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BACKGROUND: This study analyzed pregnancy outcomes in postpartum women who were infected with COVID-19 during their pregnancy in resource-limited settings during the second wave of the COVID-19 pandemic. MATERIALS AND METHODS: This cross-sectional study included all pregnant women with COVID-19 at a tertiary referral hospital in Surabaya, Indonesia, from June to August 2021. Patients were classified according to clinical presentation into asymptomatic-mild, moderate, and severe-critical. Data regarding their basic maternal characteristics, clinical symptoms, delivery, and neonatal outcomes were collected and analyzed across these severity levels through ANOVA, Kruskal-Wallis, or Mann-Whitney U test by incorporating SPSS Statistics software version 29.0. RESULTS: During the second wave of COVID-19 in Indonesia, a total of 184 COVID-19 cases were reported, with high mortality rate (22%). Only 26.6% of these cases were asymptomatic-mild, and the remaining 73.4% had more severe conditions. The severe-critical group had significantly lower gestational age, slower onset of diseases/symptoms, and higher maternal death proportions than the other two groups (P < 0.001). Clinical symptoms, vital signs, and inflammatory markers (NLR, CRP, and procalcitonin) were also significantly worse in the severe-critical group than in the other groups (P < 0.05). Consequently, severe cases showed a higher cesarean section rate (P = 0.034), lower birth weight, lower Apgar score, higher incidence of perinatal deaths (P < 0.001), and higher incidence of neonatal support (P = 0.003). CONCLUSIONS: The study's findings specified the devastating consequences of second wave of COVID-19 in a resource-limited setting. Focus on improving the health system and health facilities' capacity is warranted to anticipate all possibilities of other pandemics in the future.
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OBJECTIVES: This study aimed to evaluate the effect of pravastatin to prevent preeclampsia (PE) in pregnant women at a high risk of developing PE and the maternal and perinatal outcomes and the soluble fms-like tyrosine kinase 1/placental growth factor (sFlt1/PlGF) ratio. STUDY DESIGN: This is an open-labeled randomized controlled trial (RCT), a part of INOVASIA (Indonesia Pravastatin to Prevent Preeclampsia study) trial. Pregnant women at a high risk of developing PE were recruited and randomized into an intervention group (40) and a control group (40). The inclusion criteria consisted of pregnant women with positive clinical risk factor and abnormal uterine artery Doppler examination at 10 to 20 weeks' gestational age. The control group received low dose aspirin (80 mg/day) and calcium (1 g/day), while the intervention group received additional pravastatin (20-mg twice daily) starting from 14 to 20 weeks' gestation until delivery. Research blood samples were collected before the first dose of pravastatin and before delivery. The main outcome was the rate of maternal PE, maternal-perinatal outcomes, and sFlt-1, PlGF, sFlt-1/PlGF ratio, and soluble endoglin (sEng) levels. RESULTS: The rate of PE was (nonsignificantly) lower in the pravastatin group compared with the control group (17.5 vs. 35%). The pravastatin group also had a (nonsignificant) lower rate of severe PE, HELLP (hemolysis, elevated liver enzymes and low platelets) syndrome, acute kidney injury, and severe hypertension. The rate of (iatrogenic) preterm delivery was significantly (p = 0.048) lower in the pravastatin group (n = 4) compared with the controls (n = 12). Neonates in the pravastatin group had significantly higher birth weights (2,931 ± 537 vs. 2,625 ± 872 g; p = 0.006), lower Apgar's scores < 7 (2.5 vs. 27.5%, p = 0.002), composite neonatal morbidity (0 vs. 20%, p = 0.005), and NICU admission rates (0 vs. 15%, p = 0.026). All biomarkers show a significant deterioration in the control group compared with nonsignificant changes in the pravastatin group. CONCLUSION: Pravastatin holds promise in the secondary prevention of PE and placenta-mediated adverse perinatal outcomes by improving the angiogenic imbalance. KEY POINTS: · Prophylactic pravastatin was associated with a significantly lower rate of adverse perinatal outcome.. · The sFlt1/PlGF ratio stabilized in the pravastatin group compared with a deterioration in the control group.. · Pravastatin holds promise in the secondary prevention of PE and placenta-mediated adverse perinatal outcomes..
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Weight reduction and low power consumption are key requirements in the next generation of unmanned aerial vehicles (UAVs). To communicate with an operator, a secured link between the UAV and a ground-based station is desirable. To realize these links, retroreflecting free-space optics is potentially attractive as it offers light weight and low complexity at the UAV. However, the base station requires a high-performance tracking module to enable a steady illumination of the UAV retroreflector. In this paper, we present the design and implementation of a tracking system, which consists of coarse tracking and holographic fine tracking modules working cooperatively. Using this system, experimental field trials were carried out by mounting a multiple-quantum-well-based modulated retroreflector on a commercial UAV. A 2 Mbps optical link was achieved with a bit error rate of â¼2×10-4 at a link range of 300 m.
