Postpartum Woman Research Articles

PERI-PARTUM SEPSIS INDUCED CARDIOMYOPATHY: CASE REPORT WITH LITERATURE REVIEW

Heart failure can very rarely be caused by postpartum cardiomyopathy. Heart failure symptoms frequently resemble those of a typical pregnancy, delaying diagnosis and leading to avoidable complications. 24-year-old previously healthy pregnant women developed Sepsis induced peripartum cardiomyopathy. In this case report we discuss peripartum cardiomyopathy, mechanism, clinical diagnosis, imaging modalities, methods for management and advise for the patient. The present case report concludes that the diagnosis of peripartum cardiomyopathy should be considered in any pregnant or postpartum woman with symptoms concerning for heart failure. Most patients get successfully recovered if diagnosed in early stages and treatment received on time.

Pilates Exercise OnPost PartumWomen With Pelvic Girdle Pain


 Objective: To determine the effectof Pilates exercise on pain in post-partum women with pelvic girdle pain. Method: The research design used a pre-experimental design with one group pretest-posttest design. The population in this study were all postpartum women in Kuningan Barat sub-district, South Jakarta with complaints of pelvic girdle pain. The sampling technique in this study is non-probability method by purposive sampling in which the researcher
 took a sample based on predetermined criteria as many as 10 respondents. Pain data collection used the Visual Analog Scale and tested with the t test. Results: analysis of the dependent T test in postpartum women with pelvic girdle pain concluded that the pretest and posttest pain scores had a P-value (0.001) < α 0.05, so H0 was rejected. Conclusion: Giving Pilates exercises can reduce pain in postpartum woman with pelvic girdle pain.
 

Evaluation of Lumbar Lordosis and Hip Extensor Strength in Postpartum Woman with Pelvic Girdle Pain - A Case Control Study

Background: Pelvic Girdle Pain (PGP) is a musculoskeletal pain that arises between the posterior iliac crest and gluteal fold, at the sacroiliac joint and also radiates posteriorly in the thigh. PGP give rise to very intense pain and disability than Low Back Ache (LBA). It is a common condition during pregnancy and post-delivery. Joint laxity increases pelvic rotation and lumbar lordosis which results in adaptive hip extensor muscle weakness. Hence the studies focus on identifying the lumbar lordosis and hip extensor strength of PGP. Aim of the Study: To identify the association between lumbar lordosis and PGP and to identify the association between hip extensor strength and PGP among post-partum women. Material and Methodology: Based on inclusion and exclusion criteria a total of 80 postpartum women were assessed based on the diagnostic criteria the women were divided into two groups. Group A consists of women with PGP and group B consists of women without PGP. Both groups were assessed for lumbar lordosis using flexicurve and hip extensor strength using a manual muscle tester. Data collected was analyzed using. Outcome Measure: Flexicurve to assess lumbar lordosis. Manual muscle tester to assess hip extensor strength. Result: The study showed that the mean lumbar lordosis was significantly higher in women with PGP than in women without PGP, p = 0.001. There was a 15.46° ± 6.91° higher angle observed in persons who had pelvic girdle pain compared to those who did not have pelvic girdle pain. The mean hip extensor strength for group ‘A’ (average of right and left side) was 12.74 ± 0.73kg, whereas it was significantly higher in group ‘B’. Conclusion: The study concludes that there is a positive association between lumbar lordosis and hip extensor weakness in pelvic girdle pain.

Length of Maternity Leave Impact on Mental and Physical Health of Mothers and Infants, a Systematic Review and Meta-analysis.

Recent legislative decisions in the United States have encouraged discussion about national parental leave programs. Currently, over 47% of the United States workforce is female. However, the United States is the only nation of the 37 member countries in the Organization for Economic Co-Operation and Development (OECD) to have no national requirement for maternity leave. The first few months of a child's life are vital to their physical and mental development. Likewise, a gradual return to pre-partum functioning is important for a newly postpartum woman. While it has been shown that maternity leave positively impacts various measures of maternal and infant mental and physical health, we lack consensus on the optimal length of paid or unpaid maternity leave. Accordingly, we conducted a systematic review and meta-analysis to evaluate the optimal length of paid or unpaid maternity leave to encourage maternal and infant mental and physical health in the United States. A systematic review and meta-analysis were conducted to synthesize and critically evaluate the current research investigating the association between maternity leave and maternal and infant mental and physical health using the Preferred Reporting in Systematic Reviews and Meta-Analyses guidelines. Databases EMBASE, PsycInfo, and PubMed were searched using specific inclusion and exclusion criteria. Methodological Index for Non-Randomized Studies scale assessed the methodological quality of the included eligible studies. The magnitude of heterogeneity between-study was tested using The Cochrane χ2 test and the Moran's I2 statistic. Possible publication bias was assessed through the funnel plot and the Egger regression test. A p-value of < 0.10 will be considered as an indication for the existence of potential publication bias. All statistical analyses were carried out with Stata software version 15. A total of 21 studies were analyzed. It was found that longer maternity leave may decrease rates of maternal mental and physical health complaints. It was also found that longer maternity leave leads to more positive mother-child interactions, decreased infant mortality, and longer periods of breastfeeding. Maternity leave of 12weeks or more confers the greatest benefit for mothers and their infants.

A Rare Case of Incidentally Diagnosed Pulmonary Inflammatory Myofibroblastic Tumour with Dramatic Response to Crizotinib in a Postpartum Woman.

Inflammatory myofibroblastic tumours are rare neoplasms which most commonly affect children and young adults. With an intermediate malignant potential, they are typically detected in the abdomen, lung, mediastinum, head and neck, gastrointestinal tract, and genitourinary tract. We describe the case of a 33-year-old postpartum woman incidentally diagnosed with a pulmonary inflammatory myofibroblastic tumour following complaints of poorly controlled hypertension a week after caesarean section. She was ALK-negative and received an ALK inhibitor with complete resolution of the lesion. A ROS1-TFG fusion confirmed the diagnosis of an inflammatory myofibroblastic tumour after CT-guided fine needle aspiration. This case highlights an uncommon presentation posing a diagnostic and therapeutic challenge and the potential treatment option of crizotinib. Inflammatory myofibroblastic tumour (IMT) is a rarely reported neoplasm arising in the abdominal soft tissues, the lung, mediastinum, head, neck, gastrointestinal tract, and genitourinary tract, with intermediate malignant potential.IMT is definitively diagnosed only after histological examination following surgical biopsy, based on immunohistochemical markers and the molecular characteristics of the tumour, but small biopsies may have a role in a large lesion.IMT did not cause any complications during gestation.Therapeutic approaches include surgical resection and chemotherapy, including with crizotinib, an ALK tyrosine kinase inhibitor.

POTENTIALLY ENHANCEMENT OF POSTPARTUM PSYCHOLOGICAL DISORDERS IN THE PANDEMIC OF COVID-19

Background: The resulting consequences of pandemic COVID-19 include non-natural disasters, as well as trauma, which causes challenges in the psychological field due to the resulting situational under pressures. This can also be used as a benchmark for psychological well-being in postpartum women. The process of giving birth is one of the stressful events for the mother and this is a critical period for the mother, it can cause some physical and psychological damage due to unpleasant experiences during childbirth, such as difficult cases, prolonged labor, and traumatic manipulation during labor. Objective: To discussed the factors that can have a potential effect on the risk of this incident, the potential to exacerbate psychological disorders in postpartum women, including factors from a medical, social, and psychological perspective. Method: This paper involved on referral sources and based on observation by author. Results: Prevalence of disorders such as depression and PTSD increased during the COVID-19 pandemic. Other supportive conditions such as the lack of mental support from families, the process of independent isolation, limited access to health services which also causes stress and feelings of being alone. Based on the literature, all of these events can create fear and suppress the mental state of the post partum woman, hinder the postpartum process of transition, and increase the intensity of depression severity Conclusion: Pandemic COVID-19 made alleviate of postpartum psychological disorder, therefore preventive effort can be choosen to bring positive impact by increasing productivity and make a positive mind in the mother, also described as an efficient and useful method for postpartum mothers. Keywords: enhancement, psychological, pregnancy.

PENYEMBUHAN LUKA PERINEUM PADA IBU NIFAS DENGAN MENGGUNAKAN EKSTRAK SIDAGURI (SIDA RHOMBIFOLIA)

Infection during the postpartum period is still a big problem for postpartum mothers during the postpartum period, data show that 50% of nifas women experience infection, and every day one postpartum woman experiences infection due to perineal lacerations. This study aims to determine the healing of perineal wounds in postpartum mothers using Sida Rhombifolia extract in the working area of ??the Watampone Health Center and BPS Hj Harfiani. This type of experimental research with accidental sampling method with a total sample of 36 people, the instruments used were questionnaires and perineal wound healing assessment checklist. Statistical tests show the results of the Independent T-test intervention group mean value of 3.000 standard deviations of 0.000 control mean value of 2.384 standard deviations of 0.650 with a P-Value of 0.00 based on this shows the results of the intervention sample given sidaguri (sida rhombifolia) extract and also not taking antibiotics has a greater effect compared to controls who are not given sidaguri (sida rhombifolia) extract by taking antibiotics. ) ). So that this research can be used as an alternative in accelerating the healing of perineal wounds for postpartum mothers to reduce the incidence of perineal wound infections.

Care for pregnant and postpartum woman with cerebral palsy

Abstract Introduction. Disabled women are often overlooked when it comes to procreation plans and encounter social misunderstanding and lack of support. In addition, their sexual needs are often marginalized. It means that education and professional care of midwives and doctors are necessary to put flesh on problem. Aim. The aim of the work is to present knowledge and familiarize with the subject of perinatal care for a woman with a disability based on an individual case study. Method. For the purposes of this study, the qualitative research method “study case” was used, containing a description of the patient’s obstetric and clinical condition, aimed at its in-depth analysis and assessment. The patient’s informed consent to participate in the study was obtained. C-Hobic care outcome indicators were also used to describe the case. ICNP® reference terminology was used to develop care plans. Summary. Taking care of a patient with cerebral palsy, the midwife undertakes numerous interventions in the field of education of both the woman and the whole family. The overriding goal is to increase the woman’s independence, increase her confidence that she will be able to take care of a newborn and improve her competence in self-care. Due to the constant progress in maternal-fetal medicine, further research is needed on preconception and perinatal care for patients with CP.

Discharge Readiness and Associated Factors Among Postpartum Women in Tamale, Ghana.

Ghana experiences a relatively high maternal mortality ratio, with the majority of maternal deaths occurring in the postpartum period. Discharge readiness is a reliable indicator of maternal health outcomes and involves a postpartum woman's perception of preparedness to leave the hospital following delivery. We measured the discharge readiness of postpartum women in Ghana through an institutional-based cross-sectional study involving 151 participants. Participants completed an interviewer-administered survey, and data analyses included linear regression models. The study sample demonstrated relatively high discharge readiness, with a mean score of 177.57 on a scale from 0.00 to 220.00. Higher gravidity was positively associated with discharge readiness score, while longer length of hospital stay and receiving educational handouts were negatively associated with discharge readiness score. Clinical interventions addressing the factors found to be associated with discharge readiness have significant potential to improve postpartum care and maternal outcomes in Ghana.

Massive pleural effusion post-emergency cesarean in undiagnosed congenital diaphragmatic hernia

Introduction: Bochdalek’s hernia is a congenital diaphragmatic hernia (CDH) resulting from inadequate closure of the membrane over the left side of the hemidiaphragm. Patients will start to develop symptoms upon displacement of abdominal contents into the thoracic cavity. This case report highlights the radiological modality findings that can be used in diagnosing a late-presentation CDH in adults. Case Report: A 35-year-old postpartum woman developed shortness of breath, left-sided chest pain, episodes of vomiting and epigastric tenderness within 24 hours post-emergency cesarean section. An initial diagnosis of left tension hydrothorax was made based on the clinical and radiological findings. Left diagnostic and therapeutic thoracocentesis using landmark technique was performed and brownish fluid was obtained upon aspiration. Post-procedural chest X-ray (CXR) reported cystic-like features over the left hemithorax. Therefore, computed tomography (CT) thorax was proceeded and confirmed the left diaphragmatic hernia with a mediastinal shift to the right. However, the patient’s condition worsened and required emergency open thoracotomy with left diaphragmatic hernia repair. Intraoperative findings showed left Bochdalek’s hernia complicated by multiple visceral organ perforations secondary to previous thoracocentesis. The patient was discharged well after a few weeks of hospital stays. Conclusion: The diagnosis of late-presentation Bochdalek’s diaphragmatic hernia remained challenging and can be easily missed. Therefore, a comprehensive evaluation is required prior to performing an invasive diagnostic procedure. Chest X-ray and ultrasound are useful diagnostic aid in the absence of CT thorax and magnetic resonance imaging (MRI) modalities.

Challenges in Cerebral Venous Thrombosis Management-Case Reports and Short Literature Review.

Cerebral venous thrombosis (CVT) is a rare type of stroke, with a complex clinical presentation that can make it a diagnostic challenge for the swift initiation of anticoagulation. When a hemorrhagic transformation is added, therapeutic management becomes even more complex. We describe a series of four cases, aged between 23 and 37 years old, with cerebral venous thrombosis. They were admitted to our clinic between 2014 and 2022. All cases presented significant challenges in either diagnostic, therapeutic or etiologic evaluation, at different stages of the disease. Late complications such as epilepsy or depression and other behavioral disorders represent long-term sequelae for the patient. Therefore, through its late complications, CVT is not only an acute disease but a chronic disorder with long-term follow-up requirements. The first case of the series is of a postpartum woman with focal neurological deficit caused by CVT with hemorrhagic transformation that presented multiple thrombotic complications and severe depression. The second case is of a man with extensive cerebral thrombosis who developed bilateral papillary edema under therapeutic anticoagulation treatment. The third case is of a woman with bilateral cavernous sinus thrombosis who later developed depressive disorder and focal seizures. The fourth case is of a pregnant woman in the first trimester presenting with a steep decline in consciousness level secondary to deep cerebral vein thrombosis requiring intensive care and subsequently developing a memory disorder. For a long period of time, due to being underdiagnosed, few things were known about CVT. Nowadays, we have all the tools to diagnose, treat, and follow up cases of CVT.

Pyomyoma associated with bacteremia and puerperal pyrexia: A case report

ObjectiveTo report a case of pyomyoma, a serious complication of the uterine leiomyoma, in a postpartum woman. As the occurrence of pyomyoma in association with pregnancy is rather rare, a brief literature review of the condition in pregnant women is provided. Case reportA 41-year-old woman was found to have pyomyoma following persistent fever during the postpartum period of a first-time vaginal delivery. Her pregnancy course was complicated by preterm labor, for which the patient had received tocolysis since 30-week gestation. The pyomyoma was promptly removed by myomectomy on day-6 postpartum. ConclusionPyomyoma can occur in both pre- and post-menopausal women, and may even complicate pregnancies. Therefore, obstetricians and gynecologists should be wary of pyomyoma in postpartum women with histories of leiomyoma that present with sepsis of unknown focus that is refractory to standard antibiotics. Fertility may be preserved through timely diagnosis, followed by a prompt intervention.

Care plan for pregnant and postpartum woman with diagnosed cancer – metastatic lymphoma

Care plan for pregnant and postpartum woman with diagnosed cancer – metastatic lymphoma

Критические акушерские состояния и риск материнской смертности: данные Приволжского федерального округа

Aim: To identify additional risk factors for maternal mortality (MM) in critical obstetric conditions (COC) and opportunities for their reduction. Design: Retrospective observational sample study. Materials and methods. Analysis of 2508 cases entered into the Register of COC of the module “Obstetrics and Neonatology” of the Vertically Integrated Medical Information Systems of the Ministry of Health of Russia in the period from 01.01.2021 to 12.31.2022 in the Volga Federal District. “Patient's age”, “leading criterion of COC in the development of symptoms”, “obstetric status at the time of development of COC symptoms”, “level of obstetric care” indicators analyzed and their influence on the probability of death were studied. A total of 59 (2.7%) deaths were registered: 49 (83.1%) MM and 10 (16.9%) deaths of women during pregnancy, childbirth and the postpartum period who did not meet the criteria. 8 deaths from external causes were excluded from the analysis. After excluding patients with COVID-19, the authors identified 2201 (87.8%) cases to analyze. Results. The risk of MM increased in the presence of jaundice in preeclampsia by 70.047 times (95% confidence interval (CI): 6.206–790.68; p &lt; 0.001), ketoacidosis by 12.306 times (95% CI: 1.415–106.983; р = 0.023), cardiac arrest by 6.478 times (95% CI: 2.945–14.251; p &lt; 0.001), pulmonary edema any etiology by 4.123 times (95% CI: 1.215–13.990; р = 0.023), predicted or ongoing difficult tracheal intubation by 526.500 times (95% CI: 25.567–10842.032; p &lt; 0.001), cardiopulmonary resuscitation by 11.488 times (95 % CI: 2.170–60.824; р = 0.004), anaphylactic shock by 25.204 times (95% CI: 1.779–357.153; р = 0.017). The presence of severe preeclampsia did not significantly affect the likelihood of death (HR = 0.833; 95% CI: 0.643–1.080; p = 0.169). With the development of COC symptoms, the risk of death in a pregnant woman was 5.569 times lower than in a woman in labor, and in a postpartum woman it was 6.600 times lower. In a tertiary hospital, the probability of death was 14.226 times less. Conclusion. Certain extragenital pathology leading to the development of COC is the main risk factor for MM. Obstetric pathology is much more common, but due to the competence of obstetrician-gynecologists in secondary and tertiary obstetric hospitals, the risk of death, is significantly reduced. At the same time, at each stage of care, indications for routing the patient to a higher-level hospital should be taken into account in order to provide adequate medical care for extragenital diseases. Keywords: critical obstetric conditions, maternal mortality, mortality risks.

PS-C30-9: CHALLENGES IN MANAGING PERIPARTUM CARDIOMYOPATHY COMPLICATED WITH SEVERE PRE-ECLAMPSIA IN SUBURBAN AREA: A CASE REPORT

Background: Peripartum cardiomyopathy (PPCM) is a life-threatening condition, refers to rare dilated cardiomyopathy causing heart failure in late pregnancy or early postpartum woman. The diagnosis was based on pregnant/peripartum woman who had sudden cardiac decompensation without any history of cardiac disease. Pre-eclampsia (PE) could be co-existed with PPCM because of similar pathophysiology mechanism, which leads to higher mortality. Hereby we present the challenges of managing PPCM complicated with severe PE in suburban areas. Case Illustration: A 36-year-old woman referred to hospital with shortness of breath. Her past medical history was remarkable for severe-PE and had undergone caesarean section two-day-ago. Upon arrival, her saturation-75%, HR-120x/min, BP-140/80 and RR exceeds-40x/min. She was in respiratory distress with JVP increased, coarse crackles at basal lungs, and leg swelling. Laboratory studies were unremarkable. The x-ray revealed cardiomegaly and ECG showing LVH. Initial echocardiography demonstrated left ventricular systolic dysfunction with ejection fraction-34%. The patient was suggestive for PPCM with previous history of PE. Continuous administration of IV-furosemide-5 mg/h, spironolactone-25 mg, bisoprolol-2.5 mg, and candesartan-8 mg were administered. Her condition improved rapidly with increased saturation from 75% to 95% and significant reduced in dyspnoea. She was transferred to intensive cardiovascular unit for further management and discharged after 7-days for outpatient control. Discussion: PPCM is a devastated diagnosis among pregnancy woman. The diagnosis should be distinguish from PE induced heart failure. In PPCM, the echocardiography findings is related with left ventricular systolic dysfunction and reduced EF, whereas diastolic dysfunction with preserved EF is identified in PE induced heart failure patient. PE is associated with PPCM based on the shared pathophysiology. It is related with the angiogenic imbalance and excess expression of antiangiogenic factor sFlt1 soluble fms-like tyrosine kinase-1, which have found increased in both of the diseases. This is explained why PE has been recorded to occur in 30% of PPCM cases and it contributes to the increasing maternal mortality when most of the causes of maternal death are preventable.

Demographic Variables as a Determinant of Health Promotion Practices among Postpartum Women Attending Primary Health Care Centers in Abia State

Little is known about the engagement of health promotion practices of postpartum women in Abia State; and no empirical data was identified in Abia State hence the motivation to determine demographic Variables as a determinant of health promotion practices among postpartum women attending primary health care centers in Abia State. To achieve this purpose, 8 specific purposes, and 8 corresponding research questions and 8 hypotheses were raised. Descriptive survey design was adopted. Multi-stage sampling technique was used to draw 600 postpartum women attending primary health care centers at Abia State between September and October, 2021. Research instrument was a researcher- developed questionnaire tagged “Health Promotion Practices Questionnaire, (HPPQ)” which was divided into two clusters (breastfeeding and personal hygiene). Three experts validated the instrument. The HPPQ was subjected to reliability test using Kuder-Richardson (K-R 20) and the reliability coefficients 0.61 and 0.69 were obtained for breastfeeding and personal hygiene respectively. Analysis was done using 462 adequately completed copies of the instrument. Frequencies and percentages were used to answer the research questions, while chi-square statistics was used to test the hypotheses at .05 alpha levels. The findings showed that greater proportion of women below 23years of age engaged less in health promotion practices regarding personal hygiene and breastfeeding. Also, postpartum women of parity level of 1-3 engaged most in health promotion practices of breastfeeding and personal hygiene. Postpartum women who were either civil servants or business women engaged most in health promotion practices stipulated in this study while those postpartum women of educational group of primary education and no-formal education engaged less in health promotion practices of breastfeeding and personal hygiene. There were significant differences among postpartum women of different ages, parity levels, educational status and occupational levels in their engagement of health promotion practices. Based on the above findings, conclusions were drawn and recommendations among others were made: every postpartum woman should be adequately informed and sensitized on the importance of postpartum care and the essence of regular attendance to Primary Health care centers during postpartum period, particularly the younger ones, using appropriate channels and settings.

Postpartum Typhoid Intestinal Perforation

Background: Typhoid fever remains a highly contagious and multi-systemic infection caused by salmonellae typhi, and like other gastro-enteric infection, it poses a higher risk of morbidity and mortality during pregnancy as a result of the physiological changes associated with pregnancy as well as concerns of antibiotic safety in pregnancy. The occurrence of typhoid perforation in pregnancy may be easily confused for other causes of acute abdomen in pregnancy.&#x0D; We report the presentation, management and outcome of a 25 year old postpartum woman who presented with typhoid intestinal perforation in a resource limited environment. She had an emergency exploratory laparotomy and was managed post operatively in the ICU but clinically deteriorated and subsequently died on the third post-operative day secondary to multiple organ failure from severe sepsis.&#x0D; Typhoid perforation in pregnancy is a rare presentation, a high index of suspicion, and early intervention, would reduce the incidence of morbidity and mortality associated with this disease condition.

Postpartum Hypernatremia with Extrapontine Rhabdomyelinolysis: A Case Report.

Hypernatremia (serum sodium>160 meq/L) present with diverse neurological manifestations, ranging from flaccid paralysis to impaired cognition, encephalopathy, and even deep coma. Osmotic demyelination refers to changes in brain cells because of an acute change in plasma osmolality. It is further divided into two types, i.e., central pontine myelinolysis (CPM) and extrapontine myelinolysis (EPM). Patients with EPM, besides spasticity, may also present with other movement disorders such as catatonia, parkinsonism, and dystonia. We present a case of a postpartum woman bought to the emergency department by her relatives in an unconscious state. In view of poor sensorium (Glasgow coma scale < 7), she was intubated and received mechanical ventilatory support. On admission, computed tomography ofthebrain was normal, and the patient was transferred to the intensive care unit (ICU) for further management. The preliminary work-up in the ICU showed hypernatremia (serum sodium of 182 mEq/L) with hyper-osmolality (359 mOsm/kgH2O). She was managed as per the ICU protocol for hypernatremia. During her ICU stay, her sensorium improved, but she developed flaccid paralysis and was quadriplegic. Thus, a tracheostomy was performed, and she was weaned from the ventilator. After ventilator weaning, she was transferred to the ward for further rehabilitation. During rehabilitation, the patient was able to sit and takefoodorally.To date, only a few cases are reported in postpartum women with acute severe hypernatremia caused by high-grade fever and loss of body fluids leading to extra-pontine demyelination and flaccid paralysis. This case highlightsthat prompt recognition and appropriate intervention can improve the outcomes in these patients.

Postpartum pancreatitis in young female – a rare case in the Emergency Department

Abstract Introduction: Acute pancreatitis is a condition that leads to multiple organ failure syndromes if not diagnosed and treated correctly. The most frequent causes of acute pancreatitis are gallstones, alcohol consumption, and elevated triglyceride serum level. Case Presentation: A 21-year-old female presented to the emergency department with epigastric pain, nausea, vomiting, and diaphoresis. The patient had a non-complicated vaginal birth four months prior, had no personal history of illness, reported no alcohol consumption, and had a slender body constitution. Laboratory tests outlined a white blood cell count of 22.000/µL, elevated neutrophil count, lactate dehydrogenase 294 U/L, and lipemic serum sample reported for chemistry laboratory test. In addition, the contrast-enhanced computed tomography scan revealed severe pancreatitis, with an intraabdominal fluid collection. Conclusions: This case report highlights the importance of correct early diagnosis in the postpartum and late postpartum period and raises awareness concerning the possibility of acute pancreatitis in a postpartum woman even if she does not have the two most common risk factors: gallstones or alcohol consumption.

Overcoming Barriers to Kangaroo Care in a Metropolitan NICU During the COVID-19 Pandemic

Overcoming Barriers to Kangaroo Care in a Metropolitan NICU During the COVID-19 Pandemic