Successful Treatment of Preterm Labor in Association with Acute COVID-19 Infection.

Novel coronavirus disease 2019 (COVID-19) infection occurring during pregnancy is associated with an increased risk of preterm delivery. This case report describes successful treatment of preterm labor during acute COVID-19 infection. Standard treatment for preterm labor may allow patients with acute COVID-19 infection to recover without the need for preterm delivery. KEY POINTS: · Acute COVID-19 infection is associated with a high rate of preterm delivery.. · Standard treatment for preterm labor such as intravenous magnesium sulfate, antepartum steroid therapy and antibiotic prophylaxis for group B streptococcus infection were effective in this patient.. · In the absence of maternal or fetal compromise, acute COVID-19 infection is not an indication for early elective delivery..

Screening for Chlamydia and Gonorrhea Cervicitis and Implications for Pregnancy Outcome. Are We Testing and Treating at the Right Time?

OBJECTIVE: To evaluate the effect of gonorrheal and chlamydial cervicitis (GCC) on the risk of preterm labor (PTL) and preterm premature rupture of membranes (PPROM). STUDY DESIGN: A large cross-sectional sample of patients (N = 1,120) was studied. Data on samples for GCC and pregnancy outcome were entered into a database from a retrospective chart review. RESULTS: There were 1,120 pregnancies with adequate data for analysis. Of those pregnancies 933 were unaffected by GCC, and 187 were affected. The rates of preterm delivery were 17.79% and 16.58% for GCC-negative and GCC-positive pregnancies, respectively. PPROM occurred in 3.97% and 2.67% of GCC-negative and GCC-positive pregnancies, respectively. PTL occurred in 8.25% and 8.02% of GCC-negative and GCC-positive pregnancies, respectively. No outcomes met statistical significance. When pregnancy outcomes were analyzed by trimester of infection, there was a higher risk of preterm delivery but not preterm labor with earlier infection. This did meet statistical significance. There was a trend towards lower rate of cesarean section in the infected group of patients, which did not meet statistical significance. CONCLUSION: Maternal infection with gonorrhea and/or chlamydia is not associated with PPROM or PTL.

Second trimester amniotic fluid is reliably fern positive and α1-microglobulin positive: dispelling a labor deck myth.

OBJECTIVE: Many physicians erroneously believe and have propagated the "myth" that a second trimester amniotic fluid sample will not fern. We attempted to redemonstrate ferning and to demonstrate the efficacy of an assay for α1-microglobulin in second trimester amniotic fluid samples. STUDY DESIGN: Amniotic fluid samples were collected from women undergoing routine genetic amniocentesis between 15 and 26 weeks. A total of 97 samples of second trimester amniotic fluid were placed on slides and examined for ferning at 5 and 10 minutes. An α1-microglobulin assay was performed on each sample. Data were recorded and reported. RESULTS: Approximately 93% of samples were fern positive at 5 minutes and 100% were fern positive at 10 minutes. All samples were α1-microglobulin positive. CONCLUSION: Pure amniotic fluid is reliably fern and α1-microglobulin positive in the second trimester. Republication of data only available in pre-online sources will benefit physicians and patients.