Living with the Threat of Covid-19: Exploring the Psychological Impact of Covid-19 in Those who Conceived Through ART Versus Spontaneously.

OBJECTIVES: To explore and compare anxiety relating to the threat of Covid-19 in pregnancy by women who conceived through assisted reproductive technology (ART) and spontaneously. We also examined the psychological coping strategies used and lived experience for both groups. METHODS: A total of 21 women who conceived through ART at a private university based IVF and a matched sample of women who conceived spontaneously were enrolled from July 2020 to February 2021. This was a mixed methods study. Covid-19-specific anxiety was measured using the coronavirus anxiety scale (CAS) as well as a validating qualitative data model with the use of open-ended questions to expand on quantitative findings. RESULTS: In both groups of women the level of anxiety detected by the CAS was low and mixed coping strategies (emotion-focused and problem-solving) were utilized. The ART group expressed more positive feelings towards pregnancy during the Covid-19 pandemic. CONCLUSION: The vulnerable ART group is no more at risk for negative emotional well-being during the Covid-19 pandemic. Additionally, healthcare providers ought to be knowledgeable of various Covid-19 coping strategies that may provide emotionally protective measures for all women of reproductive age. This is of particular importance as effective coping may ultimately prevent disruptions that could compromise prenatal care during the covid-19 pandemic.

A trial comparing the use of rectal misoprostol plus perivascular vasopressin with perivascular vasopressin alone to decrease myometrial bleeding at the time of abdominal myomectomy.

OBJECTIVE: To compare the efficacy of rectal misoprostol plus perivascular vasopressin with perivascular vasopressin alone as hemostatic agents for the reduction of blood loss during myomectomies. DESIGN: Prospective, randomized, double-blind, controlled study. SETTING: University of the West Indies and Andrews Memorial Hospital. PATIENT(S): Fifty women with symptomatic uterine fibroids, 25 receiving misoprostol and vasopressin and 25 receiving vasopressin alone before myomectomy. INTERVENTION(S): Abdominal myomectomies on patients with symptomatic uterine fibroids. MAIN OUTCOME MEASURE(S): Perioperative blood loss and febrile morbidity. RESULT(S): There were no statistically significant differences in sociodemographic, clinical, or myoma characteristics between the two groups at baseline. Postoperatively, there were no statistically significant differences in perioperative febrile morbidity or blood pressure between the groups. However, the group treated with misoprostol plus vasopressin had statistically significantly lower blood loss (geometric mean with 95% confidence interval, 334 mL [261 to 428] vs. 623 mL [354 to 1,094], a smaller change in hemoglobin (1.6 ± 1.5 vs. 3.0 ± 2.0), and a lower requirement for transfusion. In addition to treatment, significant determinants of blood loss were larger size of fibroids and greater number of fibroids. CONCLUSION(S): We conclude that perivascular vasopressin plus misoprostol caused a significant reduction in blood loss compared with perivascular vasopressin alone. CLINICAL TRIAL REGISTRATION NUMBER: NCT01700478.