Abstract:
:Pregnant patients with severe acute respiratory syndrome coronavirus 2, the virus responsible for the clinical condition newly described in 2019 as coronavirus disease 2019 (COVID-19) and illness severity to warrant intensive care have a complex disease process that must involve multiple disciplines. Guidelines from various clinical societies, along with direction from local health authorities, must be considered when approaching the care of an obstetric patient with known or suspected COVID-19. With a rapidly changing landscape, a simplified and cohesive perspective using guidance from different clinical society recommendations regarding the critically-ill obstetric patient with COVID-19 is needed. In this article, we synthesize various high-level guidelines of clinical relevance in the management of pregnant patients with severe disease or critical illness due to COVID-19. KEY POINTS: · When caring for severely ill obstetric patients with COVID-19, one must be well versed in the complications that may need to be managed including, but not limited to adult respiratory distress syndrome with need for mechanical ventilation, approach to refractory hypoxemia, hemodynamic shock, and multiorgan system failure.. · Prone positioning can be done safely in gravid patients but requires key areas of support to avoid abdominal compression.. · For the critically ill obstetric patient with COVID-19, the focus should be on supportive care as a bridge to recovery rather than delivery as a solution to recovery..
journal_name
Am J Perinatoljournal_title
American journal of perinatologyauthors
Oxford-Horrey C,Savage M,Prabhu M,Abramovitz S,Griffin K,LaFond E,Riley L,Easter SRdoi
10.1055/s-0040-1713121subject
Has Abstractpub_date
2020-08-01 00:00:00pages
1044-1051issue
10eissn
0735-1631issn
1098-8785journal_volume
37pub_type
杂志文章,评审abstract::We evaluated if maternal demographic and ultrasound parameters predict perinatal mortality in preterm intrauterine growth restriction (IUGR). Retrospective cohort study of preterm IUGR (delivery gestational age <35 weeks and birth weight <10th percentile for gestation). We excluded twins and fetuses with aneuploidy, i...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0029-1223284
更新日期:2009-11-01 00:00:00
abstract::We compared perinatal outcomes between live-born nonisolated and isolated omphaloceles diagnosed during a prenatal ultrasound. Fetuses (n = 86) with omphalocele were identified between 1995 and 2007 at a single institution. Inclusion criteria were an omphalocele >14 weeks' gestation, available fetal and/or neonatal ka...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0031-1276737
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVES:This article prospectively examines the use of ultrasound for antenatal detection of abnormal placental cord insertion (PCI) and compares the antenatal classification with delivered placental classification. STUDY DESIGN:This prospective cohort study examined 277 singleton pregnancies in a tertiary center. ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0039-3400309
更新日期:2020-01-01 00:00:00
abstract::A patient with a homozygous marital partner had three progressively less seriously involved RH-positive babies after a fetal demise due to erythroblastosis. Only the first of the three required fetal transfusions. All were Rh genotypically identical. The case is presented for interest and to illustrate an exception to...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999655
更新日期:1988-01-01 00:00:00
abstract::This communication examines the diagnostic value of the leukocyte esterase activity (LEA) test in the detection of intra-amniotic infection. Amniotic fluid from 171 consecutive patients with premature rupture of membranes (n = 149) and preterm labor (n = 22) was obtained through amniocentesis. Gram stain, bacterial an...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999657
更新日期:1988-01-01 00:00:00
abstract::The novel coronavirus disease 2019 (COVID-19) pandemic has resulted in changes to perinatal and neonatal care, concentrating on minimizing risks of transmission to the newborn and health care staff while ensuring medical care is not compromised for both mother and infant. Current recommendations on infant care and fee...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0040-1716506
更新日期:2020-11-01 00:00:00
abstract::The estimation of plasma bilirubin concentration in neonates, using a transcutaneous, noninvasive jaundice meter, is significantly affected by many factors, such as gestational age, birthweight, phototherapy, and skin pigmentation. In an attempt to minimize the influence of skin color and hence circumvent the need for...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2008-1040751
更新日期:1994-05-01 00:00:00
abstract::Amniocentesis to guide the management of preterm pregnancies complicated by premature rupture of the membranes (PROM) has been adopted at several centers. The purpose of this study was to evaluate this practice prospectively among comparable groups of patients, which has not previously been reported. Forty-seven patie...
journal_title:American journal of perinatology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1055/s-2007-1000031
更新日期:1984-07-01 00:00:00
abstract::We present an unusual case in which sonographic assessment at 33 weeks' gestation, 5 weeks following a normal fetal anatomical survey and biometry, demonstrated a large, irregular-shaped, echogenic, suprasellar midline intracranial mass occupying the anterior and middle fossas. Associated severe obstructive hydrocepha...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994064
更新日期:1998-01-01 00:00:00
abstract:OBJECTIVE:To compare the efficacy of similar buccal and vaginal misoprostol doses for induction of labor. STUDY DESIGN:Retrospective chart review of 207 consecutive women undergoing term induction of labor with misoprostol. Misoprostol route and dosing were collected. Time to delivery and other labor outcomes (e.g., v...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0038-1675219
更新日期:2019-06-01 00:00:00
abstract::Studies of the effect of body position during and after bolus feeding upon gastric emptying or gastric residual have not had consistent results. We tested the hypotheses that right lateral decubitus leads to less gastric residual than left lateral decubitus and that the prone position leads to less gastric residual th...
journal_title:American journal of perinatology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1055/s-2004-823778
更新日期:2004-04-01 00:00:00
abstract::Care of women with preterm labor has been reported by Katz et al to be enhanced by use of an electronic uterine contraction monitor. We enrolled 76 women with singleton gestations who had been successfully treated for preterm labor into a prospective randomized trial, assigning subjects in a ratio of 1:2 to a group of...
journal_title:American journal of perinatology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1055/s-2007-999473
更新日期:1990-04-01 00:00:00
abstract:OBJECTIVE:This study assessed the impact of a nurse simulation training program on perception of kangaroo mother care (KMC) value and transfer skill competency. STUDY DESIGN:An 8-item Likert scale skill survey tool and a 24-item Likert developmental care survey tool were used in a prospective cohort study to analyze p...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0034-1371359
更新日期:2014-11-01 00:00:00
abstract::A case is presented of a primigravida with transient diabetes insipidus, gestational hypertension, and multiple seizures resistant to magnesium sulfate and diazepam. After addition of phenytoin, no further seizures occurred. Transient diabetes insipidus in pregnancy has been previously associated with hypertension, li...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999504
更新日期:1990-07-01 00:00:00
abstract::Arteriovenous malformations of the Vein of Galen continue to present diagnostic and therapeutic challenges in the neonatal period. Approximately 40-50% of all malformations of the Vein of Galen present in the neonatal period, usually with congestive heart failure. These neonates represent the most severe cases and are...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2000-13456
更新日期:2000-01-01 00:00:00
abstract:OBJECTIVE: The aim of the study is to model amplitude-integrated electroencephalography (aEEG) utility to diagnose seizures in common clinical scenarios. STUDY DESIGN: Using reported neonatal seizure prevalence and aEEG sensitivities and specificities, likelihood ratios (LRs) and post-test probabilities were calculate...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0040-1721711
更新日期:2020-12-15 00:00:00
abstract:OBJECTIVE:To investigate the effect of pretreatment with obestatin (OB), an endogenous hormone also found in mother's milk, in experimental necrotizing enterocolitis (NEC). STUDY DESIGN:Pups were randomized into four groups: control, OB-control, NEC, and OB-NEC. NEC was induced by asphyxia and hypothermia in the NEC a...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0038-1676491
更新日期:2019-09-01 00:00:00
abstract:OBJECTIVE:Buprenorphine (BUP) is commonly used for opioid maintenance therapy in pregnancy. Our goal was to determine whether liver dysfunction related to hepatitis C virus (HCV) infection impacts BUP dosing requirements in pregnancy. STUDY DESIGN:This was a retrospective cohort study of pregnant women with antenatal ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0039-1698838
更新日期:2020-01-01 00:00:00
abstract::In this paper the results gathered in a longitudinal ultrasound study (LS) of fetal growth are presented. The study is unusual in design because of its homogeneity, the number of parameters recorded, the exact spacing between the examinations, and the number of examinations per subject. Information not available in th...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999987
更新日期:1984-01-01 00:00:00
abstract:OBJECTIVE:This article assesses the degree of variability in the current practice of skin antiseptics used in Canadian neonatal intensive care units (NICUs) and different experiences related to each antiseptic used. METHODS:An anonymous survey was distributed to a clinical representative of each of the 124 Canadian le...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0038-1661406
更新日期:2019-01-01 00:00:00
abstract::In order to assess the prognosis of hypertension first documented during labor, an inception cohort of all women with hypertension complicating pregnancy was assembled. In this cohort, even extreme elevations of blood pressure, regardless of the degree of proteinuria, were not associated with either maternal or fetal ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999799
更新日期:1987-10-01 00:00:00
abstract::Chorioamnionitis has generally been thought to be a contraindication to attempting a delayed interval delivery in a multiple gestation. We present a twin gestation in which a delay of 88 days between the birth of the two infants occurred. Chorioamnionitis observed immediately after the delivery of Twin A was successfu...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-993962
更新日期:1998-06-01 00:00:00
abstract:OBJECTIVE: According to the most recent metanalysis, the best way to establish safe enteral feeding in preterm babies using nasogastric or orogastric tubes is still not well understood. This study aimed to determine the effects of bolus nasal tubes versus bolus orogastric tubes on the time required to reach full entera...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0040-1713865
更新日期:2020-07-03 00:00:00
abstract::The objective of this paper was to determine if routine postpartum hemoglobin (Hb) determination changes patient management. One thousand patients with a vaginal delivery at Hermann Hospital, Houston, TX, had antepartum Hb testing, and a postpartum Hb for: (1) an antepartum Hb <9.0 mg/dL, (2) an estimated blood loss (...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-993881
更新日期:1999-01-01 00:00:00
abstract::Elevated serum transaminase levels can have many different etiologies, especially in the pregnant patient. Hypoxic hepatitis is a distinct syndrome caused by decreased hepatic blood flow that presents with a marked, but transient, increase in liver enzymes. A 28-year-old woman, gravida 3, para 2 with history of gastri...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0028-1085065
更新日期:2008-09-01 00:00:00
abstract::There were 107 episodes of pyelonephritis associated with pregnancy or the early puerperium occurring in 103 gravidas investigated retrospectively for information concerning prematurity, low birthweight, and antibiotic susceptibility patterns in the recovered microorganisms. No difference was found in the incidence of...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999800
更新日期:1987-10-01 00:00:00
abstract::Two cases of fetal myocardial calcification confirmed postnatally are reported. In contrast to other reports, both infants survived with resolution of calcification by 6 and 12 months. Diagnostic investigations failed to confirm the presence of congenital infection. Both pregnancies were complicated by early cocaine u...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2008-1040740
更新日期:1994-05-01 00:00:00
abstract::In Finland a nationwide free prenatal care system was mandated by law in 1944. At present, 99.9% of Finland's pregnant women use it. The primary aim is to provide advice and care to all women in local centers and to identify pregnant women exhibiting risk factors and refer them to specialized prenatal units located in...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999581
更新日期:1989-04-01 00:00:00
abstract::We present an unusual case, in which a woman presenting with markedly decreased fetal movements at 29 weeks gestation following a recent increase in fundal height was noted sonographically to have fetal hydrops consisting of scalp edema, marked hepatomegaly, ascites, and polyhydramnios. No lethal structural congenital...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-993933
更新日期:1998-04-01 00:00:00
abstract::This article evaluates the role of alpha-fetoprotein (AFP) testing in the diagnosis of ruptured membranes in the preterm patient. AFP is normally found in amniotic fluid and is not present in vaginal secretions. Testing for AFP in vaginal fluid was compared with nitrazine evaluation and ferning in two groups of preter...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999500
更新日期:1990-07-01 00:00:00