Acute Hepatitis in Pregnancy – Diagnostic Challenges

A 35-year-old nulliparous woman, 22 weeks of gestation, with no relevant personal or family history, on Doxylamine Succinate+ Dicyclomine Hydrochloride + Pyridoxine Hydrochloride and Chlorpromazine, was admitted in the Obstetric Department for hyperemesis gravidarum. Physical examination was unremarkable. After stopping her previous medication, she was started on ondansetron. Blood analysis revealed INR 1.0; AST 525U/L; ALT 952U/L, GGT 55U/L, FA 72U/L, total bilirubin (TB) 2.05mg/dL, with direct of 1.37mg/dL. Abdominal ultrasound only revealed vesicular microlithiasis. Choledocholithiasis or hyperemesis gravidarum were the preliminary diagnostic hypotheses.

Current status of community-acquired infection of COVID-19 in delivery facilities in Japan

A nationwide questionnaire survey about community-acquired infection of coronavirus disease 2019 (COVID-19) was conducted in July 2020 to identify the characteristics of and measures taken by Japanese medical facilities providing maternity services. A case-control study was conducted by including medical facilities with (Cases) and without (Control) community-acquired infection of COVID-19. Responses from 711 hospitals and 707 private clinics were assessed (72% of all hospital and 59% all private clinics provided maternity service in Japan). Seventy-five COVID-19-positive pregnant women were treated in 52 facilities. Community-acquired infection was reported in 4.1% of the facilities. Of these, 95% occurred in the hospital. Nine patients developed a community-acquired infection in the maternity ward or obstetric department. Variables that associated with community-acquired infection of COVID-19 (adjusted odds ratio [95% confidence interval]) were found to be state of emergency prefecture (4.93 [2.17–11.16]), PCR test for SARS-CoV-2 on admission (2.88 [1.59–5.24]), and facility that cannot treat COVID-19 positive patients (0.34 [0.14–0.82]). In conclusion, community-acquired infection is likely to occur in large hospitals that treat a higher number of patients than private clinics do, regardless of the preventive measures used.

Pregnancy and Childbirth in Women with Confirmed COVID-19

Introduction: A new viral infection, dubbed “COVID-19” in the spring of 2020, became pandemic. Data on the impact of Covid-19 on pregnant women and childbirth are scarce and contradictory. Purpose: to study the peculiarities of the course and outcome of labor in women with positive results from COVID-19. Materials and Methods: An analysis of 222 birth histories of women with laboratory-confirmed COVID-19 PCR directed to delivery to the specialized obstetric department of the Fergana city medical association for October-December 2020 is presented. Results: A mild form of infection was in 70,2%, moderate - in 21.2%, severe - in 8.1%, and critical - in 0.5%. The frequency and nature of the upper and lower respiratory tract lesions, SPO2 parameters and lung damage, as well as the age of pregnant women, parity, the presence of somatic and obstetric pathology are presented. The frequency of delivery by weight section was 25.2%, preterm birth - 9.5%. Conclusions: In most pregnant women the severe form of COVID-19 is characterized by bilateral pneumonia with ARS and anemia in 100% of cases, the frequency of miscarriage in them is high and reaches 37%. The condition of pregnant women with COVID-19 aggravated the development of severe preeclampsia, premature placental abruption, and multiple pregnancy

Frequency of Beta Thalassemia in Anemic Pregnant Women

Objective: To determine the frequency of beta thalassemia trait among pregnant women presenting with anemia. Method: A cross sectional study was conducted in Gynecology & Obstetric department, district headquarters hospital Mardan from January 2019 to June 2020. This study includes all pregnant women who presented with anemia and having age 15 to 45 years. Patients with known hemoglobinopathies were excluded from the study. Collected data was analyzed using SPSS 20. Results: Mean age of the patient was 27.7 years and mean hemoglobin level was 8.7g/dl. Age distributions showed mother age 15 to 25 years were 40%, 26 to 36 years were 35% and 36 to 45 years were 25%. Thalassemia trait was found in 40% anemic pregnant women. Thalassemia trait percentage was high in mother having age 15 to 25 years. Conclusion: Beta thalassemia trait is a common cause anemia in pregnancy. All pregnant women presenting with anemia should be investigated for it.

Medical report of the obstetric department of the clinic prof. K.F. Slavyansky for 1894 and 1895

During 1894-95. to the obstetric department of the clinic prof. K. F. Slavyanskogo accepted 1527 women in labor, 44 pregnant women and 5 women in childbirth soon post partum. Of the pregnant women, 17 after a certain time were resolved in the clinic, the rest were discharged before resolution in most cases due to the cessation of labor pain. Some of the latter were again admitted to the clinic at the onset of childbirth and were included in the total number of resolved.