 1 000 mg omega-3 fatty acids from flaxseed oil containing 400 mg α-linolenic acid (n=30) or placebo (n=30) twice a day for 12 weeks. Gene expressions involved in the insulin and lipid-signaling pathway were quantified in blood samples of PCOS women with RT-PCR method. Quantitative results of RT-PCR demonstrated that compared with the placebo, omega-3 fatty acids supplementation upregulated peroxisome proliferator-activated receptor gamma (PPAR-γ) mRNA (p=0.005) in peripheral blood mononuclear cells of women with PCOS. In addition, compared to the placebo, omega-3 fatty acids supplementation downregulated expressed levels of oxidized low-density lipoprotein receptor (LDLR) mRNA (p=0.002) in peripheral blood mononuclear cells of women with PCOS. We did not observe any significant effect of omega-3 fatty acids supplementation on expressed levels of glucose transporter 1 (GLUT-1) and lipoprotein(a) [Lp(a)] genes in peripheral blood mononuclear cells. Overall, omega-3 fatty acids supplementation for 12 weeks in PCOS women significantly improved gene expression of PPAR-γ and LDLR