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1.
Viruses ; 13(6)2021 05 26.
Artigo em Inglês | MEDLINE | ID: mdl-34073492

RESUMO

The current coronavirus pandemic has affected, in a short time, various and different areas of medicine. Among these, the obstetric field has certainly been touched in full, and the knowledge of the mechanisms potentially responsible for placental damage from SARS-CoV-2 occupy a certain importance. Here we present here a rare case of dichorionic twins born at 30 weeks and 4 days of amenorrhea, one of whom died in the first few hours of life after placental damages potentially related to SARS-CoV-2. We also propose a brief review of the current literature giving ample emphasis to similar cases described.


Assuntos
COVID-19/complicações , Placenta/patologia , Complicações Infecciosas na Gravidez/virologia , SARS-CoV-2/patogenicidade , Adulto , COVID-19/diagnóstico , COVID-19/transmissão , COVID-19/virologia , Feminino , Humanos , Recém-Nascido , Transmissão Vertical de Doenças Infecciosas , Masculino , Complicações do Trabalho de Parto/virologia , Placenta/virologia , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Resultado da Gravidez , Gravidez de Gêmeos , SARS-CoV-2/isolamento & purificação
2.
Nat Commun ; 12(1): 3270, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-34075035

RESUMO

Little is known about the long-term neurological development of children diagnosed with congenital Zika infection at birth. Here, we report the imaging and clinical outcomes up to three years of life of a cohort of 129 children exposed to Zika virus in utero. Eighteen of them (14%) had a laboratory confirmed congenital Zika infection at birth. Infected neonates have a higher risk of adverse neonatal and early infantile outcomes (death, structural brain anomalies or neurologic symptoms) than those who tested negative: 8/18 (44%) vs 4/111 (4%), aRR 10.1 [3.5-29.0]. Neurological impairment, neurosensory alterations or delays in motor acquisition are more common in infants with a congenital Zika infection at birth: 6/15 (40%) vs 5/96 (5%), aRR 6.7 [2.2-20.0]. Finally, infected children also have an increased risk of subspecialty referral for suspected neurodevelopmental delay by three years of life: 7/11 (64%) vs 7/51 (14%), aRR 4.4 [1.9-10.1]. Infected infants without structural brain anomalies also appear to have an increased risk, although to a lesser extent, of neurological abnormalities. It seems paramount to offer systematic testing for congenital ZIKV infection in cases of in utero exposure and adapt counseling based on these results.


Assuntos
Desenvolvimento Infantil , Malformações do Sistema Nervoso/epidemiologia , Complicações Infecciosas na Gravidez/virologia , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Infecção por Zika virus/complicações , Adolescente , Adulto , Pré-Escolar , Feminino , Guiana Francesa/epidemiologia , Humanos , Lactente , Recém-Nascido , Masculino , Idade Materna , Malformações do Sistema Nervoso/etiologia , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Efeitos Tardios da Exposição Pré-Natal/etiologia , Medição de Risco/estatística & dados numéricos , Adulto Jovem , Zika virus/isolamento & purificação , Infecção por Zika virus/congênito , Infecção por Zika virus/diagnóstico , Infecção por Zika virus/virologia
3.
Int J Mol Sci ; 22(11)2021 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-34071527

RESUMO

A pandemic of acute respiratory infections, due to a new type of coronavirus, can cause Severe Acute Respiratory Syndrome 2 (SARS-CoV-2) and has created the need for a better understanding of the clinical, epidemiological, and pathological features of COVID-19, especially in high-risk groups, such as pregnant women. Viral infections in pregnant women may have a much more severe course, and result in an increase in the rate of complications, including spontaneous abortion, stillbirth, and premature birth-which may cause long-term consequences in the offspring. In this review, we focus on the mother-fetal-placenta interface and its role in the potential transmission of SARS-CoV-2, including expression of viral receptors and proteases, placental pathology, and the presence of the virus in neonatal tissues and fluids. This review summarizes the current knowledge on the anti-viral activity of lactoferrin during viral infection in pregnant women, analyzes its role in the pathogenicity of pandemic virus particles, and describes the potential evidence for placental blocking/limiting of the transmission of the virus.


Assuntos
Anti-Infecciosos/farmacologia , COVID-19/imunologia , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Lactoferrina/farmacologia , Placenta/imunologia , Complicações Infecciosas na Gravidez/virologia , SARS-CoV-2/imunologia , COVID-19/complicações , Feminino , Humanos , Recém-Nascido , Lactoferrina/metabolismo , Placenta/patologia , Placenta/virologia , Gravidez , Complicações Infecciosas na Gravidez/imunologia
4.
Isr Med Assoc J ; 23(5): 318-322, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34024050

RESUMO

BACKGROUND: The incidence of congenital cytomegalovirus (CMV) infection in Israel is 0.7%. Only 10-15% are symptomatic. Valganciclovir has been shown to improve hearing and neurodevelopmental outcomes in neonates with symptomatic congenital CMV infection. Targeted examination of infants who fail routine neonatal hearing screening or have clinical or laboratory findings suggestive of symptomatic congenital CMV infection may be a cost-effective approach. OBJECTIVES: To assess the possibility of targeted examination for the detection of newborns with symptomatic congenital CMV infection. METHODS: A prospective observational study was conducted in 2014-2015 at two medical centers in northern Israel. Included were all newborns who were tested in the first 3 days of life by polymerase chain reaction (PCR) for urine CMV DNA (n=692), either for failure the hearing screening (n=539, 78%), clinical or laboratory findings suggestive of symptomatic congenital CMV infection, or primary CMV infection during pregnancy (n=153, 22%). RESULTS: During the study period 15,433 newborns were born. The predicted rate of infection was 10-15% (symptomatic) of 0.7% of newborns, namely 0.07-0.105% or 10-15 infants. In fact, 15 infants (0.11%, 95% confidence interval 0.066-0.175) were diagnosed with symptomatic congenital CMV infection, 2/539 (0.37%) in the failed hearing group and 13/153 (8%) in the clinical/laboratory findings group. The incidence of symptomatic congenital CMV infection was within the predicted range. CONCLUSIONS: Targeted examination of only 4.5% (n=692) of newborns detected the predicted number of infants with symptomatic congenital CMV infection in whom valganciclovir therapy is recommended.


Assuntos
Infecções por Citomegalovirus/diagnóstico , Perda Auditiva Neurossensorial/diagnóstico , Triagem Neonatal/métodos , Reação em Cadeia da Polimerase , Antivirais/administração & dosagem , Infecções por Citomegalovirus/congênito , Infecções por Citomegalovirus/tratamento farmacológico , DNA Viral/urina , Feminino , Perda Auditiva Neurossensorial/virologia , Humanos , Incidência , Recém-Nascido , Israel , Gravidez , Complicações Infecciosas na Gravidez/virologia , Estudos Prospectivos , Valganciclovir/administração & dosagem
5.
Taiwan J Obstet Gynecol ; 60(3): 405-411, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33966721

RESUMO

COVID-19 a pandemic disease caused by the SARS-CoV2 virus, which has been emerged in Wuhan city China from early December 2019 which subsequently spreading globally. As a consequence of the physiological adaptive changes and immunosuppressive condition during pregnancy are more susceptible to respiratory tract infection and pneumonia that perhaps makes them more at risk to COVID-19. There is scarce information available on COVID-19 pregnancy and no reliable evidence for vertical transmission. It is a concern that newborns are risk from postpartum contamination. Meanwhile, there was no vaccine and specific therapeutic drugs for COVID19. The Multidisciplinary team will manage by close supervision, isolated negative pressure room, and routinely fetal monitoring. The timing and mode of delivery depend on the critical condition of the mother and fetal. The newborns need a14 days period of precautionary isolation. In the present study, addressed the most recent data on 149 pregnant women and 96 newborns with typical symptoms and planning of management which response to COVID-19 that will help for frontline doctor to the management of COVID-19 associated pregnancy and newborns baby. Repeated testing, contact tracing and self-isolation will assist to control the spread of SARS-CoV2 infection and COVID-19 disease until specific vaccine and pharmaceuticals drugs of COVID-19 are available.


Assuntos
/transmissão , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Complicações Infecciosas na Gravidez/virologia , Adulto , Feminino , Humanos , Recém-Nascido , Masculino , Gravidez , Resultado da Gravidez
6.
Taiwan J Obstet Gynecol ; 60(3): 458-462, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33966728

RESUMO

OBJECTIVE: To evaluate the clinical characteristics and outcomes of pregnant women with Covid-19. MATERIALS AND METHODS: This case series study was performed to investigate demographic, clinical and obstetric characteristics of 26 pregnant women with COVID-19 referring to a university hospital of Kashan during the epidemic of COVID-19 (March to May 2020). RESULTS: The mean gestational age of the patients at admission and delivery was 31.8 ± 5.2 and 36.3 ± 3.4 weeks, respectively. The most common symptoms were fever (96.2%) followed by dyspnea and cough (30.8%). The findings of lung CT scan showed abnormalities confirming the pneumonia in 22 patients (84.6%). Cesarean section was performed in 69.2% of the mothers. The most common maternal-fetal outcome was preterm delivery (38%). Two mothers were transferred to the ICU due to deterioration in clinical condition and they underwent mechanical ventilation without any maternal death. The most common neonatal outcomes were prematurity (38%) and low birth weight (34.6%). No cases of confirmed COVID-19 were observed in the neonates. CONCLUSION: Clinical manifestations and laboratory and radiographic findings in pregnant women with COVID-19 are similar to the general population. Common outcomes of pregnancy and delivery in mothers included increased rate of preterm delivery and cesarean section. The most prevalent neonatal outcomes included prematurity and LBW. Careful monitoring of pregnant women with COVID-19 is recommended.


Assuntos
/complicações , Parto Obstétrico/estatística & dados numéricos , Complicações Infecciosas na Gravidez/virologia , Resultado da Gravidez/epidemiologia , Adulto , /virologia , Parto Obstétrico/métodos , Feminino , Idade Gestacional , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Transmissão Vertical de Doenças Infecciosas/estatística & dados numéricos , Gravidez , Nascimento Prematuro/virologia
7.
Rev Bras Enferm ; 74(suppl 1): e20200849, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34037165

RESUMO

OBJECTIVE: Analyze available evidence related to SARS-CoV-2 infection and vertical transmission. METHODS: Scoping review, according to the Joanna Briggs Institute and PRISMA-ScR. Searches were conducted in five electronic databases to find publications about coronavirus infection and vertical transmission. Data were extracted, analyzed and synthesized by three independent researchers using a descriptive approach. RESULTS: The search resulted in 76 publications. After selective steps, 15 articles - retrospective descriptive or case studies - were analyzed, all in English. In order to track the infection, specimens were collected from neonates through nasal swabs and C-reactive protein from breast milk, cord blood, amniotic fluid, placenta and vaginal secretion was analyzed. A small percentage of neonates tested positive for COVID-19, but these cases were not attributed to vertical transmission. CONCLUSION: Vertical transmission could not be demonstrated. Research protocol registered with the Open Science Framework (https://osf.io/fawmv).


Assuntos
/transmissão , Transmissão Vertical de Doenças Infecciosas , Complicações Infecciosas na Gravidez/virologia , Proteína C-Reativa/análise , DNA Viral/análise , Feminino , Humanos , Recém-Nascido , Pandemias , Gravidez , Reação em Cadeia da Polimerase em Tempo Real
8.
BMC Pregnancy Childbirth ; 21(1): 397, 2021 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-34020600

RESUMO

BACKGROUND: Coronavirus disease is now a global concern with the non-availability of antiviral treatment and attacks all groups of the population. Hence, applying preventive measures is the most critical intervention to control the infection. Pregnant women are particularly susceptible to respiratory pathogens because of their immunosuppressive state and physiological adaptive change during pregnancy. Therefore, this study was aimed to assess knowledge and practice to prevent coronavirus disease and its associated factors among pregnant women in Debre Tabor Town. METHODS: Community-based cross-sectional study was conducted among 422 participants from May 25-June 15, 2020. A simple random sampling technique was employed. Data were collected by face-to-face interview using a structured and pre-tested questionnaire and analysis using SPSS version 23. Bivariable and multivariable logistic regression analysis was carried out and p-value < 0.05 at 95% CI were considered as statistically significant. RESULTS: Overall 46.8 and 47.6% of women were knowledgeable and had good practice to prevent coronavirus respectively. Women's age (15-24 years) (AOR = 4.85, 95% CI: 1.34-5.42), educational status (AOR:3.70; 95% CI: 1.16-5.40) being civil servant (AOR:2.84; 95% CI: 1.55-5.21), wanted pregnancy (AOR:3.37; 95% CI: 1.20-9.45), antenatal care follow-up (AOR:2.07; 95% CI: 1.03-4.13) were significantly associated with COVID-19 knowledge, whereas educational status (AOR:3.78; 95% CI: 1.19-5.11), number of children (AOR:2.89; 95% CI: 1.29-6.45) and knowledge (AOR:8.42;95% CI: 4.50-15.85), were also found to be statistically significant with practice. CONCLUSIONS: Most of the participants had poor knowledge and inappropriate practice. Increasing health education programs via different media, coordinated and combined efforts of authorities and all individuals will be needed to battles the spread of the infection.


Assuntos
/prevenção & controle , Complicações Infecciosas na Gravidez/prevenção & controle , Cuidado Pré-Natal/estatística & dados numéricos , Inquéritos e Questionários/normas , Adolescente , Adulto , /epidemiologia , Estudos Transversais , Escolaridade , Etiópia/epidemiologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Modelos Logísticos , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/virologia , Inquéritos e Questionários/estatística & dados numéricos , Adulto Jovem
9.
Front Immunol ; 12: 675476, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34012458

RESUMO

Pregnant women are generally more susceptible to viral infection. Although the impact of SARS-CoV-2 on pregnant women remains to be determined, evidence indicates that risks of adverse clinical outcomes are similar in pregnancy to the general population. Here we analyzed clinical symptoms and outcomes of 20 pregnant and 299 reproductive-aged non-pregnant female COVID-19 patients who were hospitalized during the same period. Laboratory measurements were compared among mild cases and healthy pregnant women. Our study found that pregnant patients showed enhanced innate immune response evident by higher neutrophils and C-reactive protein. Cytokines, chemokines, and growth factors (CCGFs) profiles from 11 pregnant and 4 non-pregnant COVID-19 patients and 10 healthy pregnant female patients, and lymphocyte subsets analysis of 7 pregnant patients and 19 non-pregnant patients, indicate suppressed cytokine storm and potential enhanced CD8+ T cell and NK cell activity in pregnant patients with COVID-19, which may be essential in contributing to the unique anti-SARS-CoV-2 response in pregnancy.


Assuntos
/imunologia , Complicações Infecciosas na Gravidez/imunologia , Adulto , /patologia , Citocinas/imunologia , Feminino , Hospitalização , Humanos , Subpopulações de Linfócitos/imunologia , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/patologia , Complicações Infecciosas na Gravidez/virologia
10.
Arch Gynecol Obstet ; 304(1): 39-57, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33945026

RESUMO

Coronavirus disease-2019 (COVID-19) related to Coronavirus-2 (SARS-CoV-2) is a worldwide health concern. Despite the majority of patients will evolve asymptomatic or mild-moderate upper respiratory tract infections, 20% will develop severe disease. Based on current pathogenetic knowledge, a severe COVID-19 form is mainly a hyperinflammatory, immune-mediated disorder, triggered by a viral infection. Due to their particular immunological features, pregnant women are supposed to be particularly susceptible to complicate by intracellular infections as well as immunological disturbances. As an example, immune-thrombosis has been identified as a common immune-mediated and pathogenic phenomenon both in COVID-19, in obstetric diseases and in COVID-19 pregnant women. According to extensive published clinical data, is rationale to expect an interference with the normal development of pregnancy in selected SARS-CoV-2-infected cases, mainly during third trimester.This manuscript provides insights of research to elucidate the potential harmful responses to SARS-CoV-2 and /or other coronavirus infections, as well as bidirectional interactions between COVID-19 and pregnancy to improve their respective management.


Assuntos
/imunologia , Transmissão Vertical de Doenças Infecciosas/estatística & dados numéricos , Complicações Infecciosas na Gravidez/virologia , /virologia , Feminino , Humanos , Pandemias , Gravidez , Gestantes
11.
Clin Nutr ESPEN ; 43: 1-8, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34024500

RESUMO

BACKGROUND & AIMS: Maternal gestational infection is a well-characterized risk factor for offsprings' development of mental disorders including schizophrenia, autism, and attention deficit disorder. The inflammatory response elicited by the infection is partly directed against the placenta and fetus and is the putative pathogenic mechanism for fetal brain developmental abnormalities. Fetal brain abnormalities are generally irreversible after birth and increase risk for later mental disorders. Maternal immune activation in animals models this pathophysiology. SARS-CoV-2 produces maternal inflammatory responses during pregnancy similar to previously studied common respiratory viruses. METHOD: Choline, folic acid, Vitamin D, and n-3 polyunsaturated fatty acids are among the nutrients that have been studied as possible mitigating factors for effects of maternal infection and inflammation on fetal development. Clinical and animal studies relevant to their use in pregnant women who have been infected are reviewed. RESULTS: Higher maternal choline levels have positive effects on the development of brain function for infants of mothers who experienced viral infections in early pregnancy. No other nutrient has been studied in the context of viral inflammation. Vitamin D reduces pro-inflammatory cytokines in some, but not all, studies. Active folic acid metabolites decrease anti-inflammatory cytokines. N-3 polyunsaturated fatty acids have no effect. CONCLUSIONS: Vitamin D and folic acid are already supplemented in food additives and in prenatal vitamins. Despite recommendations by several public health agencies and medical societies, choline intake is often inadequate in early gestation when the brain is forming. A public health initiative for choline supplements during the pandemic could be helpful for women planning or already pregnant who also become exposed or infected with SARS-CoV-2.


Assuntos
Encéfalo , Colina/uso terapêutico , Desenvolvimento Fetal , Mães , Estado Nutricional , Complicações Infecciosas na Gravidez/virologia , Animais , Encéfalo/efeitos dos fármacos , /virologia , Desenvolvimento Infantil/efeitos dos fármacos , Colina/farmacologia , Deficiências do Desenvolvimento/etiologia , Deficiências do Desenvolvimento/prevenção & controle , Suplementos Nutricionais , Ácidos Graxos Ômega-3/farmacologia , Ácidos Graxos Ômega-3/uso terapêutico , Feminino , Desenvolvimento Fetal/efeitos dos fármacos , Feto/efeitos dos fármacos , Ácido Fólico/farmacologia , Ácido Fólico/uso terapêutico , Humanos , Lactente , Inflamação/complicações , Inflamação/metabolismo , Necessidades Nutricionais , Pandemias , Placenta/metabolismo , Gravidez , Complicações Infecciosas na Gravidez/metabolismo , Vitamina D/farmacologia , Vitamina D/uso terapêutico
12.
Int Nurs Rev ; 68(2): 141-143, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34053073

RESUMO

In an interview, World Health Organization Chief Nursing Officer Elizabeth Iro reflected on nursing during the COVID-19 pandemic and how nurses have risen to the challenges they have faced. Despite the cancellation of virtually all the activities planned to mark 2020 as the International Year of the Nurse and Midwife, she believes that nurses' leadership, courage, compassion, commitment and expertise have been revealed to the world like never before. However, it is critical to nurture and support the next generation of nurses so that they can help to bring about the necessary reforms for health systems around the world.


Assuntos
/enfermagem , Papel do Profissional de Enfermagem , Pneumonia Viral/enfermagem , Complicações Infecciosas na Gravidez/enfermagem , Organização Mundial da Saúde , /epidemiologia , Feminino , Humanos , Liderança , Tocologia , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/virologia
13.
Arch Gynecol Obstet ; 304(1): 5-38, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33797605

RESUMO

BACKGROUND: In December 2019, a novel coronavirus disease (COVID-19) emerged in Wuhan, China, with an incredible contagion rate. However, the vertical transmission of COVID-19 is uncertain. OBJECTIVES: This is a systematic review of published studies concerning pregnant women with confirmed COVID-19 and their neonates. SEARCH STRATEGY: We carried out a systematic search in multiple databases, including PubMed, Web of Science, Google Scholar, Scopus, and WHO COVID-19 database using the following keywords: (Coronavirus) OR (novel coronavirus) OR (COVID-19) OR (COVID19) OR (COVID 19) OR (SARS-CoV2) OR (2019-nCoV)) and ((pregnancy) OR (pregnant) OR (vertical transmission) OR (neonate) OR (newborn) OR (placenta) OR (fetus) OR (Fetal)). The search took place in April 2020. SELECTION CRITERIA: Original articles published in English were eligible if they included pregnant patients infected with COVID-19 and their newborns. DATA COLLECTION AND ANALYSES: The outcomes of interest consisted of clinical manifestations of COVID-19 in pregnant patients with COVID-19 and also the effect of COVID-19 on neonatal and pregnancy outcomes. MAIN RESULTS: 37 articles involving 364 pregnant women with COVID-19 and 302 neonates were included. The vast majority of pregnant patients were in their third trimester of pregnancy, and only 45 cases were in the first or second trimester (12.4%). Most mothers described mild to moderate manifestations of COVID-19. Of 364 pregnant women, 25 were asymptomatic at the time of admission. The most common symptoms were fever (62.4%) and cough (45.3%). Two maternal deaths occurred. Some pregnant patients (12.1%) had a negative SARS-CoV-2 test but displayed clinical manifestations and abnormalities in computed tomography (CT) scan related to COVID-19. Twenty-two (6.0%) pregnant patients developed severe pneumonia. Two maternal deaths occurred from severe pneumonia and multiple organ dysfunction. Studies included a total of 302 neonates from mothers with COVID-19. Of the studies that provided data on the timing of birth, there were 65 (23.6%) preterm neonates. One baby was born dead from a mother who also died from COVID-19. Of the babies born alive from mothers with COVID-19, five newborns faced critical conditions, and two later died. A total of 219 neonates underwent nasopharyngeal specimen collection for SARS-CoV-2, of which 11 tested positive (5%). Seventeen studies examined samples of the placenta, breast milk, umbilical cord, and amniotic fluid, and all tested negative except one amniotic fluid sample. CONCLUSIONS: A systematic review of published studies confirm that the course of COVID-19 in pregnant women resembles that of other populations. However, there is not sufficient evidence to establish an idea that COVID-19 would not complicate pregnancy.


Assuntos
/diagnóstico , Transmissão Vertical de Doenças Infecciosas , Complicações Infecciosas na Gravidez/virologia , Gestantes , Adulto , Líquido Amniótico , /virologia , Feminino , Febre , Humanos , Recém-Nascido , Mães , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Resultado da Gravidez , Terceiro Trimestre da Gravidez , RNA Viral
14.
Pediatr Infect Dis J ; 40(7): e270-e271, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-33902082

RESUMO

The majority of coronavirus disease 2019 (COVID-19) have been confirmed in adults, with only a few reported cases in children. In the pediatric population, COVID-19 infection appears to be often unremarkable or associated with mild respiratory symptoms. Little is known about neurologic complications related to COVID-19 in newborns. We present a case of severe encephalitis with cytotoxic brain edema in a newborn with COVID-19.


Assuntos
Edema Encefálico/patologia , Edema Encefálico/virologia , Encéfalo/patologia , COVID-19/complicações , Encefalite Viral/etiologia , Doença Aguda , Encéfalo/diagnóstico por imagem , Encéfalo/virologia , Edema Encefálico/diagnóstico por imagem , COVID-19/diagnóstico , Feminino , Humanos , Recém-Nascido , Transmissão Vertical de Doenças Infecciosas , Imageamento por Ressonância Magnética , Masculino , Gravidez , Complicações Infecciosas na Gravidez/virologia , Convulsões/virologia
15.
PLoS One ; 16(4): e0250196, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33886645

RESUMO

INTRODUCTION: The evidence for vertical transmission of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is not well established. Therefore, the objective of this review is to summarize emerging evidence on the vertical transmission of Severe Acute Respiratory Syndrome Coronavirus 2. METHODS: We conducted a systematic search in PubMed, CINAHL, Web of Science, SCOPUS, and CENTRAL. Likewise, a search for preprint publications was conducted using MedRxiv and Research Square. Studies that addressed vertical transmission of SARS-CoV-2 (concept) among pregnant women infected by Covid-19 (population) in any setting (community, hospital, or home) in any country or context were considered for inclusion. Any types of studies or reports published between December 2019 and September 2020 addressing the effects of SARS-CoV-2 on pregnant women and their newborn babies were included. Studies were screened for eligibility against the inclusion criteria for the review by two reviewers. RESULTS: We identified 51 studies reporting 336 newborns screened for COVID-19. From the 336 newborns screened for COVID-19, only 15 (4.4%) were positive for throat swab RT-PCR. All neonates with positive throat swab RT-PCR were delivered by cesarean section. Among neonates with throat swab SARS-CoV-2 positive only five (33.3%) had concomitant placenta, amniotic fluid, and cord blood samples tested, of which only one amniotic fluid sample is positive for RT PCR. Five neonates had elevated IgG and IgM but without intrauterine tissue tested. Four neonates had chest imaging suggestive of COVID-19 pneumonia. CONCLUSION: Currently there is not enough evidence on vertical virologic transmission of COVID-19 infection during the third trimester of pregnancy. Additionally, there is no evidence to support cesarean delivery, abstaining from breast feeding nor mother and infant separation. Further research involving an adequate sample size of breast milk, placenta, amniotic fluid, and cord blood to ascertain the possibility of vertical transmission and breast milk transfer is needed.


Assuntos
/diagnóstico , Doenças do Recém-Nascido/diagnóstico , Transmissão Vertical de Doenças Infecciosas , Complicações Infecciosas na Gravidez/diagnóstico , /isolamento & purificação , /transmissão , Feminino , Humanos , Recém-Nascido , Doenças do Recém-Nascido/virologia , Gravidez , Complicações Infecciosas na Gravidez/virologia
16.
Pan Afr Med J ; 38: 54, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33854683

RESUMO

Introduction: option B+ ART is a lifelong regimen of ART using a combination of 3 ARVs and adherence to this regimen can reduce risk of MTCT to 1-2% as against 15-40% without treatment. To achieve an undetectable viral load and prevent the development of drug resistance, a person on ARV drugs need to take at least 95% of prescribed doses on time. This study assessed the level of adherence to Option B+ PMTCT program and its predictors among HIV+ Pregnant women accessing antenatal care in health facilities Abuja. Methods: we enrolled 284 HIV positive pregnant women and lactating mothers in a hospital-based cross-sectional study. We sampled respondents using two-staged sampling technique. We collected data on socio-demographic characteristics, level of adherence, patients and healthcare related factors affecting adherence, knowledge of clients on HIV, ART and MTCT. Focused group discussion guide, data abstraction form and key informant interview guide were used for PMTCT focal persons. We conducted bivariate analysis and logistic regression using Epi-Info version 7 at 5% level of significance. Results: the mean age of respondents was 30.12 years (SD±4.86) with mean knowledge score of 16.7 and 75.5%% of them had good knowledge. The level of good adherence was 83.3%. Independent factors associated with non-adherence to ART included: Forgetfulness (OR 20.02; 95% CI 6.42-62.48), having side effects (OR 39.6; 95% C.I: 4.46-352.32), lack of food (OR 34.76; 95% C.I: 2.37-509.33), disclosure of HIV status (OR 2.51; 95% CI 1.22-5.15), being too busy (OR 13.96; 95% CI 3.89-49.98). Encountering challenge in ART initiation (OR 2.05; 95% CI 1.01-4.72) and level of Knowledge (OR 2.12; 95% CI 1.06-5.42). Conclusion: the level of adherence would improve study if the Public health department of Federal Ministry of Health (FMOH), Federal Capital Development Authority (FCDA) and National Agency for the Control of AIDS (NACA) sponsors public enlightenment on HIV/AIDS through the media which may help reduce stigma and encourage voluntary HIV status disclosure. Reminders should be used by patients to help them overcome forgetfulness.


Assuntos
Fármacos Anti-HIV/administração & dosagem , Infecções por HIV/prevenção & controle , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Adesão à Medicação , Adolescente , Adulto , Estudos Transversais , Feminino , Infecções por HIV/tratamento farmacológico , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Lactação , Pessoa de Meia-Idade , Nigéria , Gravidez , Complicações Infecciosas na Gravidez/tratamento farmacológico , Complicações Infecciosas na Gravidez/virologia , Estigma Social , Revelação da Verdade , Carga Viral , Adulto Jovem
17.
Viruses ; 13(3)2021 03 10.
Artigo em Inglês | MEDLINE | ID: mdl-33801923

RESUMO

The effects of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in women on the gestation course and the health of the fetus, particularly in the first and second trimesters, remain very poorly explored. This report describes a case in which the normal development of pregnancy was complicated immediately after the patient had experienced Coronavirus disease 2019 (COVID-19) at the 21st week of gestation. Specific conditions included critical blood flow in the fetal umbilical artery, fetal growth restriction (1st percentile), right ventricular hypertrophy, hydropericardium, echo-characteristics of hypoxic-ischemic brain injury (leukomalacia in periventricular area) and intraventricular hemorrhage at the 25th week of gestation. Premature male neonate delivered at the 26th week of gestation died after 1 day 18 h due to asystole. The results of independent polymerase chain reaction (PCR), mass spectrometry and immunohistochemistry analyses of placenta tissue, umbilical cord blood and child blood jointly indicated vertical transmission of SARS-CoV-2 from mother to the fetus, which we conclude to be the major cause for the development of maternal vascular malperfusion in the studied case.


Assuntos
/transmissão , Retardo do Crescimento Fetal/virologia , Complicações Infecciosas na Gravidez/virologia , /fisiologia , Adulto , /patologia , Evolução Fatal , Feminino , Retardo do Crescimento Fetal/mortalidade , Retardo do Crescimento Fetal/patologia , Humanos , Recém-Nascido , Transmissão Vertical de Doenças Infecciosas , Masculino , Gravidez , Complicações Infecciosas na Gravidez/mortalidade , Complicações Infecciosas na Gravidez/patologia , Segundo Trimestre da Gravidez , /genética
18.
J Med Case Rep ; 15(1): 213, 2021 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-33892788

RESUMO

BACKGROUND: Vertical transmission of coronavirus disease 2019 (COVID-19) from mother to newborn infant is doubtful, and very little is known about disease severity and neonatal outcome. CASE PRESENTATION: We present a preterm Iranian infant born to a Persian mother with severe COVID-19 pneumonia. The mother underwent cesarean delivery, and amniotic fluid yielded a positive result for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by real-time reverse transcription polymerase chain reaction (RT-PCR). The newborn infant showed early-onset infection with SARS-CoV-2 confirmed on pharyngeal swabs by RT-PCR assay within 24 hours after birth, suggesting vertical transmission. Unfortunately, the mother died 14 days after delivery. We describe the clinical course and outcome of the infant up to 7 months of age. CONCLUSION: COVID-19 infection in pregnant women may increase maternal morbidity, mortality and possibly vertical transmission in severe cases. However, it does not seem to progress to serious early or late neonatal complications.


Assuntos
/diagnóstico , Transmissão Vertical de Doenças Infecciosas , Complicações Infecciosas na Gravidez/diagnóstico , Nascimento Prematuro , Líquido Amniótico/virologia , Cesárea , Evolução Fatal , Feminino , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Irã (Geográfico) , Gravidez , Complicações Infecciosas na Gravidez/virologia , Resultado da Gravidez , Ressuscitação , Adulto Jovem
19.
Pediatr Infect Dis J ; 40(5): 473-478, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33847297

RESUMO

Limited data are available about the outcomes of coronavirus disease 2019 (COVID-19) during pregnancy and risk of vertical transmission in exposed neonates. We reviewed studies published February 1, 2020, through August 15, 2020, on outcomes in pregnant women with COVID-19 and neonates with perinatal exposure. Among pregnant women with COVID-19, 181 (11%) required intensive care unit admission and 123 (8%) required mechanical ventilation. There were 22 maternal deaths. Most infections occurred in the third trimester. Among women who delivered, 28% had a preterm birth, and 57% had a Caesarean section. Sixty-one (4%) of 1222 neonates with reported testing had at least 1 positive severe acute respiratory syndrome coronavirus 2 polymerase chain reaction test. The most common symptom among neonates was respiratory distress (n = 126; 21%). There were 14 neonatal deaths, one of which occurred in a neonate with positive testing. Further study of COVID-19 in pregnant women and neonates, including standardized reporting of outcomes, testing and treatment protocols, is essential to optimize maternal and neonatal care.


Assuntos
/diagnóstico , Transmissão Vertical de Doenças Infecciosas , Complicações Infecciosas na Gravidez/virologia , /fisiologia , /virologia , Cesárea , Feminino , Hospitalização , Humanos , Recém-Nascido , Gravidez , Resultado da Gravidez , Gestantes , Nascimento Prematuro
20.
Int J Mol Sci ; 22(6)2021 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-33805739

RESUMO

As most recently demonstrated by the SARS-CoV-2 pandemic, congenital and perinatal infections are of significant concern to the pregnant population as compared to the general population. These outcomes can range from no apparent impact all the way to spontaneous abortion or fetal infection with long term developmental consequences. While some pathogens have developed mechanisms to cross the placenta and directly infect the fetus, other pathogens lead to an upregulation in maternal or placental inflammation that can indirectly cause harm. The placenta is a temporary, yet critical organ that serves multiple important functions during gestation including facilitation of fetal nutrition, oxygenation, and prevention of fetal infection in utero. Here, we review trophoblast cell immunology and the molecular mechanisms utilized to protect the fetus from infection. Lastly, we discuss consequences in the placenta when these protections fail and the histopathologic result following infection.


Assuntos
Imunidade , Placenta/imunologia , Placenta/virologia , Complicações Infecciosas na Gravidez/imunologia , Complicações Infecciosas na Gravidez/virologia , Viroses/imunologia , Vírus/imunologia , Feminino , Feto/imunologia , Feto/virologia , Humanos , Placenta/patologia , Gravidez , Trofoblastos/imunologia , Trofoblastos/virologia
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