Satisfaction of adolescent mothers with childbirth care at a public maternity hospital.

AIM: The aim was to assess adolescent satisfaction with childbirth and compare it with that of adult women. METHODS: An observational comparative study was conducted during the period of October 2016 and April 2017 in a public maternity hospital in São Paulo, Brazil. The population included 50 adolescents (14-19 years) and 51 adults (20-35 years) mothers in post-partum after a term live birth. Maternal satisfaction was assessed by the North Bristol modified Mackey Childbirth Satisfaction Rating Scale questionnaire with 18 items divided into five subscales (self, partner, baby, physician and overall) and two items on birth experience. Each item was rated on a 5-point Likert scale and a total score was calculated. The main outcome measure was a total score on questionnaire. RESULTS: The mean maternal age of adolescents was 18 years (95% confidence interval [CI] 11-25) and for adults, 28.3 years (95% CI 26.1-30.7). Primiparity was more common among adolescents than adults (92% vs 43.1%, P < 0.001). The median maternal satisfaction score of adolescents (88; 95% CI 83-90) was lower than that of adult women (90; 95% CI 87-93, P = 0.046). Adolescents also scored lower than adult women on the following subscales: satisfaction with baby (median 14 vs 15, P = 0.004) and satisfaction concerning care provided by doctors/midwives (median 33 vs 35, P = 0.006). CONCLUSION: Adolescents were statistically less satisfied with their childbirth experience. More dissatisfaction was seen among them specifically concerning their baby and the care provided by doctors/midwives. This shows that different strategies need to be developed for this specific group of women.

Asymptomatic COVID-19 in hospital visitors: The underestimated potential of viral shedding.

In a single day, six of 150 (4%) asymptomatic visitors were diagnosed with COVID-19 at a hospital with a universal masking policy. Two inpatients (contacts) subsequently developed symptoms. More rigorous protective measures during visitation periods may need to be included in infection control practices to reduce nosocomial transmissions.

Detected SARS-CoV-2 in Ascitic Fluid Followed by Cryptococcemia: a Case Report.

SARS coronavirus-2 (SARS-CoV-2) detection in different clinical specimens has raised important insights about its pathogenesis, but some details remain to be understood. In that respect, disrupt viral control seen in solid organ transplant patients on chronic immunosuppression can help unveil pathogenic mechanisms and characterize new coronavirus disease-19 (COVID-19) immunological and clinical aspects, as well as secondary complications. We herein report a case of SARS-CoV-2 detection in ascitic fluid from a kidney transplant patient with decompensated cirrhosis and COVID-19 and then discuss about immune, cellular, and virological aspects of such clinical presentation of the disease, which also included a disseminated infection, demonstrated by viral detection in his blood sample. We subsequently discuss about the fatal outcome caused by a secondary bloodstream infection by Cryptococcus neoformans. This unprecedented case report presents ascitic fluid as a novel specimen in which SARS-CoV-2 can be detected. Immune dysregulation and cumulative risk factors may lead to secondary infections by opportunistic agents, including Cryptococcus neoformans.