-
Review Article
Metformin versus insulin in gestational diabetes mellitus: a systematic review
- Giovanna Noronha Berti
, - Igor Gutschov Oviedo Garcia ,
- João Pedro Ruas Floriano de Toledo ,
- Júlia Rodrigues Tatemoto ,
- Lais Watanabe Marino , [ ... ],
- Sérgio Floriano de Toledo
12-04-2024
Summary
Review ArticleMetformin versus insulin in gestational diabetes mellitus: a systematic review
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo89
12-04-2024- Giovanna Noronha Berti ,
- Igor Gutschov Oviedo Garcia ,
- João Pedro Ruas Floriano de Toledo ,
- Júlia Rodrigues Tatemoto ,
- Lais Watanabe Marino ,
- Mariana de Medeiros Legori ,
- Sérgio Floriano de Toledo
Views237See moreAbstract
Objective:
The aim of this study is to assess the use of metformin with or without insulin for the treatment of Gestational Diabetes Mellitus compared to insulin alone.
Data sources:
This article consists of a systematic review of randomized clinical trials. The searches were carried out on MEDLINE including 7 studies, between 2010 to 2021.
Study selection:
Randomized clinical trials comparing metformin and insulin written in English, Spanish or Portuguese, with no time limit, were included.
Data collection:
Data was extracted from all the 7 articles and compared statistically when possible. Whenever data was not available or couldn't be statistically compared, the main results were described in detail.
Data synthesis:
Insulin alone is not superior than metformin with or without insulin on gestational diabetes mellitus.
Conclusion:
There is a potential viability of using metformin as an alternative compared to insulin alone in the treatment of Gestational Diabetes Mellitus. However, all assessed outcomes have a very low level of certainty of evidence and more studies are necessary to support these findings.
Views237
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Review ArticleMetformin versus insulin in gestational diabetes mellitus: a systematic review
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo89
12-04-2024- Giovanna Noronha Berti ,
- Igor Gutschov Oviedo Garcia ,
- João Pedro Ruas Floriano de Toledo ,
- Júlia Rodrigues Tatemoto ,
- Lais Watanabe Marino ,
- Mariana de Medeiros Legori ,
- Sérgio Floriano de Toledo
Views237See moreAbstract
Objective:
The aim of this study is to assess the use of metformin with or without insulin for the treatment of Gestational Diabetes Mellitus compared to insulin alone.
Data sources:
This article consists of a systematic review of randomized clinical trials. The searches were carried out on MEDLINE including 7 studies, between 2010 to 2021.
Study selection:
Randomized clinical trials comparing metformin and insulin written in English, Spanish or Portuguese, with no time limit, were included.
Data collection:
Data was extracted from all the 7 articles and compared statistically when possible. Whenever data was not available or couldn't be statistically compared, the main results were described in detail.
Data synthesis:
Insulin alone is not superior than metformin with or without insulin on gestational diabetes mellitus.
Conclusion:
There is a potential viability of using metformin as an alternative compared to insulin alone in the treatment of Gestational Diabetes Mellitus. However, all assessed outcomes have a very low level of certainty of evidence and more studies are necessary to support these findings.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Giovanna Noronha Berti
-
Review Article
Neonatal and maternal outcomes of mRNA versus Non-mRNA COVID-19 vaccines in pregnant patients: a systematic review and meta-analysis
- Juliana Almeida Oliveira ,
- Eloisa Gonçalves da Silva ,
- Ayse Filiz Gokmen Karasu ,
- Anelise Maria Nicolau Silva ,
- Chris Elizabeth Philip
09-18-2024
Summary
Review ArticleNeonatal and maternal outcomes of mRNA versus Non-mRNA COVID-19 vaccines in pregnant patients: a systematic review and meta-analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo69
09-18-2024- Juliana Almeida Oliveira ,
- Eloisa Gonçalves da Silva ,
- Ayse Filiz Gokmen Karasu ,
- Anelise Maria Nicolau Silva ,
- Chris Elizabeth Philip
Views206Abstract
Objective
To compare the effectiveness and safety of non-mRNA versus mRNA COVID-19 vaccines on pregnant women and their newborns in a systematic review with meta-analysis.
Data sources
We searched PubMed, Embase, and Cochrane Central in May 2023.
Study selection
The search strategy yielded 4451 results, 16 studies were fully reviewed. We selected case-control studies analysing non-mRNA versus mRNA vaccines. Data collection and analysis: we assessed the risk of bias using the Cochrane Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool. Standardised mean differences were pooled using random-effect models.
Data synthesis
We identified 8 prospective and retrospective studies with a total of 32,153 patients. Non-mRNA vaccines were associated with a higher incidence of fever (OR 2.67; 95% CI 2.08-3.43; p<0.001), and a lower incidence of fetal or neonatal death (OR 0.16; 95% CI 0.08-0.33; p<0.001). In subgroup analyses, the Jansen vaccine (Ad26.COV2.S) was found to have a higher rate of premature labor/delivery (OR 4.48; 95% CI 1.45-13.83; p=0.009) and missed/spontaneous abortion (OR 1.90; 95% CI 1.09-3.30; p=0.02), as compared with the Pfizer (BNT162b2) vaccine.
Conclusion
non-mRNA vaccines are associated with a lower incidence of fetal or neonatal death among pregnant women who receive a Covid19 vaccine, although at an increased rate of pyrexia compared with mRNA vaccines. Other studies are required for better assessment.
PROSPERO
CRD42023421814
Key-words coronavirus infectionsCOVID-19COVID-19 vaccinesInfant, newbornmRNA vaccinesPregnancy complicationsPregnant womenSARS-CoV-2See moreViews206This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Review ArticleNeonatal and maternal outcomes of mRNA versus Non-mRNA COVID-19 vaccines in pregnant patients: a systematic review and meta-analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo69
09-18-2024- Juliana Almeida Oliveira ,
- Eloisa Gonçalves da Silva ,
- Ayse Filiz Gokmen Karasu ,
- Anelise Maria Nicolau Silva ,
- Chris Elizabeth Philip
Views206Abstract
Objective
To compare the effectiveness and safety of non-mRNA versus mRNA COVID-19 vaccines on pregnant women and their newborns in a systematic review with meta-analysis.
Data sources
We searched PubMed, Embase, and Cochrane Central in May 2023.
Study selection
The search strategy yielded 4451 results, 16 studies were fully reviewed. We selected case-control studies analysing non-mRNA versus mRNA vaccines. Data collection and analysis: we assessed the risk of bias using the Cochrane Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool. Standardised mean differences were pooled using random-effect models.
Data synthesis
We identified 8 prospective and retrospective studies with a total of 32,153 patients. Non-mRNA vaccines were associated with a higher incidence of fever (OR 2.67; 95% CI 2.08-3.43; p<0.001), and a lower incidence of fetal or neonatal death (OR 0.16; 95% CI 0.08-0.33; p<0.001). In subgroup analyses, the Jansen vaccine (Ad26.COV2.S) was found to have a higher rate of premature labor/delivery (OR 4.48; 95% CI 1.45-13.83; p=0.009) and missed/spontaneous abortion (OR 1.90; 95% CI 1.09-3.30; p=0.02), as compared with the Pfizer (BNT162b2) vaccine.
Conclusion
non-mRNA vaccines are associated with a lower incidence of fetal or neonatal death among pregnant women who receive a Covid19 vaccine, although at an increased rate of pyrexia compared with mRNA vaccines. Other studies are required for better assessment.
PROSPERO
CRD42023421814
Key-words coronavirus infectionsCOVID-19COVID-19 vaccinesInfant, newbornmRNA vaccinesPregnancy complicationsPregnant womenSARS-CoV-2See moreThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Juliana Almeida Oliveira
-
Review Article
Prevalence of syphilis and associated factors among pregnant women in Brazil: systematic review and meta-analysis
- Iana Mundim de Oliveira ,
- Regilane Cordeiro dos Santos ,
- Renan Alves Silva ,
- Rosane Ribeiro Figueiredo Alves ,
- Bruno César Teodoro Martins , [ ... ],
- Leonardo Ribeiro Soares
06-03-2024
Summary
Review ArticlePrevalence of syphilis and associated factors among pregnant women in Brazil: systematic review and meta-analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo28
06-03-2024- Iana Mundim de Oliveira ,
- Regilane Cordeiro dos Santos ,
- Renan Alves Silva ,
- Rosane Ribeiro Figueiredo Alves ,
- Bruno César Teodoro Martins ,
- Leonardo Ribeiro Soares
Views194See moreAbstract
Objective:
This systematic review accompanied by a meta-analysis aimed to estimate the prevalence of syphilis in pregnant women in Brazil and describe its associated factors.
Methods:
Following the establishment the search strategies and the registration of the review protocol in PROSPERO, we conducted a search for relevant articles in the Pubmed, LILACS, Science Direct, SciELO and Web of Science databases. Our inclusion criteria were cross-sectional studies published between 2005 and 2023, with no language restrictions. The combined prevalence of syphilis infection was estimated using the random effects model in the R Software with a 95% confidence interval (95% CI) and p < 0.01 as statistically significant.
Results:
A total of 24 articles were recruited, which together investigated 221,884 women. The combined prevalence of syphilis in pregnant women in Brazil was 1.79% (95% CI: 1.24-2.57%), and the main factors associated with its occurrence were black and brown skin color, low education and factors related to the partner.
Conclusion:
There was a high prevalence of syphilis in pregnancy in Brazil, mainly associated with socioeconomic factors.
Views194This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Review ArticlePrevalence of syphilis and associated factors among pregnant women in Brazil: systematic review and meta-analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo28
06-03-2024- Iana Mundim de Oliveira ,
- Regilane Cordeiro dos Santos ,
- Renan Alves Silva ,
- Rosane Ribeiro Figueiredo Alves ,
- Bruno César Teodoro Martins ,
- Leonardo Ribeiro Soares
Views194See moreAbstract
Objective:
This systematic review accompanied by a meta-analysis aimed to estimate the prevalence of syphilis in pregnant women in Brazil and describe its associated factors.
Methods:
Following the establishment the search strategies and the registration of the review protocol in PROSPERO, we conducted a search for relevant articles in the Pubmed, LILACS, Science Direct, SciELO and Web of Science databases. Our inclusion criteria were cross-sectional studies published between 2005 and 2023, with no language restrictions. The combined prevalence of syphilis infection was estimated using the random effects model in the R Software with a 95% confidence interval (95% CI) and p < 0.01 as statistically significant.
Results:
A total of 24 articles were recruited, which together investigated 221,884 women. The combined prevalence of syphilis in pregnant women in Brazil was 1.79% (95% CI: 1.24-2.57%), and the main factors associated with its occurrence were black and brown skin color, low education and factors related to the partner.
Conclusion:
There was a high prevalence of syphilis in pregnancy in Brazil, mainly associated with socioeconomic factors.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Iana Mundim de Oliveira
-
Review Article
How can we reduce maternal mortality due to preeclampsia? The 4P rule
- Henri Augusto Korkes ,
- Ricardo Carvalho Cavalli ,
- Leandro Gustavo De Oliveira ,
- José Geraldo Lopes Ramos ,
- Sérgio Hofmeister de Almeida Martins Costa , [ ... ],
- Maria Laura Costa
06-03-2024
Summary
Review ArticleHow can we reduce maternal mortality due to preeclampsia? The 4P rule
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo43
06-03-2024- Henri Augusto Korkes ,
- Ricardo Carvalho Cavalli ,
- Leandro Gustavo De Oliveira ,
- José Geraldo Lopes Ramos ,
- Sérgio Hofmeister de Almeida Martins Costa ,
- Francisco Lázaro Pereira de Sousa ,
- Edson Vieira da Cunha Filho ,
- Maria Rita de Souza Mesquita ,
- Mário Dias Corrêa Júnior ,
- Ana Cristina Pinheiro Fernandes Araújo ,
- Alberto Carlos Moreno Zaconeta ,
- Carlos Henrique Esteves Freire ,
- Carlos Eduardo Poli de Figueiredo ,
- Edilberto Alves Pereira da Rocha Filho ,
- Nelson Sass ,
- José Carlos Peraçoli ,
- Maria Laura Costa
Views234See moreAbstract
In low and middle-income countries such as Brazil, most maternal deaths are related to hypertensive complications. Preeclampsia is the leading cause of maternal mortality and morbidity. Significant proportion is associated with the following factors: lack of identification of high-risk women, lack of adequate prevention, difficulty in maintaining a high-risk prenatal follow-up, delayed diagnosis, insecurity and low use of magnesium sulphate, delayed pregnancy interruption and lack of postpartum follow-up of these high-risk cases. Four major actions are proposed to minimize this alarming clinical picture and reduce the mortality rates due to preeclampsia, called the "4 P Rule" (Adequate Prevention – Vigilant Prenatal Care – Timely Delivery (Parturition) – Safe Postpartum). From this simple "rule" we can open a range of important processes and reminders that may help in the guidance of preeclampsia management.
Views234This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Review ArticleHow can we reduce maternal mortality due to preeclampsia? The 4P rule
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo43
06-03-2024- Henri Augusto Korkes ,
- Ricardo Carvalho Cavalli ,
- Leandro Gustavo De Oliveira ,
- José Geraldo Lopes Ramos ,
- Sérgio Hofmeister de Almeida Martins Costa ,
- Francisco Lázaro Pereira de Sousa ,
- Edson Vieira da Cunha Filho ,
- Maria Rita de Souza Mesquita ,
- Mário Dias Corrêa Júnior ,
- Ana Cristina Pinheiro Fernandes Araújo ,
- Alberto Carlos Moreno Zaconeta ,
- Carlos Henrique Esteves Freire ,
- Carlos Eduardo Poli de Figueiredo ,
- Edilberto Alves Pereira da Rocha Filho ,
- Nelson Sass ,
- José Carlos Peraçoli ,
- Maria Laura Costa
Views234See moreAbstract
In low and middle-income countries such as Brazil, most maternal deaths are related to hypertensive complications. Preeclampsia is the leading cause of maternal mortality and morbidity. Significant proportion is associated with the following factors: lack of identification of high-risk women, lack of adequate prevention, difficulty in maintaining a high-risk prenatal follow-up, delayed diagnosis, insecurity and low use of magnesium sulphate, delayed pregnancy interruption and lack of postpartum follow-up of these high-risk cases. Four major actions are proposed to minimize this alarming clinical picture and reduce the mortality rates due to preeclampsia, called the "4 P Rule" (Adequate Prevention – Vigilant Prenatal Care – Timely Delivery (Parturition) – Safe Postpartum). From this simple "rule" we can open a range of important processes and reminders that may help in the guidance of preeclampsia management.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Henri Augusto Korkes
-
Review Article
Technologies Applied to the Mental Health Care of Pregnant Women: A Systematic Literature Review
- Laís Lage de Carvalho ,
- Júlia Magna da Silva Teixeira ,
- Roberto José Gervásio Unger ,
- Vivian Genaro Motti ,
- Giovanni Marcos Lovisi , [ ... ],
- Fabiane Rossi dos Santos Grincenkov
07-10-2023
Summary
Review ArticleTechnologies Applied to the Mental Health Care of Pregnant Women: A Systematic Literature Review
Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(3):149-159
07-10-2023- Laís Lage de Carvalho ,
- Júlia Magna da Silva Teixeira ,
- Roberto José Gervásio Unger ,
- Vivian Genaro Motti ,
- Giovanni Marcos Lovisi ,
- Fabiane Rossi dos Santos Grincenkov
Views189See moreAbstract
Objective:
This article aims to review the literature regarding the use of technologies to promote mental health for pregnant women. We seek to: understand the strategies that pregnant women use for mental health care. Also, we investigate the existence of scientific evidence that validates such practices.
Methods:
This study follows the PRISMA guidelines for systematic reviews. We analyze 27 studies published between 2012 and 2019. We include publications in Portuguese, English, and Spanish.
Results:
The results revealed several different possibilities to use technology, including the use of text messages and mobile applications on smartphones. Mobile applications are the most commonly used approaches (22.5%). Regarding the strategies used, cognitive-behavioral approaches, including mood checks, relaxation exercises, and psychoeducation comprised 44.12% of the content.
Conclusion:
There is a need for further investigation and research and development efforts in this field to better understand the possibilities of intervention in mental health in the digital age.
Views189This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Review ArticleTechnologies Applied to the Mental Health Care of Pregnant Women: A Systematic Literature Review
Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(3):149-159
07-10-2023- Laís Lage de Carvalho ,
- Júlia Magna da Silva Teixeira ,
- Roberto José Gervásio Unger ,
- Vivian Genaro Motti ,
- Giovanni Marcos Lovisi ,
- Fabiane Rossi dos Santos Grincenkov
Views189See moreAbstract
Objective:
This article aims to review the literature regarding the use of technologies to promote mental health for pregnant women. We seek to: understand the strategies that pregnant women use for mental health care. Also, we investigate the existence of scientific evidence that validates such practices.
Methods:
This study follows the PRISMA guidelines for systematic reviews. We analyze 27 studies published between 2012 and 2019. We include publications in Portuguese, English, and Spanish.
Results:
The results revealed several different possibilities to use technology, including the use of text messages and mobile applications on smartphones. Mobile applications are the most commonly used approaches (22.5%). Regarding the strategies used, cognitive-behavioral approaches, including mood checks, relaxation exercises, and psychoeducation comprised 44.12% of the content.
Conclusion:
There is a need for further investigation and research and development efforts in this field to better understand the possibilities of intervention in mental health in the digital age.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 
- Laís Lage de Carvalho
-
Original Article
Changing Paradigms in the Initial Treatment of Ectopic Pregnancy at a University Hospital in Brazil
- Bárbara Virginia Gonçalves Tavares ,
- Letícia Sathler Delfino ,
- Isabella Silvestre Ignarro ,
- Luiz Francisco Baccaro
06-30-2023
Summary
Original ArticleChanging Paradigms in the Initial Treatment of Ectopic Pregnancy at a University Hospital in Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(4):192-200
06-30-2023- Bárbara Virginia Gonçalves Tavares ,
- Letícia Sathler Delfino ,
- Isabella Silvestre Ignarro ,
- Luiz Francisco Baccaro
Views126See moreAbstract
Objective
To evaluate the use of different treatment options for ectopic pregnancy and the frequency of severe complications in a university hospital.
Methods
Observational study with women with ectopic pregnancy admitted at UNICAMP Womeńs Hospital, Brazil, between 01/01/2000 and 12/31/2017. The outcome variables were the type of treatment (first choice) and the presence of severe complications. Independent variables were clinical and sociodemographic data. Statistical analysis was carried out by the Cochran–Armitage test, chi-square test, Mann–Whitney test and multiple Cox regression.
Results
In total 673 women were included in the study. The mean age was 29.0 years (± 6.1) and the mean gestational age was 7.7 (± 2.5). The frequency of surgical treatment decreased significantly over time (z = -4.69; p < 0.001). Conversely, there was a significant increase in the frequency of methotrexate treatment (z = 4.73; p < 0.001). Seventy-one women (10.5%) developed some type of severe complication. In the final statistical model, the prevalence of severe complications was higher in women who were diagnosed with a ruptured ectopic pregnancy at admission (PR = 2.97; 95%CI: 1.61–5.46), did not present with vaginal bleeding (PR = 2.45; 95%CI: 1.41–4.25), had never undergone laparotomy/laparoscopy (PR = 6.69; 95%CI: 1.62–27.53), had a non-tubal ectopic pregnancy (PR = 4.61; 95%CI: 1.98–10.74), and do not smoke (PR = 2.41; 95%CI: 1.08–5.36).
Conclusion
there was a change in the first treatment option for cases of ectopic pregnancy in the hospital during the period of analysis. Factors inherent to a disease that is more difficult to treat are related to a higher frequency of severe complications.
Views126This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticleChanging Paradigms in the Initial Treatment of Ectopic Pregnancy at a University Hospital in Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(4):192-200
06-30-2023- Bárbara Virginia Gonçalves Tavares ,
- Letícia Sathler Delfino ,
- Isabella Silvestre Ignarro ,
- Luiz Francisco Baccaro
Views126See moreAbstract
Objective
To evaluate the use of different treatment options for ectopic pregnancy and the frequency of severe complications in a university hospital.
Methods
Observational study with women with ectopic pregnancy admitted at UNICAMP Womeńs Hospital, Brazil, between 01/01/2000 and 12/31/2017. The outcome variables were the type of treatment (first choice) and the presence of severe complications. Independent variables were clinical and sociodemographic data. Statistical analysis was carried out by the Cochran–Armitage test, chi-square test, Mann–Whitney test and multiple Cox regression.
Results
In total 673 women were included in the study. The mean age was 29.0 years (± 6.1) and the mean gestational age was 7.7 (± 2.5). The frequency of surgical treatment decreased significantly over time (z = -4.69; p < 0.001). Conversely, there was a significant increase in the frequency of methotrexate treatment (z = 4.73; p < 0.001). Seventy-one women (10.5%) developed some type of severe complication. In the final statistical model, the prevalence of severe complications was higher in women who were diagnosed with a ruptured ectopic pregnancy at admission (PR = 2.97; 95%CI: 1.61–5.46), did not present with vaginal bleeding (PR = 2.45; 95%CI: 1.41–4.25), had never undergone laparotomy/laparoscopy (PR = 6.69; 95%CI: 1.62–27.53), had a non-tubal ectopic pregnancy (PR = 4.61; 95%CI: 1.98–10.74), and do not smoke (PR = 2.41; 95%CI: 1.08–5.36).
Conclusion
there was a change in the first treatment option for cases of ectopic pregnancy in the hospital during the period of analysis. Factors inherent to a disease that is more difficult to treat are related to a higher frequency of severe complications.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Bárbara Virginia Gonçalves Tavares
-
Review Article
Clinical Features and Maternal-fetal Results of Pregnant Women in COVID-19 Times
- Ana Paula Nogueira Godoi ,
- Gilcelia Correia Santos Bernardes ,
- Leilismara Sousa Nogueira ,
- Patrícia Nessralla Alpoim ,
- Melina de Barros Pinheiro
07-30-2021
Summary
Review ArticleClinical Features and Maternal-fetal Results of Pregnant Women in COVID-19 Times
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(5):384-394
07-30-2021- Ana Paula Nogueira Godoi ,
- Gilcelia Correia Santos Bernardes ,
- Leilismara Sousa Nogueira ,
- Patrícia Nessralla Alpoim ,
- Melina de Barros Pinheiro
Views206See moreAbstract
Objective
Coronavirus disease 2019 (COVID-19) is a disease caused by a newly discovered coronavirus, severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), which usually leads to non-specific respiratory symptoms. Although pregnant women are considered at risk for respiratory infections by other viruses, such as SARS and Middle East respiratory syndrome (MERS), little is known about their vulnerability to SARS-CoV-2. Therefore, this study aims to identify and present the main studies on the topic, including the postpartum period.
Methods
In this narrative review, articles were searched in various databases, organizations, and health entities using keywords compatible with medical subject headings (MeSH), such as: COVID-19, pregnancy, vertical transmission, coronavirus 2019, and SARS-CoV-2.
Results
The review of the scientific literature on the subject revealed that pregnant women with COVID-19 did not present clinical manifestations significantly different from those of non-pregnant women; however, there are contraindicated therapies. Regarding fetuses, studies were identified that reported that infection by SARS-CoV-2 in pregnant women can cause fetal distress, breathing difficulties and premature birth, but there is no substantial evidence of vertical transmission.
Conclusion
Due to the lack of adequate information and the limitations of the analyzed studies, it is necessary to provide detailed clinical data on pregnant women infected with SARS-CoV-2 and on the maternal-fetal repercussions caused by this infection. Thus, this review may contribute to expand the knowledge of professionals working in the area as well as to guide more advanced studies on the risk related to pregnant women and their newborns. Meanwhile, monitoring of confirmed or suspected pregnant women with COVID-19 is essential, including in the postpartum period.
Views206This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Review ArticleClinical Features and Maternal-fetal Results of Pregnant Women in COVID-19 Times
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(5):384-394
07-30-2021- Ana Paula Nogueira Godoi ,
- Gilcelia Correia Santos Bernardes ,
- Leilismara Sousa Nogueira ,
- Patrícia Nessralla Alpoim ,
- Melina de Barros Pinheiro
Views206See moreAbstract
Objective
Coronavirus disease 2019 (COVID-19) is a disease caused by a newly discovered coronavirus, severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), which usually leads to non-specific respiratory symptoms. Although pregnant women are considered at risk for respiratory infections by other viruses, such as SARS and Middle East respiratory syndrome (MERS), little is known about their vulnerability to SARS-CoV-2. Therefore, this study aims to identify and present the main studies on the topic, including the postpartum period.
Methods
In this narrative review, articles were searched in various databases, organizations, and health entities using keywords compatible with medical subject headings (MeSH), such as: COVID-19, pregnancy, vertical transmission, coronavirus 2019, and SARS-CoV-2.
Results
The review of the scientific literature on the subject revealed that pregnant women with COVID-19 did not present clinical manifestations significantly different from those of non-pregnant women; however, there are contraindicated therapies. Regarding fetuses, studies were identified that reported that infection by SARS-CoV-2 in pregnant women can cause fetal distress, breathing difficulties and premature birth, but there is no substantial evidence of vertical transmission.
Conclusion
Due to the lack of adequate information and the limitations of the analyzed studies, it is necessary to provide detailed clinical data on pregnant women infected with SARS-CoV-2 and on the maternal-fetal repercussions caused by this infection. Thus, this review may contribute to expand the knowledge of professionals working in the area as well as to guide more advanced studies on the risk related to pregnant women and their newborns. Meanwhile, monitoring of confirmed or suspected pregnant women with COVID-19 is essential, including in the postpartum period.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Ana Paula Nogueira Godoi
-
Case Report
Coronavirus 2019, Thrombocytopenia and HELLP Syndrome: Association or Coincidence?
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(10):669-671
12-21-2020
Summary
Case ReportCoronavirus 2019, Thrombocytopenia and HELLP Syndrome: Association or Coincidence?
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(10):669-671
12-21-2020Views103See moreAbstract
The present report describes the case of a 31-year-old primigravida, with dichorionic twins at 31 weeks. She presented with history of myalgia, jaundice, and abdominal discomfort. No flu-like symptoms as fever or cough. She was not aware of exposure to COVID-19. Normal blood pressure and O2 saturation. Laboratory tests showed platelet count of 218,000 mm3, alanine aminotransferase (ALT) 558 IU and serum creatinine 2.3 mg/dl. Doppler ultrasound in one twin was compatible with brain sparing. Partial hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome was the hypothesis, and a cesarean section was performed. On day 2, the white-cell count reached 33,730, with decreased consciousness and mild respiratory distress. Tomography revealed both lungs with ground-glass opacities. Swab for COVID-19 polymerase chain reaction (PCR) was positive. Thrombocytopenia in patients with COVID-19 appears to be multifactorial, similar to what occurs in preeclampsia and HELLP syndrome. We assume that the synergism of these pathophysiological mechanisms could accelerate the compromise of maternal conditions and could be a warning to the obstetric practice.
Views103This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Case ReportCoronavirus 2019, Thrombocytopenia and HELLP Syndrome: Association or Coincidence?
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(10):669-671
12-21-2020Views103See moreAbstract
The present report describes the case of a 31-year-old primigravida, with dichorionic twins at 31 weeks. She presented with history of myalgia, jaundice, and abdominal discomfort. No flu-like symptoms as fever or cough. She was not aware of exposure to COVID-19. Normal blood pressure and O2 saturation. Laboratory tests showed platelet count of 218,000 mm3, alanine aminotransferase (ALT) 558 IU and serum creatinine 2.3 mg/dl. Doppler ultrasound in one twin was compatible with brain sparing. Partial hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome was the hypothesis, and a cesarean section was performed. On day 2, the white-cell count reached 33,730, with decreased consciousness and mild respiratory distress. Tomography revealed both lungs with ground-glass opacities. Swab for COVID-19 polymerase chain reaction (PCR) was positive. Thrombocytopenia in patients with COVID-19 appears to be multifactorial, similar to what occurs in preeclampsia and HELLP syndrome. We assume that the synergism of these pathophysiological mechanisms could accelerate the compromise of maternal conditions and could be a warning to the obstetric practice.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Pregnancy complications Archives - Revista Brasileira de Ginecologia e Obstetrícia
