Severe Maternal Morbidity and Neonatal Mortality After COVID-19 Infection: Case Report.

BACKGROUND: Maternal coagulopathy and adverse fetal effects are both possible results of COVID-19 infection during pregnancy. This case demonstrates the potentially fatal outcomes when both occur simultaneously. CASE PRESENTATION: A 39-year-old multiparous woman at 31 weeks gestation presented with mild COVID-19 symptoms and decreased fetal movement. Evaluation included a biophysical profile with 2/8 scoring and fetal heart rate tracing that developed a terminal bradycardia. She underwent an emergent cesarean delivery that was complicated by disseminated intravascular coagulation (fibrinogen < 60mg/dL, platelets 34, international normalized ratio [INR] 2.1) and maternal hemorrhage requiring massive transfusion. The neonate ultimately required prolonged resuscitation with Apgar scores of 0/0/0 at 1, 5, and 10 minutes and passed away on day 6 of life. CONCLUSIONS: Even in the absence of severe symptoms, maternal COVID-19 infection during pregnancy can cause a maternal systemic and placental reaction that can lead to serious maternal morbidity, as well as fetal or neonatal morbidity and mortality.

The Adaptive Learner: How Faculty and Medical Students' Perceptions of Learning Needs and Desires Differ.

PROBLEM CONSIDERED: Medical schools historically have utilized instructor-centered lectures to teach medical students the basic sciences. Several commercial electronic-based resources are now available to enhance lecture-based content. This study examines perceptions between students and faculty regarding the efficacy of lecture-based teaching and learning strategies used by students overall. RESEARCH METHODS: The authors distributed surveys to medical students and basic science teaching faculty at the Medical College of Wisconsin. Survey items used categorical and 10-point scales and open-ended text response. Mean scores were compared with independent t tests and Cohen d effect sizes. Pearson (r) and Spearman rho (ρ) correlations were used for relational analysis. IBM SPSS 24.0 was used for statistical analysis, NVivo 11 was used for qualitative analysis. RESULTS: Faculty's perception of meeting students' learning needs was rated significantly higher (mean [SD] = 7.3 [1.3]) than students (5.9 [2.0]) (Cohen d = 1.0/P < .001). There was a significant negative correlation between lectures meeting students' learning needs and time students spent outside of lecture seeking supplemental learning resources (ρ = -0.4/P < .001). Students highlighted their use of personal learning strategies, desire for equitable access to resources, and preparation for national board examinations. Faculty emphasized their perceptions of learning resources, recognition of learning styles, time restrictions, and desire to utilize diverse teaching methods. CONCLUSIONS: Student and faculty perceptions regarding student learning needs were significantly different. Students use lectures extensively, but additionally add to the financial burden of medical school by personally funding supplemental resources. This study helps bridge the gap between medical students and faculty regarding what educational tools are best suited to support a student population with increasingly diverse learning needs.