The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
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The aim of this study was to collect and analyze data from different sources to have a general overview of COVID-19-related maternal deaths in Brazil, as well as to compare data with worldwide reports. ⋯ To the best of our knowledge, this is the largest available series of maternal deaths due to COVID-19. Barriers to access healthcare, differences in pandemic containment measures in the country and high prevalence of concomitant risk factors for COVID-19 severe disease may play a role in the observed disparity compared to worldwide reports on maternal outcomes.
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J. Matern. Fetal. Neonatal. Med. · Jul 2020
Personal Protective Equipment during the COVID-19 pandemic and operative time in cesarean section: retrospective cohort study.
The covid-19 pandemic has meant a change in working protocols, as well as in Personal Protective Equipment (PPE). Obstetricians have had to adapt quickly to these changes without knowing how they affected their clinical practice. The aim of the present study was to evaluate how COVID-19 pandemic and PPE can affect operative time, operating room time, transfer into the operating room to delivery time and skin incision to delivery time in cesarean section. ⋯ There were no significant differences in the operative time, transfer into the operating room to delivery time and skin incision to delivery time when wearing PPE in cesarean section. The COVID-19 pandemic and the use of PPE resulted in a significant increase in operating room time.
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J. Matern. Fetal. Neonatal. Med. · Jul 2020
Impact of sodium bicarbonate therapy on hemodynamic parameters in infants: a meta-analysis.
Objective: Sodium bicarbonate is a frequently used electrolyte for the acute treatment of metabolic acidosis in critically ill patients. We performed a systematic review and meta-analysis to determine the effect of sodium bicarbonate on hemodynamics, gas exchange and oximetry in critically children. Methods: A systematic review of published manuscripts was conducted to identify studies of children who received sodium bicarbonate as part of the treatment for metabolic acidosis. ⋯ There was no change in heart rate, blood pressure, pH, partial pressure of oxygen, or saturation by pulse oximetry. Conclusion: Sodium bicarbonate has a statistically significant but not clinically significant impact on partial pressure of carbon dioxide and base deficit 60 min after sodium bicarbonate administration in critically ill infants. There is no difference noted in pH, partial pressure of oxygen, or saturation by pulse oximetry.
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J. Matern. Fetal. Neonatal. Med. · Jul 2020
Meta AnalysisIntrapartum cardiotocography with and without computer analysis: a systematic review and meta-analysis of randomized controlled trials.
Objective: To evaluate whether intrapartum cardiotocography with computer analysis decreases the incidence of newborn metabolic acidosis or obstetric intervention when compared with visual analysis through a systematic review with meta-analysis of randomized controlled trials. Methods: The research was conducted using Medline, Embase, Web of Science, Scopus, ClinicalTrial.gov, Ovid and Cochrane Library as electronic databases from the inception of each database to May 2018. Selection criteria included randomized trial evaluating women with cephalic presentation at term or late preterm term during labor who were randomized to electronic fetal heart rate monitoring with either computer analysis (i.e. intervention group) or standard visual analysis (i.e. control group). ⋯ Women who received continuous CTG during labor with computerized analysis had similar risk of newborn metabolic acidosis. No between group differences were found in the secondary outcomes. Conclusions: Compared with visual analysis, use of computer analysis of fetal monitoring signals during labor did not significantly reduce the rate of metabolic acidosis or obstetric intervention.
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J. Matern. Fetal. Neonatal. Med. · Jun 2020
The effects of hemodilution on coagulation in term parturients: an in vitro study utilizing rotational thromboelastometry.
Objective: To examine the impact of hemodilution on components of blood coagulation using rotational thromboelastometry (ROTEM®) in term parturientsMethods: This is a prospective, observational pilot study including 35 healthy, parturients at term (≥37 weeks) without history of bleeding or clotting disorder or on medication affecting coagulation. Venous blood samples were collected and divided into specimen tubes to generate varying degrees of hemodilution with Plasma-Lyte (0%, 20%, 25%, 30%, 35%, 40%, 45%, 55%, 60%, 65%, 70%, 75%, 80%). ROTEM® was performed to assess for coagulation changes. ⋯ However, the samples analyzed by the FIBTEM assay trended toward a coagulopathy at a lower degree of hemodilution compared to the EXTEM assay. As FIBTEM tests analyze the role of fibrinogen in hemostasis and EXTEM tests analyze the role of platelets, our findings suggest that platelets may be able to withstand higher degrees of hemodilution before impairing hemostasis compared to fibrinogen. These findings support the growing body of literature that in early stages of severe obstetric hemorrhage, the prioritization of fibrinogen replacement may be critical in preventing further coagulopathy.