Study of amniotic fluid in pregnant women infected with SARS-CoV-2 in first and second trimester. Is there evidence of vertical transmission?

COVID-19 is a respiratory disease caused by Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The effects of this infection on fetal development and whether there is vertical transmission are currently unknown. We present two cases of pregnant women with COVID-19 infection during the first and second trimester of gestation in which a PCR study of SARS-CoV-2 in amniotic fluid extracted by amniocentesis is performed to try to determine if there is vertical transmission. In both cases, the PCR result was negative. This fact could support the absence of vertical transmission when the infection occurs in these quarters. It would be advisable to carry out more extensive studies to be able to make this statement safely.

COVID-19 infection in symptomatic pregnant women at the midpoint of the pandemic in Spain: a retrospective analysis.

OBJECTIVES: Determine the strengths and weakness of a symptomatic screening for COVID-19 in pregnant women. Analyze the clinical presentation, management, and outcomes. DESIGN: Descriptive retrospective observational study. SETTING: Mancha-Centro Hospital (Spain). MATERIAL AND METHODS: Population: Symptomatic pregnant women with confirmed diagnosis of COVID-19. Between the 12th of March and 17th of April 2020, all the symptomatic pregnancies were screened with diagnostic test for SARS-CoV-2. Data collection was done by reviewing the medical records and telephone interviews. MAIN OUTCOME MEASURES: Clinical characteristics, management, treatment, and obstetric and neonatal outcomes. RESULTS: Twenty patients with positive COVID-19 diagnostic test out of thirty-four suspected. The most common symptoms were fever (70%), cough (65%) and myalgia (35%). A unique symptom of presentation in 20% of cases. COVID-19 pneumonia was diagnosed in 30% by chest X-ray and one case had pulmonary embolism associated diagnosed by CT-Scan. Thromboprophylaxis was indicated in 16 out of 20 patients. Eight women finished their pregnancy during the observation period. Type of birth: 25% natural birth, 12.5% assisted vaginal delivery and 62.5% caesarean section. We had three severe cases, two of them with intensive care support. All neonates had negative test for COVID 19 infection. CONCLUSIONS: We recommend universal screening of all pregnant woman for COVID-19 during the pandemic because of the limits of the symptomatic screening seen in this studio and the ratio of asymptomatic pregnancies with positive test for COVID-19 recently published.

Evaluation of the results of end-of-pregnancy protocols in diabetic pregnant women / Evaluación de los resultados de dos protocolos de finalización de la gestación en gestantes diabéticas

Objective: The objective of our study was to compare perinatal outcomes in 2 cohorts; one from before and one from after the implementation of a new protocol for the care of pregnant diabetic woman. Material and methods: We performed a retrospective study on 262 pregnant women diagnosed with pregestational or gestational diabetes in whom labor was induced. Results: Diabetes went from being the second reason for induction to the third reason, with a statistically sig-nificant increase in the duration of gestation in favor of the second cohort. The percentage of premature births was lower, as was that of low-birth-weight newborns. Conclusions: There are no quality studies in the literature that indicate guidelines to be followed for the monito-ring and treatment of diabetic pregnant women. In our hospital, induction rates improved after implementation of the protocol

Objetivo: el objetivo de nuestro estudio fue comparar los resultados perinatales en dos cohortes; antes y después de la implantación de un nuevo protocolo de asistencia a la gestante diabética. Material y métodos: se llevó a cabo un estudio sobre dos cohortes retrospectivas formadas por un total de 262 gestantes con diagnóstico de diabetes pregestacional o gestacional a las que se les indujo el parto .Resultados: las inducciones por diabetes pasaron de constituir el segundo motivo de inducción al tercer motivo con un aumento estadísticamente significativo de duración de la gestación a favor de la cohorte del protocolo 2. Se observó con un menor porcentaje de partos prematuros; así como un menor porcentaje de recién nacidos de bajo peso Conclusiones: en la literatura no aparecen estudios de buena calidad que marquen las directrices a realizar en el seguimiento y tratamiento de la gestante diabética. En nuestro hospital se han mejorado las tasas de inducción con el nuevo protocolo establecido