Maternal and fetal outcomes of COVID-19, SARS, and MERS: a narrative review on the current knowledge.

OBJECTIVE: Coronavirus infections, including SARS, MERS and COVID-19 have significant impact on global health as well as on pregnancies. The aim of this review was to enlighten and summarize the cumulative knowledge regarding the relationship between Coronavirus outbreaks and pregnancy. MATERIALS AND METHODS: Literature search was commenced in order to analyze the maternofetal effects of Coronavirus outbreaks. RESULTS: Fever and cough are the most common presenting symptoms of COVID-19 which mostly affects pregnant women in their 3rd trimester with a maternal mortality rate of  0-77%  and fetal and neonatal mortality rates of 1.2%. Fetal demise is common in critically ill pregnant. Pregnancy seems as a worsening factor for SARS and MERS epidemics and both infections affect prominently 3rd trimester pregnancies, although abortion (57%) is a significant risk for cases of early pregnancy. Clinical course of COVID-19, SARS and MERS may be rapid and worse in pregnant women than non-pregnant individuals. Cesarean section is the choice of delivery in most reported women due to mostly obstetrical reasons, although vaginal delivery seems not a worsening factor for the disease. CONCLUSIONS: COVID-19, SARS and MERS have significant detrimental effect on pregnancy. Rapid intervention, treatment, and intensive care support are essential for infected pregnant. Timely delivery is important in order to avoid intrauterine fetal death.

Cervicovaginal washing prolactin assay in prediction of preterm delivery.

OBJECTIVE: Our purpose was to determine the utility of cervicovaginal washing prolactin assay in prediction of preterm birth in women without rupture of membranes. METHODS: Sixty-six women with normal singleton pregnancy were submitted to cervicovaginal washing and serum prolactin assays. The latency period to delivery and gestational age at admission and at delivery were also recorded. According to uterine contractions and obstetrical history regarding the previous preterm delivery, the pregnant women were divided into 4 groups: 18 symptomatic (group 1) and 15 asymptomatic (group 2) pregnancies who had previously had preterm delivery, and 18 symptomatic (group 3) and 15 asymptomatic (group 4) pregnancies without a history of prior preterm delivery were enrolled in the study. RESULTS: The cervicovaginal washing prolactin concentrations were significantly higher in groups 1 and 3 than in group 4 (P < 0.0083). With respect to the latency period to delivery and the birth weeks, groups 2 and 4 were significantly higher than groups 1 and 3 (F < 0.0001). In the evaluation of the whole group, a significant negative correlation was observed both between cervicovaginal washing prolactin concentrations and the lapsed times to delivery, and the gestational ages at delivery. The finding of a cervicovaginal washing prolactin value exceeding 50 ng/ml in the 12 days preceding preterm delivery had sensitivity, specificity, positive and negative predictive values of 65%, 95%, 86%, and 81%, respectively. CONCLUSIONS: A cervicovaginal washing prolactin value more than 50 ng/ml precedes preterm delivery within 12 days at > 29 weeks. The easy application, the good feasibility, the success in identifying pregnancies at risk for preterm labor, and the cost effectiveness suggests cervicovaginal washing prolactin assay as a biochemical marker for preterm delivery.

Effects of carbendazim on rat thyroid, parathyroid, pituitary and adrenal glands and their hormones.

The purpose of this study is to determine the effects of low and high dose of carbendazim on the level of certain hormones and endocrine glands (thyroid, parathyroid, adrenal and pituitary glands) of male rats. Carbendazim is a systemic fungicide with activity against a number of plant pathogens. In this study, daily doses of 0, 150, 300 and 600 mg/kg per day carbendazim were applied to male rats by gavage for 15 weeks. At the end of the experiment, T3, T4, TSH, ACTH and GH levels in rat serum were analysed. Thyroid, parathyroid, adrenal and pituitary glands of rats were taken. A significant increase was observed in serum T3 levels of the rats, which were exposed to 300 mg/kg per day carbendazim doses, compared to the serum T3 levels of the control group. There were no differences between the control and carbendazim-treated group of rats regarding serum TSH, T4, ACTH and growth hormone levels. This showed us that carbendazim caused histopathological damages in thyroid, parathyroid and adrenal glands of rats. No changes were observed in pituitary glands of treated rats. These results suggest that a high quantity of subchronic carbendazim exposure affects thyroid, parathyroid and adrenal glands.

Carbendazim-induced haematological, biochemical and histopathological changes to the liver and kidney of male rats.

Carbendazim is a systemic broad-spectrum fungicide controlling a wide range of pathogens. It is also used as a preservative in paint, textile, papermaking and leather industry, as well as a preservative of fruits. In the present study, carbendazim was administered at 0, 150, 300 and 600 mg/kg per day doses orally to male rats (Rattus rattus) for 15 weeks. At the end of the experiment, blood samples, liver and kidney tissues of each animal were taken. Serum enzyme activities, and haematological and biochemical parameters were analysed. In toxicological tests, 600 mg/kg per day doses of carbendazim caused an increase of albumin, glucose, creatinine and cholesterol levels. Also, at the same doses, white blood cell and lymphocyte counts decreased. However, mean cell hemoglobin and mean cell hemoglobin concentrations increased. Histopathological examinations revealed congestion, an enlargement of the sinusoids, an increase in the number of Kupffer cells, mononuclear cell infiltration and hydropic degeneration in the liver. At the highest doses, congestion, mononuclear cell infiltration, tubular degeneration and fibrosis were observed in the kidney tissue. These results indicate that 300 and 600 mg/kg per day carbendazim affected the liver and kidney tissue and caused some changes on haematological and biochemical parameters of rats.

Prophylaxis of the occurrence of hyperbilirubinemia in relation to maternal oxytocin infusion with steroid treatment.

This study was carried out to investigate the steroid prevention on the occurrence and the severity of red blood cell destruction by the effect of oxytocin usage for labor induction. Venous cord blood was collected from the pregnancies who had oxytocin-induced or augmented labors (20), oxytocin-infused deliveries with steroid use (20), deliveries without oxytocin use (20) and cesarean sections (20). Evaluation of the data showed significant increase in serum bilirubin level, serum lactic dehydrogenase activity, erythrocyte fragility and reticulocyte count (p < 0.0083), and a significant decrease in hemoglobulin concentration, packed red cell volume fraction (p < 0.01) in groups with labor induction or augmentation with oxytocin in comparison to deliveries with oxytocin plus steroid use and the two other methods of delivery. Moreover, with regard to the above data, no significant difference was observed between the deliveries other than oxytocin-only use. Mean corpuscular volume in the oxytocin group was apparently (not significant) higher than the steroid group. The results of this study suggest that the use of 16 mg dexamethasone 21-phosphate at the beginning of the induction or augmentation of labor with oxytocin, followed by an additional 4-mg dose 4 h later intravenously, is advantageous for the prevention of erythrocyte destruction.