Differences In Apgar Scores Research Articles

Maternal and Fetal Outcomes of COVID-19 According to the Trimester of Diagnosis: A Cross-Sectional Prospective Study in a Tertiary University Hospital.

Objectives: Pregnant women are considered a high-risk group because they may be particularly susceptible to COVID-19. Our study tried to relate fetomaternal outcomes and trimester-specific infection. Methods: A prospective study on 224 pregnant women with confirmed antenatal infections at a tertiary hospital. Data from the antenatal clinic records, admission files, labor ward and neonatal notes, lab results, respiratory consultations, and ICU admission were analyzed using Jamovi 2.2.5, with p < 0.05 indicating significance. Results: A total of 224 patients were included-10, 32, and 182 patients were diagnosed in the first, second, and third trimesters, respectively. Neonatal NICU admissions were significantly higher among those with infections in the third trimester compared to those in the first trimester (p = 0.008). Significant differences in Apgar scores at 1 and 5 min emerged between the second and third trimesters (p = 0.014 and p = 0.037, respectively). However, no significant differences were observed in Apgar scores between the first and second trimesters (p = 0.341, p = 0.108) or the first and third trimesters (p = 0.545, p = 0.755). Complications of pregnancy, including maternal mortality and various conditions (respiratory, obstetrical, sepsis, DIC), neonatal outcomes, ICU admission, and cesarean section indications, showed no significant differences related to the trimester of infection (p-values: 0.989, 0.892). Study limitations include sample size impacting generalization, higher COVID-19 cases in the third trimester than other trimesters, and potential historical data availability and accuracy issues. Conclusions: In the third trimester, COVID-19 caused more neonatal ICU admissions than the first trimester, with lower Apgar scores at 1 and 5 min compared to the second trimester, indicating an increasing susceptibility and vulnerability to COVID-19 infection with an increasing pregnancy age. Other fetal and maternal outcomes showed no significant differences in infection timing.

The value of umbilical artery blood gas analysis in the rapid diagnosis of fetomaternal hemorrhage.

As a rare obstetric disease, fetomaternal hemorrhage (FMH) often causes severe fetal anemia, edema and even death, easily to be confused with severe neonatal asphyxia. Currently, there are several ways to detect or predict FMH, however, most of them are flawed and time-consuming, as well as unsuitable for rapid diagnosis and timely intervention of FMH. To explore the values of umbilical artery blood gas analysis in the rapid diagnosis of FMH, providing basis for rapid guidance of newborn rescue. Five cases of neonates with FMH from the First Affiliated Hospital of Army Military Medical University (Chongqing Southwest Hospital) from January 2013 to January 2016 were selected as the study group. Another 9 cases of severe asphyxia neonates were chosen into the control group. The difference in Apgar score and umbilical artery blood gas analysis between the 2 groups at birth was compared, and the treatments and clinical outcomes of the 2 groups were analyzed. The PH value of umbilical artery blood gas analysis in the study group was higher than that of the control group, but the difference was not statistically significant (P > .05). In the study group, cases with pH value < 7.0 accounted for 0%, whereas the cases with pH < 7.0 accounted for 66.67% in the control group, and the difference between the 2 groups was statistically significant (P < .05). Compared with the control group, the arterial oxygen partial pressure (PO2), the absolute value of (PCO2), lactic acid (lac) and alkali were not significantly different from those of the control group (P > .05), while the total hemoglobin (tHb) and hematocrit (Hct) were significantly lower than the control group (P < .0001). In the study group, tHb in the umbilical cord blood of 2 newborns with FMH death was significantly lower than 40 g/L. FMH should be highly suspected when there is an expression of severe asphyxia in neonates, indicated by significantly lower tHb levels in umbilical cord blood. It is helpful to improve the neonatal outcome by FMH neonatal resuscitation as soon as possible.

The Effects of Acknowledgment of Paternity and Marital Status on Infant Morbidity and Mortality [ID 2683463

INTRODUCTION: Research shows that maternal behavior during the perinatal period has a significant effect on neonatal outcomes and that instability in the social support structure can cause undue perinatal stress. With unmarried women accounting for nearly one in three births in the United States, this analysis reviewed how marital status and paternity acknowledgment (AOP) affected infant morbidity and mortality utilizing national 2017–2019 data from the CDC-WONDER databases. METHODS: A series of chi-squared analysis and logistic regressions were performed to assess for differences in infant outcomes between married women, unmarried women with AOP, and unmarried women without AOP, as well as assess the effect of socioeconomic covariates. RESULTS: Results demonstrated that marital and AOP status had significant correlation on frequency of preterm birth, low birth weight, newborn need for assisted ventilation, antibiotics for suspected sepsis, and neonatal intensive care unit admission (P&lt;.0001). Additionally, there were significant differences in Apgar scores found at 5 and 10 minutes for AOP and at 5 minutes for marital status. Furthermore, significant differences in rate of prenatal complication related infant mortality, as well as overall infant mortality up to 1 year of age were seen. These trends persisted when accounting for mother's age, race, nativity, education, insurance status, and select maternal health risk factors. CONCLUSION: It is evident that infants born to unmarried women and women without AOP are at increased risk for development of complex infant morbidity and mortality. This suggests that increased monitoring, precautions, and social support may be indicated. Further studies are needed to evaluate the role of paternal and other support during pregnancy.

COMPARISON OF NEONATAL OUTCOMES IN TERM PREGNANCIES IN NORMAL VS ABNORMAL CARDIOTOCOGRAPHY- AN EXPERIENCE AT A TERTIARY CARE TEACHING HOSPITAL

OBJECTIVE: To compare the neonatal outcomes in normal vs abnormal cardiotocograhy in term pregnancy. MATERIALS AND METHODS: This was a prospective analytical study carried out in A unit of obstetrics and Gynaecology department of Khyber Teaching Hospital Peshawar from 15th April 2022 to 15th October 2022. A total 224 patients meeting inclusion criteria were included in study. In Group A (normal CTG) there were 111 patients and 113 were in Group B (abnormal CTG). Patients with known fetal congenital abnormalities, intrauterine growth restriction, and fetal mal presentations were excluded from the study. RESULTS: The mean age of sample population was 26.02+4.497. Multigravidae were more than primigravidae in both groups (86.4% vs 13.6% in Group A and 72.5% vs 27.5% in Group B). In Group B, caesarean section rate was higher (82.3%) than Group A (9%). From Group B, 26 (23%) newborns went to NICU for admission, whereas only 8 (7.2%) newborns from Group A needed NICU admission. Hypoxic ischemic encephalopathy was also observed more in newborns in Group B compared to Group A (10 vs 1). In Group A 12 babies had APGAR score &lt;7 at 1 minute while in Group B 18 babies had APGAR score &lt; 7 at 1 minute. In Group A 2 babies had APGAR score &lt;7 at 5 minutes whereas in Group B 7 babies had APGAR score &lt; 7. CONCLUSION: The caesarean section rate, NICU admission and hypoxic ischemic encephalopathy were more in Group B than in Group A and this difference was statistically significant (p-value 0.000, 0.000 and 0.006 respectively). Whereas there was no statistically significant difference in APGAR Score at 1 and 5 minutes in both groups (p-value 0.26 and 0.094 respectively) KEY WORDS: Cardiotocography, APGAR score, Caesarean section, hypoxic ischemic encephalopathy.

Comparison between conventional-dose and high-dose rocuronium use in general anesthesia for Cesarean section.

Background: There have been few studies comparing the effects of high- and low-dose rocuronium during cesarean section by directly measuring the concentration. Therefore, we conducted a study to examine the blood concentrations and clinical effects of both doses of rocuronium on mothers and fetuses. Methods: Eighteen patients were randomly assigned to two groups: C Group (0.6 mg/kg), and H Group, (1.0 mg/kg). The primary outcome was the comparison of umbilical vein rocuronium concentration between two groups. We assessed ease of intubation, time from rocuronium administration to some TOF points, post-anesthesia care unit (PACU) stay time, infused remifentanil dose, maternal rocuronium concentration, and Apgar scores. Results: No differences were observed in demographic data, ease of intubation, PACU stay time, 1 min Apgar scores, umbilical venous blood gas analysis between both groups. However, the time from rocuronium administration to T3 disappearance was shorter (p=0.009) and time to T1 and T2 reappearance were longer (p=0.003, p=0.009) in H group than that in C group. The administered remifentanil dose (p=0.042) was lower in the H group than in the C group. Rocuronium concentrations in the umbilical vein (p=0.004) and maternal vein before cord clamping (p=0.002) and at discharge (p<0.001) were also found to be higher in the H group than in the C group. Conclusions: We observed no prolongation of PACU stay, and no differences in Apgar scores in H group compared to C group. It suggests that 1.0 mg/kg of rocuronium has no negative effects on the fetus and mother in cesarean section.

Развитие острой фето-фетальной трансфузии при родоразрешении монохориальных диамниотических двоен

Objective. To determine the incidence and characteristics of acute feto-fetal transfusion (FFT) in patients with an uncomplicated monochorionic diamniotic (MCDA) twin pregnancy who had a vaginal delivery and to compare their perinatal outcomes with those patients who underwent elective cesarean section. Patients and methods. This retrospective study included data on perinatal outcomes of 92 births in patients with MCDA twins delivered at the Maternity Hospital No 17 between 2019 and 2021. All patients were divided into two groups according to the mode of delivery: the study group (n = 49) – vaginal delivery, the control group (n = 43) – elective cesarean section before the onset of labor. Results. No diagnostically significant signs of acute FFT were found among newborns delivered by cesarean section. Acute FFT was detected in four neonates born to two (4%) patients delivered vaginally. These neonates had the Apgar score at 1 minute and 5 minutes greater than 7. Only one of these four neonates required phototherapy for neonatal jaundice caused by polycythemia and transfer to a pediatric hospital for stage 2 neonatal nursing. When comparing perinatal outcomes in patients in both groups delivered after 36 weeks’ gestation, no statistically significant differences in Apgar scores at 1 minute and 5 minutes and differences in hemoglobin levels in newborns were found regardless of delivery. In case of delivery before 36 weeks’ gestation, Apgar scores at 1 minute and 5 minutes were statistically significantly higher in the vaginal delivery group than in the cesarean section group. Conclusion. The data obtained show a low incidence of acute FFT in neonates born through vaginal delivery in an uncomplicated MCDA twin pregnancy and the absence of this complication in newborns delivered by cesarean section. When this specific complication of MCDA twin pregnancy developed among newborns, no perinatal losses were detected, and subsequent postnatal outcomes were favorable. It appears that further studies to clarify the diagnostic criteria and risk factors for the development of acute FFT in labor and the long-term health outcomes for newborns in an uncomplicated MCDA twin pregnancy may reduce the rate of cesarean delivery without worsening perinatal outcomes. Key words: monochorionic twins, acute feto-fetal transfusion, twin-to-twin transfusion syndrome, twin anemia polycythemia sequence

Clinical Features and Antibiotic Treatment of Neonatal Listeriosis: A Hospital-Based Study.

To determine the clinical features, laboratory findings, antibiotic treatment, and outcomes of neonatal listeriosis in a specialized tertiary hospital in Wuhan, China. We retrospectively analyzed the medical records of patients diagnosed with neonatal listeriosis at Maternal and Child Health Hospital of Hubei Province from January 2015 to December 2022. Listeriosis was indicated by positive culture for Listeria monocytogenes (LM). A total of 11 cases were included in our study. The incidence rate of neonatal listeriosis was 2.06 per 100,000 live births. Seventy-three percent of the cases were born prematurely, caused early onset sepsis. Respiratory distress (100%) was the most common and earliest symptom, followed by fever (64%) and rashes (27%). The levels of C-reactive protein (CRP) and procalcitonin (PCT) were elevated in 100% of the cases. The median time-to-positivity (TTP) of the culture was 15 hours (range 9-28hours). Of the 11 neonates, 6 were cured, 2 showed improvement, and 3 died, with a mortality rate of 27%. There were statistically significant differences in Apgar score at 5 minutes (p=0.037) and CRP (p=0.025) between the survival group and fatality group. Ampicillin was sensitive to LM isolates and effective for therapy if initiated early. Neonatal listeriosis is a rare but severe infection with a high mortality rate. Early identification and appropriate use of effective antibiotics are particularly critical for achieving positive outcomes. Apgar score and CRP are relevant indices for prognosis. Ampicillin is the first-line therapy and can be empirically administered to neonates suspected of having listeriosis.

The Effect of Adding 1% Glucose to Crystalloid on Maternal Hemodynamics After Spinal Anesthesia for Cesarean Delivery: A Double-Blind, Randomized Clinical Trial

Background: We aimed to evaluate the effect of glucose-containing crystalloid infusion before anesthesia induction on hemodynamics and postanesthesia complications. Methods: This double-blind, randomized clinical trial was conducted on 60 parturient cases scheduled for elective Cesarean delivery under spinal anesthesia who were referred to the teaching hospitals of Mashhad University of Medical Sciences (Iran). The parturients were randomized into two groups. Both groups received 5 - 7 mL/kg of intravenous bolus serum before spinal anesthesia. The parturients in the glucose-containing normal saline (GcNS) group received 1% glucose solution in normal saline. The normal saline (NS) group received only normal saline. Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), blood glucose concentrations, neonatal Apgar scores, postanesthesia complications, and ephedrine and atropine consumption were evaluated. Results: Sixty patients were recruited (30 in each group), with a mean age of 29.14 ± 6.01 and 29.76 ± 6.15 years in the GcNS and NS groups, respectively. There was no significant difference between the two groups in SBP, DBP, or HR after baseline adjustment. The incidence of hypotension was higher in the NS (70.0%) compared to the GcNS group (46.6%), but the difference was not significant. There was no significant difference in Apgar scores. The incidence of nausea, vomiting, pallor, and shivering was higher in the NS group. However, only nausea and vomiting 10 minutes after anesthesia induction were significant. Ephedrine and atropine consumption was higher in the NS group, but not significantly. Conclusions: The present study did not show any clear benefit for adding 1% glucose to normal saline solution preload for hypotension in parturients undergoing Cesarean delivery with spinal anesthesia.

Improving Delivery Outcomes with the Application of Murottal Therapy Al-Qur'an on Length of Second Stage of Labor and Apgar Score.

Introduction: The second stage of labor is called the expulsion period, starting when the opening of the cervix is complete (10 cm) and ending with the birth of the baby with his force and straining the fetus is pushed out until birth. Childbirth is a stress response that the body responds to. Anxiety in pregnant women is caused by psychosocial factors such as the need for security and comfort. Al-Qur'an stimulants can generate delta waves of 63.11% with reduced anxiety in the mother making the muscles more relaxed and the mother can go through labor easily so there are no cases of prolonged labor and can improve the welfare of the fetus. Method: This type of research is a quasi-experimental study that aims to determine the increase in labor outcomes by applying the Murottal Al-Quran to the Length of the Second Stage of Labor and the APGAR Score. While the research design used was a pre- experimental design with a posttest only with a control group design to measure the effect of murottal QS. Ar-Rahman in the experimental group by comparing it with the control group. The population in this study were all mothers giving birth during the first active phase at the Ar-Rahmah Indaralaya Maternity Clinic in Palembang. Results: There were 66 respondents (55.5%) who applied Murottal Al-Quran with a duration of 2 under 1 hour, while 53 respondents (44.5%) did not apply Murottal Al-Quran with a duration of 2 under 1 hour. Respondents who applied Murottal Al-Quran in the absence of asphyxia were 64 people (66%) while respondents who did not apply Murottal Al-Quran in the absence of perineal rupture were 33 people (34%). Discussion: There was a difference in the length of stage II between the intervention group and the control group after the application of Murottal Al- Qur'an and there were differences in APGAR scores between the intervention group and the control group after the application of Murottal Al-Qur'an.

Myomectomy in adult women of reproductive age: a propensity score-matched study for pregnancy rates.

To study whether it is better to perform or not a myomectomy, in terms of surgical and reproductive outcomes in patients of advanced reproductive age, by an observational prospective study in university-affiliated and Community Hospitals. 40years and older patients affected by non-submucous symptomatic uterine fibroids and desiring future fertility were enrolled and treated by laparoscopic intracapsular myomectomy by (LIM) or by open laparotomy (OIM), or by a non-surgical management as control group, while attempting to conceive. The primary outcome measures were fibroid characteristics, pre- and post-surgical parameters, pregnancy achievement; the secondary outcome measures were the spontaneous or ART pregnancy outcomes, eventual week of abortion and type of delivery. Propensity scores have been calculated with logistic regression for binary and continuous variables. 202 patients completed the study: 112 operated by LIM, 40 by OIM and 50 patients as control group. Patients undergoing OIM have a worse surgical outcome than LIM. No difference was seen in pregnancy either after myomectomy or control group during follow-up. In the LIM group, there were 44 pregnancies (39.2%), and in the OIM group, there were 9 (22.5%) and 16 in the control group (32%). The weeks of delivery were statistically greater for the control group versus the surgical groups, with no difference in Apgar score between the 3 groups. Patients aged over 40years did not show substantial differences in reproductive outcome, whether operated or not. Myomectomy in over 40-year-old patients has no detrimental effect on future pregnancy rates and over when compared to expectant management.

Efficacy of intravenous ketamine as premedicant for prevention of intraoperative hypotension after spinal anesthesia in parturients posted for elective cesarean section

Background: Hypotension following spinal anesthesia (SA) in lower segment cesarean section can be deleterious to the parturient and to fetus. Ketamine acts by stimulating the cardiovascular system leading to high blood pressure and increase in heart rate (HR) and cardiac output. Aims and Objectives: This study aimed to assess the efficacy of 15 mg of prophylactic intravenous ketamine in elective cesarean section for prevention of hypotension after SA. Materials and Methods: This double-blinded randomized controlled study was conducted on 98 participating parturients who were American Society of Anesthesiologists term pregnant women. The parturients were randomly divided into two groups (n=49 in each). All the parturients received SA. Ketamine group - Group K received 15 mg of ketamine IV bolus in 3 mL saline and control group - Group C received the same volume of normal saline IV bolus. HR and systolic blood pressure (SBP) were recorded at baseline at 5, 10, 15, and 20 min after the injection and then every 15 min till the end of the operation. Incidences of hypotension were recorded. The total number dose of ephedrine used, APGAR score, and Visual Analog Scale scores were recorded. The Ramsay Sedation Score was also recorded at baseline, then 5, 10, 15, 30, and 45 min after injection, and then at the end of the operation. Results: This study showed a statistically significant increase in the incidence of hypotension and higher use of intravenous ephedrine 6 mg boluses in the control group when compared to the ketamine group. Forty-two parturients in the control group developed hypotension compared to 23 parturients in the ketamine group with P&lt;0.001. The total ephedrine dose was significantly lower among the ketamine group. Sedation was observed for the first 15 min intraoperatively in the ketamine group with P=0.001. There was no statistically significant difference in APGAR score between the two groups. Conclusion: There was significantly higher hemodynamic stability in the ketamine group with regard to SBP, diastolic blood pressure, and HR. Hence, low-dose ketamine, when used as a premedicant, is an effective agent that can be used in preventing post-spinal intraoperative hypotension in parturients undergoing cesarean section delivery.

Automated mandatory bolus versus basal infusion for maintenance of epidural analgesia in labour.

Automated mandatory bolus versus basal infusion for maintenance of epidural analgesia in labour.

The impact of epidural analgesia on delivery mode in Robson class 1 women: a retrospective cohort study

The use of epidural analgesia represents the gold standard for pain management during labor, but the influence of the use of epidural analgesia on delivery mode is not fully understood. This study aimed to analyze the impact of epidural analgesia on the delivery mode, namely, cesarean delivery, vaginal delivery, and operative vaginal delivery rates, in Robson class 1 women. A retrospective cohort study was conducted on all Robson class 1 women who delivered from January 1, 2019, to December 31, 2019, in the University Hospital of Modena. The primary outcome was the delivery mode (cesarean delivery, vaginal delivery, and operative vaginal delivery rates), and the secondary outcomes were maternal, anesthesiologic, and neonatal effects of epidural analgesia (duration of labor, duration of the second stage of labor, Apgar score, and neonatal intensive care unit admission). A total of 744 women were included in the final analysis, of which 198 (26.6%) underwent epidural analgesia on request and 546 (73.4%) did not. In women with and without epidural analgesia, the cesarean delivery rate was 8.1% vs 7%, the vaginal delivery rate was 79.3% vs 81.1%, and the operative vaginal delivery rate was 12.6% vs 11.9%, respectively. A significant increase in both the first stage of labor (66.3±38.5 vs 43.8±38.8 minutes; P<.0001) and total duration of labor (328.0±206.7 vs 201.7±168.3 minutes; P<.0001) was found in women receiving epidural analgesia. No change was recorded in the second stage of labor. A shorter duration of labor was observed (P<.0001) when epidural analgesia was started earlier (dilation: 2-4 cm vs >4 cm). No significant difference in Apgar score and neonatal intensive care unit admission was found. The use of epidural analgesia was not associated with an increased risk of cesarean delivery or operative vaginal delivery in Robson class 1 women. Further investigations are needed to evaluate its impact on the duration of labor, namely the duration of the first stage of labor, and on the possible advantages of starting epidural analgesia at an early stage.

The dynamics of mental health measures of pre- and postpartum women undergoing assisted reproductive technology

BACKGROUND: The number of infertile women has been increasing since 2015, with a 1015% increase in IVF cycles every year. The data on mental health of women using assisted reproductive technology are contradictory; there is little research on the dynamics of mental health outcomes from pregnancy to postpartum.&#x0D; AIM: The aim of this study was to evaluate the dynamics of mental health measures in the groups of pre- and postpartum women using assisted reproductive technology and to compare these groups with women who conceived spontaneously.&#x0D; MATERIALS AND METHODS: This study had three stages: during pregnancy, within one month after delivery, and in four to nine months after childbirth, and included 59 women who used assisted reproductive technology (34.0 4.60 years old) and 85 women with natural pregnancy (30.6 4.39 years old). All the women had singleton, planned pregnancy, with the most of them at more than 20 weeks pregnant. Drop out within research stages was approximately 2030%. We used the Achenbach System of Empirically Based Assessment, socio-demographic and obstetric data gathering, as well as a postpartum telephone interview.&#x0D; RESULTS: Women in the assisted reproductive technology group were less likely (р = 0.000) to attend or plan to attend childbirth preparation courses. In this study group, emergency (40%) and planned (26%) caesarean sections were used more often (p = 0.001); in 17% of cases, they gave birth before 37 weeks of gestation (vs. 1.9% in the group of women with natural pregnancy); and only 51% of women undergoing assisted reproductive technology used breast feeding (vs. 78% in the group of women with natural pregnancy). No significant differences in Apgar scores and the number of problems in childs health straight after the delivery were shown. In 49 months after the childs birth in the group of women using assisted reproductive technology, the number of somatic disorders was significantly higher (р = 0.046) compared to the group of women with natural pregnancy. The analysis of the dynamics of mental health measures revealed an increase of withdrawal (p = 0.010) and thought problems (p = 0.001) in the group of women using assisted reproductive technology. In the group of women with natural pregnancy, the analysis revealed a decrease in the number of mental health problems such as anxiety / depression, somatic problems, delinquent behavior, as well as DSM-associated anxiety disorder and avoidance (р 0.05).&#x0D; CONCLUSIONS: Mental health measures of women undergoing assisted reproductive technology, their dynamics after childbirth, the number of preterm births and cesarean sections, as well as feeding type altogether may be a risk factor for the mental health and development of the children. These women may require additional support.

THE EFFECT OF RAMADAN FASTING ON PREGNANCY OUTCOMES DURING THE SECOND AND THIRD TRIMESTER

Background &#x0D; Fasting during pregnancy has always been considered a debatable condition. Some Muslim women do not fast during pregnancy for their children’s health; however, they feel uncomfortable because of their religious beliefs. On the other hand, some pregnant mothers prefer to fast despite their anxiety about their children’s health, and they fast during pregnancy.&#x0D; Objectives &#x0D; To evaluate Ramadan fasting effects in the second and third trimesters of pregnancy on maternal health, fetal growth and early neonatal outcome.&#x0D; Patients and Methods&#x0D; An observational case-control study carried out in Sulaymaniyah City/Kurdistan region/Iraq within a period between April to October 2021, involving 220 healthy pregnant women presented one week before and within the first week of Ramadan in their second or third trimester of pregnancy, they are grouped into two groups (fasting and non-fasting) according to their choice. Both groups followed 4-8 weeks after the first visit and at the delivery time.&#x0D; The parameters observed in the first and second visits were maternal age, weight, residency, maternal job, maternal blood pressure, haemoglobin (Hb), random blood glucose (RBS), gestational age measured by ultrasound, amniotic fluid index (AFI), fetal growth measured by ultrasound.&#x0D; The mode of delivery with an indication of cesarean section(C/S) was recorded in addition to the above parameters at the time of delivery. In addition, birth weight and 5 minutes APGAR score were also recorded.&#x0D; Results&#x0D; Of 220 women, 77 were not fasting, and 143 were fasting. About 87 women presented in the second trimester (57 cases were fasting), while 133 women presented in the third trimester (86 cases were fasting), and no significant changes in the evaluated parameters were observed. There was no significant difference between the fasting and non-fasting groups. Three babies from the fasting group were delivered during the preterm period, while two were delivered preterm in the non-fasting group. This study recorded neither intrauterine fetal death (IUFD) nor stillbirth. No significant difference in APGAR scores at 5 minutes and birth weight was observed between the two groups. &#x0D; Conclusion&#x0D; Ramadan fasting does not increase the risk of maternal, fetal and early neonatal complications. Most Muslim pregnant women do not recognize their right to be excused from fasting Ramadan by the Islamic religion, and they have a high rate of fasting with very strong desire and happiness.

Effect of intraspinal dexamethasone on intrapartum fever, and maternal and infant outcomes

Purpose: To study the effect of intraspinal injection of dexamethasone (DXMS) on intrapartum fever and maternal and infant outcomes.&#x0D; Methods: A total of 200 puerperal women who gave birth in The Fourth Hospital of Shi Jia Zhuang from May 2020 to September 2021 were randomly selected and randomly divided into two groups: routine group (control group) and study group, with 100 women in each group. The routine group received epidural block anesthesia. In addition to the treatment given to the routine group, mothers in the study group were injected with 5 mg of dexamethasone in the spinal canal through an epidural catheter. Pain, fever, as well as maternal and infant outcomes were evaluated.&#x0D; Results: There were no statistically significant differences in the degree of pain between the two groups, before and 1 h after anesthesia (p &gt; 0.05). However, visual analogue scale (VAS) scores at the end of the first and second stage of labor were significantly lower in the study group (1.76 ± 0.56 and 3.41 ± 0.39, respectively) than in the control group (4.73 ± 0.48 and 6.11 ± 0.63, respectively; p &lt; 0.05). In the control group, 23 puerperal women (23 %) had body temperature ≥ 37.5 oC but &lt; 38 oC, while 19 puerperal women (19 %) had body temperature ≥ 38 oC. There was no statistically significant difference in Apgar scores between the two groups at 1 min and 5 min after delivery (p &gt; 0.05). In the control group, there were 9 (9 %) cases of headache, 5 (5 %) cases of prolonged labor, and 7 (7 %) cases of weak contractions, while the corresponding numbers in the study group were 2 (2 %), 0 (0 %) and 1 (1 %), respectively.&#x0D; Conclusion: The use of intrathecal dexamethasone in women reduced maternal pain and likelihood of fever during labor, with no significant effect on the newborn.

Transition of Extremely Preterm Infants from Birth to Stable Breathing: A Secondary Analysis of the CORSAD Trial

Objective: Exploratory secondary analysis of the CORSAD trial compared a new resuscitation system (rPAP) to the standard T-piece system. This analysis focused on the subgroup of infants who were not intubated in the delivery room. The aim was to compare the use of noninvasive positive pressure ventilation (PPV), oxygen saturation, and Apgar scores for the two resuscitation systems during the 30-min intervention period. Methods: This is secondary analysis of CORSAD trial using data from the intervention period in the delivery room. Infants in the original randomized system groups were divided into intubated and nonintubated groups. For nonintubated breathing infants, we compared demographics, the use of PPV, Apgar scores, and oxygen saturation at 5 and 10 min after birth. Generalized linear models were applied to calculate the risk difference and odds ratio with 95% CI between the two groups. Results: Among nonintubated infants, the use of PPV repeatedly (defined as PPV with at least 1 min of spontaneous breathing between PPV cycles) was less frequent in the rPAP group (26.8% vs. 43.3%, %RD −16.5, 95% CI [−31.7 to −1.1], p 0.04). The use of PPV after 5 min of age was also less common in the rPAP group (23.2% vs. 38.8%, %RD −15.6, 95% CI [−30.7 to −0.8], p 0.04). There were no statistically significant differences in Apgar scores or oxygen saturation levels between the groups. Conclusion: In the CORSAD trial, less PPV was needed to establish stable breathing in extremely preterm infants using the rPAP compared to using the standard T-piece without significant difference in Apgar scores or oxygenation.

The Effects of Asymptomatic Coronavirus Disease-2019 on Placenta at Third Trimester Pregnancy: A Comprehensive Study

Objective: By the time coronavirus disease-2019 (COVID-19) had been announced as pandemic, the disease was shown to have a great risk among pregnant woman if lower respiratory system is involved. We aimed to describe clinical characteristics of deliveries with asymptomatic COVID-19 infection, investigate transplacental transmission, and compare first-line histopathological findings with healthy controls. Material and Methods: We conducted a prospective cohort study of consecutive term deliveries at our tertiary hospital's obstetric unit between March and November 2021. Forty-five patients with asymptomatic reverse transcription-polymerase chain reaction (RT-PCR) positivity were matched with 45 controls with negative RT-PCR testing. All newborns of mothers with positive RT-PCR results for COVID19 underwent a nasopharyngeal swab following delivery, and Apgar scores of the newborns were extracted from pediatric charts. Placentas were transported and fixated in 10% formaldehyde solution before pathological evaluation. Results: There were no significant differences in Apgar scores, birth weights, head circumferences, birth height, and genders between the 2 groups. RT-PCR results were negative in all of the newborns, indicating no vertical transmission. Placental focal and global calcification, and choriamnionitis frequencies were similar between the groups, whereas placental fibrin deposits were significantly more frequent in the placentas of infected pregnancies. Conclusion: There was no evidence of vertical transmission and any characteristic feature in the placentas of pregnancies with asymptomatic COVID-19 infection. Although no significant clinical implication was found, increased perivillous fibrin deposition in the study group could be a baseline step for the progression of perinatal infection.

Preeclampsia and neonatal outcomes in adolescent and adult patients

Preeclampsia is an important health problem with a higher prevalence in the adolescent population. Furthermore, preeclampsia causes adverse maternal and neonatal outcomes. Newborns can be affected by preeclampsia, resulting in lower birth weight or Apgar score, the need for neonatal intensive care, or prematurity. All these complications are also associated with adolescent pregnancies, and together with preeclampsia, it can determine poorer neonatal outcomes. The aim of the study was to compare the neonatal outcomes of adolescents and adults with preeclampsia. We analyzed data on all the newborns of adolescents with preeclampsia (n=12) who delivered at the Department of Obstetrics and Gynecology of University Emergency Hospital in Bucharest between January 1st, 2019, and December 31st, 2019 and compared it with data from 12 aleatory newborns of adults diagnosed with preeclampsia. The prevalence of preeclampsia was higher in the adolescent population compared with the adult one. The weight of newborns was lower among adolescents with preeclampsia. There were no significant differences in Apgar scores between the two groups. Preterm delivery was more frequent in adolescent patients with preeclampsia. Preeclampsia is an additional risk factor for adolescent pregnancy, but it is also a severe materno-fetal complication for this population.

Analysis of Maternal and Infant Outcomes and Related Factors of Vaginal Delivery of Second Pregnancy after Cesarean Section.

Objective To explore the clinical effect of different delivery methods and the safety of vaginal delivery of second pregnancy after cesarean section and analyze the related factors. Methods A total of 738 eligible pregnant women who underwent cesarean section from September 2018 to August 2020 were randomly selected from our hospital. Among them, 527 pregnant women successfully delivered vaginally were selected as the observation group, and 211 pregnant women who failed vaginal delivery were selected as the control group. To analyze the factors that influence the success of vaginal delivery of second pregnancy after cesarean section and compare the outcomes of mother and infant in two groups. Results There was no significant difference in age, prenatal body mass index (BMI), and thickness of lower uterine segment between the two groups (P > 0.05). There were significant differences in fetal head orientation, fetal abdominal circumference, fetal biparietal diameter, uterine height, premature rupture of membranes, Bishop score, and epidural anesthesia during labor between the two groups (P < 0.05). Multivariate logistic regression analysis showed that fetal abdominal circumference, fetal head orientation, Bishop score, and epidural anesthesia during labor were independent factors affecting the success of VBAC (P < 0.05). There was no significant difference in the incidence of uterine rupture between the two groups (P > 0.05). The amount of postpartum hemorrhage in the observation group was significantly lower than that in the control group (P < 0.05). There was no significant difference in Apgar score, asphyxia rate, and hospitalization rate between the two groups (P > 0.05). There was no significant difference in the incidence of complications between the two groups (P > 0.05). Conclusion There are many factors that influence the success of vaginal delivery after cesarean section. Through prenatal comprehensive evaluation of vaginal delivery conditions, we can guide the parturient to choose a reasonable mode of delivery, reduce the incidence of complications, and improve the outcome of mother and baby.