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1. Workshop for Basic Gynaecological Examinations: Improving Medical Student Learning through Clinical Simulation.

Author

Cuñarro-López, Yolanda, Sánchez Llanos, Lucia, Cueto Hernández, Ignacio, González-Garzón De Zumárraga, Blanca, Del Pilar Pintado Recarte, María, Ruiz Labarta, Francisco Javier, Cano-Valderrama, Óscar, Aedo Ocaña, Olga, Pérez Lucas, Raquel, Viñuela Benéitez, María Del Carmen, Reyes Angullo, Zurine Raquel, Fernández Muñoz, María, Pina Moreno, Juan Manuel, Sanchez Rodriguez, Maria Mercedes, Aracil Rodríguez, Rocío, Pérez Burrel, Laura, Sáez Prat, Ainoa, Fraile López, Andrea, Gutiérrez Del Río, Beatriz, and Quintana Coronado, María de Guadalupe

Subjects
SCHOOL environment, MEDICAL students, PATHOLOGICAL physiology, MATHEMATICAL models, GYNECOLOGIC examination, SIMULATION methods in education, UNDERGRADUATES, TREATMENT effectiveness, COMPARATIVE studies, QUESTIONNAIRES, INTELLECT, THEORY, DESCRIPTIVE statistics, ADULT education workshops, EDUCATION
Abstract

Introduction: This study was designed to evaluate whether the Workshop on Basic Principles for Clinical Gynaecological Exploration, offered to medical students, improves theoretical–practical knowledge, safety, confidence, global satisfaction and the achievement of the proposed objectives in the area of gynaecological clinical examinations. Materials and Methods: This was a quasi-experimental pre–post-learning study carried out at the Gynaecology and Obstetrics department of Gregorio Marañón Hospital in Madrid (Spain). The volunteer participants were 4th-year students earning a degree in Medicine during the 2020–2021 and 2021–2022 academic years. The study period was divided into the following stages: pre-workshop, intra-workshop and 2 weeks post-workshop. In the pre-workshop stage, students completed a brief online course to prepare for the workshop. The effectiveness of the workshop was evaluated through multiple-choice tests and self-administered questionnaires to assess self-assurance, self-confidence, self-satisfaction and the achievement of the objectives. Results: Of the 277 students invited in both academic years, 256 attended the workshop (92.4%), with a total participation in the different stages of the study greater than 70%. A total of 82.5% of the students in the 2020–2021 academic year and 80.6% of students in the 2021–2022 academic year did not have any type of experience performing gynaecological clinical examinations. Between the pre-workshop and 2 weeks post-workshop stages, there was significant improvement in theoretical–practical knowledge (improvement mean = 1.38 and 1.21 in 2020–2021 and 2021–2022 academic years, respectively). The security and confidence of the students prior to the workshop were low (average scores less than 5 points) in both academic years. However, post-workshop scores for satisfaction and the achievement of objectives were high in the two academic years; all the values approached or exceeded 8 points. Conclusions: Our students, after outstanding participation, evaluated the BPCGE, and improved their theoretical and practical knowledge, as well as their skills in a gynaecological clinical examination. Moreover, in their view, after the workshop, they felt very satisfied, far outreaching the proposed aims. In addition, excellent results were maintained over time, year after year. [ABSTRACT FROM AUTHOR]

Published
2023
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3. Influence of the Human Development Index on the Maternal–Perinatal Morbidity and Mortality of Pregnant Women with SARS-CoV-2 Infection: Importance for Personalized Medical Care.

Author

Cuñarro-López, Yolanda, Larroca, Santiago García-Tizón, Pintado-Recarte, Pilar, Hernández-Martín, Concepción, Prats-Rodríguez, Pilar, Cano-Valderrama, Óscar, Cueto-Hernández, Ignacio, Ruiz-Labarta, Javier, Muñoz-Chápuli, María del Mar, Martínez-Pérez, Óscar, Ortega, Miguel A., and De León-Luis, Juan Antonio

Subjects
HUMAN Development Index, PREGNANT women, SARS-CoV-2, MEDICAL care, WOMEN'S mortality
Abstract

Coronavirus disease-19 (COVID-19) is perhaps the most worrisome pandemic in the 21st century, having entailed devastating consequences for the whole society during the last year. Different studies have displayed an existing association between pregnancy and COVID-19 severity due to the various physiological changes that occur during gestation. Recent data identified maternal country of origin as an important determinant of COVID-19 presentation in pregnant women. However, the explanation of this fact remains to be fully elucidated. Therefore, the purpose of this work is to analyze the possible relationship between Human Development Index (HDI) of maternal country of origin with the morbimortality of pregnant women and their newborns. Here, we conducted a multicentric, ambispective, observational case-control study (1:1 ratio) and compare with the HDI of each country (group 1—very high HDI, group 2—high HDI, group 3—medium HDI, and group 4—low HDI). In total, 1347 pregnant women with confirmed SARV-CoV-2 infection (cases) were enrolled, and each was paired with one control to give a total number of 2694 participants from 81 tertiary care centers. Among the women with SARS-CoV-2 infection, more cases were produced of perinatal mortality, overall maternal morbidity, COVID-19 maternal morbidity, C-sections, hypertensive maternal morbidity, and perinatal morbidity. Our results described an inverse association between HDI and maternofetal morbidity and mortality. Moreover, the countries with an HDI lower than 1 showed higher rates of patients with maternal COVID-19-related morbidity (6.0% vs. 2.4%, p < 0.001), a need for oxygen therapy (4.7% vs. 1.8%, p < 0.001), and maternal ICU admission (2.6% vs. 1.0%, p = 0.007). Compared to other risk factors such as overweight, obesity, preexisting and obstetric comorbidities, HDI emerged as an independent risk factor explaining much of the increased maternal–perinatal morbidity and mortality detected in our group of cases. Further research is needed to establish to confirm the real impact of this factor and its components on pregnancy outcomes. [ABSTRACT FROM AUTHOR]

Published
2021
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4. Risk Factors in Third and Fourth Degree Perineal Tears in Women in a Tertiary Centre: An Observational Ambispective Cohort Study.

Author

Barca, Juan A., Bravo, Coral, Pintado-Recarte, Maria P., Cueto-Hernández, Ignacio, Ruiz-Labarta, Javier, Cuñarro, Yolanda, Buján, Julia, Alvarez-Mon, Melchor, Ortega, Miguel A., and De León-Luis, Juan A.

Subjects
BIRTH weight, PERINEUM, HOSPITAL maternity services, CESAREAN section, COHORT analysis, INDUCED labor (Obstetrics), NEWBORN infants, LABOR (Obstetrics)
Abstract

Objectives: To analyze the main risk factors associated with third and fourth degree postpartum perineal tears in women attended to in our obstetrics service. Methods: An observational, retrospective, hospital cohort study was carried out in women whose deliveries were attended to in the obstetrics service of the Hospital General Universitario Gregorio Marañón de Madrid (HGUGM), during the period from January 2010 to April 2017. Results: During the study period, a total of 33,026 patients were included in the study. For maternal variables, the associated increased risk of severe perineal tearing in nulliparous women is OR = 3.48, for induced labor OR = 1.29, and for instrumental delivery by forceps OR = 4.52 or spatulas OR = 4.35; for the obstetric variable of episiotomy, it is OR = 3.41. For the neonatal variables, the weight of the newborns has a directly proportional relationship with the risk of severe tears, and for birth weights of 3000 g (OR = 2.41), 3500 g (OR = 1.97), and 4000 g (OR = 2.17), statistically significant differences were found in each of the groups (p < 0.05). Conclusion: Primiparity, induction of labor, episiotomy, instrumental delivery with forceps or spatula, and a birth weight of 3000 g or more are significantly associated with an increased risk of third and fourth degree perineal tears. [ABSTRACT FROM AUTHOR]

Published
2021
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5. Comparing Infection Profiles of Expectant Mothers with COVID-19 and Impacts on Maternal and Perinatal Outcomes between the First Two Waves of the Pandemic.

Author

Cuñarro-López, Yolanda, Pintado-Recarte, Pilar, Hernández-Martín, Concepción, Paya-Martínez, Pilar, López-Pérez, Rocío, Cueto-Hernández, Ignacio, Ruiz-Labarta, Javier, Cano-Valderrama, Óscar, Martínez-Pérez, Óscar, Bravo-Arribas, Coral, Ortega, Miguel A., and De León-Luis, Juan Antonio

Subjects
PREGNANT women, COVID-19, PANDEMICS, SYMPTOMS, CESAREAN section, PREMATURE labor, MATERNAL mortality
Abstract

During 2020, Coronavirus Disease-19 (COVID-19) incidence fluctuated in two clear waves across the spring and autumn periods. This study was designed to compare the maternal and perinatal clinical outcomes in obstetrics patients with COVID-19 between the two waves of infection in Spain. We conducted an observational, analytical, ambispective cohort study with longitudinal follow-up of mothers with confirmed SARV-CoV-2 infection from different hospitals in our country between March–November 2020. We recruited 1295 pregnant women with SARS-CoV2 infection from 78 hospitals, 846 (65.3%) of whom were diagnosed during the first wave and 449 (34.7%) during the second wave. Our results show that patients developing COVID-19 during the first wave had more symptoms at triage, early in pregnancy with greater rates of COVID-19-related maternal morbidity; caesarean section and preterm birth in the first wave. We register two cases of maternal mortality and only during the first wave. Maternal morbidity events showed a strong link to perinatal mortality events in the first wave compared to the second wave, in which maternal morbidity was more associated with pneumonia. Likewise, maternal morbidity showed a strong correlation with perinatal morbidity events in both waves. We describe the differences between the patients' profiles and management between the two waves and related to maternal and perinatal outcomes. Differences were also observed in the management of pregnant women with COVID-19. Thus, there were fewer caesarean sections, and maternal and perinatal morbidity events were reduced in the second wave, while the impacts of respiratory symptoms and their severity, including a greater need for maternal treatment, were greater in this last period. Identifying the impact that changes in the profile as well as in the treatment have on maternal–perinatal morbidity and mortality will help improve the well-being of our patients and their newborns. [ABSTRACT FROM AUTHOR]

Published
2021
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6. Pelvic Floor Morbidity Following Vaginal Delivery versus Cesarean Delivery: Systematic Review and Meta-Analysis.

Author

Barca, Juan A., Bravo, Coral, Pintado-Recarte, Maria P., Asúnsolo, Ángel, Cueto-Hernández, Ignacio, Ruiz-Labarta, Javier, Buján, Julia, Ortega, Miguel A., and De León-Luis, Juan A.

Subjects
PELVIC floor, CESAREAN section, URINARY incontinence, MEDICAL subject headings, PELVIC organ prolapse
Abstract

Objective: To compare pelvic floor disorders between vaginal delivery (VD) and cesarean delivery (CD). Methods: For this study, a PUBMED database search was used, utilizing a combination of relevant medical subjects' headings (MeSH) terms, with the following keywords: "Pelvic floor disorders" or "Pelvic floor morbidity" and "Delivery". Search limits were articles in English or Spanish, about women, published from December 2009 to December 2019. The STATA 16 package was used for meta-analysis and data heterogeneity assessment. Results: Thirteen studies meeting eligibility criteria were identified comprising 1,597,303 participants. Abstract: Pelvic floor morbidity prevalence was Urinary Incontinence (UI) 27.9% (5411 patients in 7 studies with reported cases), Pelvic Organ Prolapse (POP) 14.2% (6019 patients in 8 studies with reported cases), and Anal Incontinence (AI) 0.4% (1,589,740 patients in 5 studies with reported cases). Our meta-analyses revealed significantly higher rates of all three morbidities and overall morbidity in the VD versus CD group: UI OR = 2.17, 95% CI 1.64–2.87, p for heterogeneity ≤ 0.0001, I2 = 84%; POP OR = 3.28, 95% CI 1.91–5.63, p for heterogenicity ≤ 0.043, I2 = 63%; AI OR = 1.53, 95% CI 1.32–1.77; p for heterogeneity ≤ 0.291, I2 = 20%; and overall morbidity (OR = 2.17, 95% CI 1.64–2.87; p for heterogeneity ≤ 0.0001, I2 = 84%). Conclusion: Vaginal delivery is directly related to the appearance of pelvic floor disorders, mainly UI, POP, and AI. The risk of POP should be taken into higher consideration after vaginal delivery and postpartum follow-up should be performed, to identify and/or treat it at the earliest stages. [ABSTRACT FROM AUTHOR]

Published
2021
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7. The Profile of the Obstetric Patients with SARS-CoV-2 Infection According to Country of Origin of the Publication: A Systematic Review of the Literature.

Author

Cuñarro-López, Yolanda, Pintado-Recarte, Pilar, Cueto-Hernández, Ignacio, Hernández-Martín, Concepción, Payá-Martínez, María Pilar, Muñóz-Chápuli, María del Mar, Cano-Valderrama, Óscar, Bravo, Coral, Bujan, Julia, Álvarez-Mon, Melchor, Ortega, Miguel A., and De León-Luis, Juan Antonio

Subjects
SARS-CoV-2, COUNTRY of origin (Immigrants), COVID-19, PROGNOSIS
Abstract

SARS-CoV-2 is the novel member of coronavirus responsible for the worldwide pandemic COVID-19, affecting all types of people. In this context, established research identified pregnant women as a susceptible group of SARS-CoV-2 infection, although there is still limited data regarding the real impact of COVID-19 in this group. With that purpose, we conducted a systematic review describing the maternal-fetal results of pregnant women infected by SARS-CoV-2, in aim to analyze the profile of the obstetric patients according to the country of origin of the publication. A total of 38 articles were included in this systematic review with 2670 patients from 7 countries, with 20 works published from China (52.6%). We reported significative differences according to the median maternal age, with Spain as the country with the highest age (34.6 years); The percentage of tabaquism; proportion of symptomatic patients in the triage; type of radiological exam (China and France conduct CT scans on all their patients in comparison to the use of chest X-Ray in the rest of the countries studied); percentages of C-sections (83.9% in China; 35.9% Spain, p < 0.001); maternal mortality rate, proportion of patients who need treatments, the use of antivirals, antibiotics, and anticoagulants as well as measurements of the newborns. Perinatal results are favorable in the majority of countries, with very low rates of vertical transmission in the majority of works. The studies collected in this review showed moderate to high index of quality. The different works describe the affectation during the first wave of the pandemic, where the pregnant woman with SARS-CoV-2 infection is generally symptomatic during the third trimester of gestation along with other factors associated with worse prognosis of the disease, such as higher age, body mass index, and further comorbidities developed during pregnancy. In the obstetric patient, proportion of C-sections are elevated together with prematurity, increasing maternal perinatal morbimortality. Differences found between countries could be based on the proper profile of the patient in each region, the period of the pandemic directly affecting how it was managed, and the variations regarding in situ medical attention. [ABSTRACT FROM AUTHOR]

Published
2021
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8. Maternal and Perinatal Outcomes in Patients with Suspected COVID-19 and Their Relationship with a Negative RT-PCR Result.

Author

Cuñarro-López, Yolanda, Cano-Valderrama, Óscar, Pintado-Recarte, Pilar, Cueto-Hernández, Ignacio, González-Garzón, Blanca, García-Tizón, Santiago, Bujan, Julia, Asúnsolo, Ángel, Ortega, Miguel A., and De León-Luis, Juan Antonio

Subjects
COVID-19, REVERSE transcriptase polymerase chain reaction
Abstract

This study was designed to examine maternal-perinatal outcomes in pregnant women with suspected coronavirus disease 2019 (COVID-19) according to the result of a real-time reverse transcription polymerase chain reaction (RT-PCR) test and to investigate possible variables that could be useful for predicting a negative RT-PCR result. Participants of this retrospective cohort study were obstetrics patients with suspected COVID-19 who underwent an RT-PCR test in a tertiary hospital in Madrid, Spain. Maternal-perinatal features were analysed according to the results of this test. Clinical, radiological and analytical characteristics that could be associated with a negative result were also explored. In a final subgroup analysis, patients were included if they had pneumonia and a negative test result for the virus. Out of the 111 obstetric patients with suspected COVID-19 that were enrolled, 38.7% returned a negative result. In this RT-PCR-negative group, we recorded lower rates of pneumonia (21.4% vs. 45.6%, p = 0.009), severe or critical clinical features (4.7% vs. 11.8% and 0.0% vs. 5.9%, p = 0.02, respectively), lower lactate dehydrogenase (LDH) levels (168 UI/L vs. 224.5 UI/L, p = 0.003), a greater need for maternal treatment (60.3% vs 24.4%, p < 0.001), a reduced need for oxygen therapy (2.4% vs 28.8%, p < 0.001) and a lower rate of intensive care unit admission (0.0% vs. 3.7%, p = 0.046) than the RT-PCR-positive group. While no differences were found in other variables, the monocyte count was higher (946.2/μL vs. 518.8/μL, p = 0.022) in this group. The predictive model for a negative test result included the monocyte count, LDH level and no need for oxygen therapy. This model was able to identify 73.5% of patients with a negative RT-PCR result. Only 11% of the patients with pneumonia testing negative for the virus had IgG antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The proportion of pregnant women with suspected COVID-19 and a negative RT-PCR result was nearly 39%. In these patients, the symptoms were mild and the systemic severity of the disease was lower. The monocyte count, LDH level and no need for oxygen therapy were the factors that were more related to a negative test result in this group. These variables could be used to guide the management of patients with suspected COVID-19, mainly while waiting for RT-PCR results or in settings where this test is not available. [ABSTRACT FROM AUTHOR]

Published
2020
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9. Maternal and perinatal outcomes of pregnant women with SARS-CoV-2 infection

Author

Di Mascio Daniele, Gabriele, Saccone, Cihat, Sen, Daniele Di Mascio, Alberto, Galindo, Amos, Grünebaum, Jun, Yoshimatsu, Milan, Stanojevic, Asım, Kurjak, Frank, Chervenak, María José Rodríguez Suárez, Zita Maria Gambacorti-Passerini, María de Los Angeles Anaya Baz, Esther Vanessa Aguilar Galán, Yolanda Cuñarro López, Juan Antonio De León Luis, Ignacio Cueto Hernández, Ignacio, Herraiz, Cecilia, Villalain, Roberta, Venturella, Rizzo, GIUSEPPE DAVIDE, Ilenia, Mappa, Giovanni, Gerosolima, Lars, Hellmeyer, Josefine, Königbauer, Giada, Ameli, Tiziana, Frusca, Nicola, Volpe, Giovanni Battista Luca Schera, Stefania, Fieni, Eutalia, Esposito, Giuliana, Simonazzi, Gaetana Di Donna, Aly, Youssef, Anna Nunzia Della Gatta, Mariano Catello Di Donna, Vito, Chiantera, Natalina, Buono, Giulio, Sozzi, Pantaleo, Greco, Danila, Morano, Beatrice, Bianchi, Maria Giulia Lombana Marino, Federica, Laraud, Arianna, Ramone, Angelo, Cagnacci, Fabio, Barra, Claudio, Gustavino, Ferrero, Simone, Fabio, Ghezzi, Antonella, Cromi, Antonio Simone Laganà, Valentina Laurita Longo, Francesca, Stollagli, Angelo, Sirico, Antonio, Lanzone, Lorenza, Driul, Fabiana, Cecchini, Serena, Xodo, Brian, Rodriguez, Felipe, Mercado-Olivares, Deena, Elkafrawi, Giovanni, Sisti, Rosanna, Esposito, Antonio, Coviello, Marco, Cerbone, Maddalena, Morlando, Antonio, Schiattarella, Nicola, Colacurci, Pasquale De Franciscis, Ilaria, Cataneo, Marinella, Lenzi, Fabrizio, Sandri, Riccardo, Buscemi, Giorgia, Gattei, Francesca Della Sala, Eleonora, Valori, Maria Cristina Rovellotti, Elisa, Done, Gilles, Faron, Leonardo, Gucciardo, Esposito, Valentina, Flaminia, Vena, Antonella, Giancotti, Roberto, Brunelli, Ludovico, Muzii, Luigi, Nappi, Felice, Sorrentino, Marco, Liberati, Danilo, Buca, Martina, Leombroni, Francesca Di Sebastiano, Massimo, Franchi, Quintino Cesare Ianniciello, Simone, Garzon, Giuliano, Petriglia, Leonardo, Borrello, Albaro Josè Nieto-Calvache, Juan Manuel Burgos-Luna, Caroline, Kadji, Andrew, Carlin, Elisa, Bevilacqua, Marina, Moucho, Pedro, Viana, Rita, Figueiredo, José Morales Roselló, Gabriela, Loscalzo, Alicia, Martinez-Varea, Vincente, Diago, Jesús, S Jimenez Lopez, Alicia Yeliz Aykanat, Cosma, Stefano Domenico, Carosso, ANDREA ROBERTO, Benedetto, Chiara, Amanda, Bermejo, Otto Henrique May Feuerschuette, Ozlem, Uyaniklar, Sakine Rahimli Ocakouglu, Zeliha, Atak, Reyhan, Gündüz, Esra Tustas Haberal, Bernd, Froessler, Anupam, Parange, Peter, Palm, Igor, Samardjiski, Chiara, Taccaliti, Erhan, Okuyan, George, Daskalakis, Renato Augusto Moreira de Sa, Alejandro, Pittaro, Maria Luisa Gonzalez-Duran, Ana Concheiro Guisan, Şerife Özlem Genç, Blanka, Zlatohlávková, Anna Luengo Piqueras, Dolores Esteban Oliva, Aylin Pelin Cil, Olus, Api, Panos, Antsaklis, Liana, Ples, Ioannis, Kyvernitakis, Holger, Maul, Marcel, Malan, Albert, Lila, Roberta, Granese, Alfredo, Ercoli, Giuseppe, Zoccali, Villasco, Andrea, Biglia, Nicoletta, Ciuhodaru, Madalina, Costa, Elena, Caroline, Daelemans, Axelle, Pintiaux, Elif Gül Yapar Eyi, Elisa, Cueto, Eran, Hadar, Sarah, Dollinger, Noa, A Brzezinski-Sinai, Erasmo, Huertas, Pedro, Arango, Amadeo, Sanchez, Javier Alfonso Schvartzman, Liviu, Cojocaru, Sifa, Turan, Ozhan, Turan, Maria Carmela Di Dedda, Rebeca Garrote Molpeceres, Snezana, Zdjelar, Tanja, Premru-Srsen, Lilijana, Kornhauser-Cerar, Mirjam, Druškovič, Valentina De Robertis, Vedran, Stefanovic, Irmeli, Nupponen, Kaisa, Nelskylä, Zulfiya, Khodjaeva, Ksenia, A Gorina, Gennady, T Sukhikh, Giuseppe Maria Maruotti, Silvia, Visentin, Erich, Cosmi, Jacopo, Ferrari, Alessandra, Gatti, Daniela, Luvero, Roberto, Angioli, Ludovica, Puri, Marco, Palumbo, Giusella, D'Urso, Francesco, Colaleo, Agnese Maria Chiara Rapisarda, Ilma Floriana Carbone, Manzoli, Lamberto, Maria Elena Flacco, Giovanni, Nazzaro, Mariavittoria, Locci, Maurizio, Guida, Attilio Di Spiezio Sardo, Pierluigi Benedetti Panici, Asma, Khalil, Vincenzo, Berghella, Giuseppe, Bifulco, Giovanni, Scambia, Fulvio, Zullo, Francesco, D'Antonio, Saccone, Gabriele, Sen, Cihat, Di Mascio, Daniele, Galindo, Alberto, Grünebaum, Amo, Yoshimatsu, Jun, Stanojevic, Milan, Kurjak, Asım, Chervenak, Frank, Suárez, María José Rodríguez, Gambacorti‐Passerini, Zita Maria, de los Angeles Anaya Baz, María, Galán, Esther Vanessa Aguilar, López, Yolanda Cuñarro, Luis, Juan Antonio De León, Hernández, Ignacio Cueto, Herraiz, Ignacio, Villalain, Cecilia, Venturella, Roberta, Rizzo, Giuseppe, Mappa, Ilenia, Gerosolima, Giovanni, Hellmeyer, Lar, Königbauer, Josefine, Ameli, Giada, Frusca, Tiziana, Volpe, Nicola, Schera, Giovanni Battista Luca, Fieni, Stefania, Esposito, Eutalia, Simonazzi, Giuliana, Di Donna, Gaetana, Youssef, Aly, Gatta, Anna Nunzia Della, Di Donna, Mariano Catello, Chiantera, Vito, Buono, Natalina, Sozzi, Giulio, Greco, Pantaleo, Morano, Danila, Bianchi, Beatrice, Marino, Maria Giulia Lombana, Laraud, Federica, Ramone, Arianna, Cagnacci, Angelo, Barra, Fabio, Gustavino, Claudio, Ferrero, Simone, Ghezzi, Fabio, Cromi, Antonella, Laganà, Antonio Simone, Longo, Valentina Laurita, Stollagli, Francesca, Sirico, Angelo, Lanzone, Antonio, Driul, Lorenza, Cecchini, Fabiana, Xodo, Serena, Rodriguez, Brian, Mercado‐Olivares, Felipe, Elkafrawi, Deena, Sisti, Giovanni, Esposito, Rosanna, Coviello, Antonio, Cerbone, Marco, Morlando, Maddalena, Schiattarella, Antonio, Colacurci, Nicola, De Franciscis, Pasquale, Cataneo, Ilaria, Lenzi, Marinella, Sandri, Fabrizio, Buscemi, Riccardo, Gattei, Giorgia, Sala, Francesca Della, Valori, Eleonora, Rovellotti, Maria Cristina, Done, Elisa, Faron, Gille, Gucciardo, Leonardo, Esposito, Valentina, Vena, Flaminia, Giancotti, Antonella, Brunelli, Roberto, Muzii, Ludovico, Nappi, Luigi, Sorrentino, Felice, Liberati, Marco, Buca, Danilo, Leombroni, Martina, Di Sebastiano, Francesca, Franchi, Massimo, Ianniciello, Quintino Cesare, Garzon, Simone, Petriglia, Giuliano, Borrello, Leonardo, Nieto‐Calvache, Albaro Josè, Burgos‐Luna, Juan Manuel, Kadji, Caroline, Carlin, Andrew, Bevilacqua, Elisa, Moucho, Marina, Viana Pinto, Pedro, Figueiredo, Rita, Morales Roselló, José, Loscalzo, Gabriela, Martinez‐Varea, Alicia, Diago, Vincente, Jimenez Lopez, Jesús S, Aykanat, Alicia Yeliz, Cosma, Stefano, Carosso, Andrea, Benedetto, Chiara, Bermejo, Amanda, Feuerschuette, Otto Henrique May, Uyaniklar, Ozlem, Ocakouglu, Sakine Rahimli, Atak, Zeliha, Gündüz, Reyhan, Haberal, Esra Tusta, Froessler, Bernd, Parange, Anupam, Palm, Peter, Samardjiski, Igor, Taccaliti, Chiara, Okuyan, Erhan, Daskalakis, George, de Sa, Renato Augusto Moreira, Pittaro, Alejandro, Gonzalez‐Duran, Maria Luisa, Guisan, Ana Concheiro, Genç, Şerife Özlem, Zlatohlávková, Blanka, Piqueras, Anna Luengo, Oliva, Dolores Esteban, Cil, Aylin Pelin, Api, Olu, Antsaklis, Pano, Ples, Liana, Kyvernitakis, Ioanni, Maul, Holger, Malan, Marcel, Lila, Albert, Granese, Roberta, Ercoli, Alfredo, Zoccali, Giuseppe, Villasco, Andrea, Biglia, Nicoletta, Madalina, Ciuhodaru, Costa, Elena, Daelemans, Caroline, Pintiaux, Axelle, Eyi, Elif Gül Yapar, Cueto, Elisa, Hadar, Eran, Dollinger, Sarah, Brzezinski‐Sinai, Noa A., Huertas, Erasmo, Arango, Pedro, Sanchez, Amadeo, Schvartzman, Javier Alfonso, Cojocaru, Liviu, Turan, Sifa, Turan, Ozhan, Di Dedda, Maria Carmela, Molpeceres, Rebeca Garrote, Zdjelar, Snezana, Premru‐Srsen, Tanja, Kornhauser‐Cerar, Lilijana, Druškovič, Mirjam, De Robertis, Valentina, Stefanovic, Vedran, Nupponen, Irmeli, Nelskylä, Kaisa, Khodjaeva, Zulfiya, Gorina, Ksenia A., Sukhikh, Gennady T., Maruotti, Giuseppe Maria, Visentin, Silvia, Cosmi, Erich, Ferrari, Jacopo, Gatti, Alessandra, Luvero, Daniela, Angioli, Roberto, Puri, Ludovica, Palumbo, Marco, D'Urso, Giusella, Colaleo, Francesco, Rapisarda, Agnese Maria Chiara, Carbone, Ilma Floriana, Manzoli, Lamberto, Flacco, Maria Elena, Nazzaro, Giovanni, Locci, Mariavittoria, Guida, Maurizio, Sardo, Attilio Di Spiezio, Panici, Pierluigi Benedetti, Khalil, Asma, Berghella, Vincenzo, Bifulco, Giuseppe, Scambia, Giovanni, Zullo, Fulvio, D'Antonio, Francesco, Dicle Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Kadın Hastalıkları ve DoğumAna Bilim Dalı, University of Helsinki, Department of Obstetrics and Gynecology, HUS Gynecology and Obstetrics, HUS Children and Adolescents, Children's Hospital, HUS Perioperative, Intensive Care and Pain Medicine, Anestesiologian yksikkö, Department of Diagnostics and Therapeutics, Saccone, G., Sen, C., Di Mascio, D., Galindo, A., Grunebaum, A., Yoshimatsu, J., Stanojevic, M., Kurjak, A., Chervenak, F., Suarez, M. J. R., Gambacorti-Passerini, Z. M., de los Angeles Anaya Baz, M., Galan, E. V. A., Lopez, Y. C., Luis, J. A. D. L., Hernandez, I. C., Herraiz, I., Villalain, C., Venturella, R., Rizzo, G., Mappa, I., Gerosolima, G., Hellmeyer, L., Konigbauer, J., Ameli, G., Frusca, T., Volpe, N., Schera, G. B. L., Fieni, S., Esposito, E., Simonazzi, G., Di Donna, G., Youssef, A., Gatta, A. N. D., Di Donna, M. C., Chiantera, V., Buono, N., Sozzi, G., Greco, P., Morano, D., Bianchi, B., Marino, M. G. L., Laraud, F., Ramone, A., Cagnacci, A., Barra, F., Gustavino, C., Ferrero, S., Ghezzi, F., Cromi, A., Lagana, A. S., Longo, V. L., Stollagli, F., Sirico, A., Lanzone, A., Driul, L., Cecchini, F., Xodo, S., Rodriguez, B., Mercado-Olivares, F., Elkafrawi, D., Sisti, G., Esposito, R., Coviello, A., Cerbone, M., Morlando, M., Schiattarella, A., Colacurci, N., De Franciscis, P., Cataneo, I., Lenzi, M., Sandri, F., Buscemi, R., Gattei, G., Sala, F. D., Valori, E., Rovellotti, M. C., Done, E., Faron, G., Gucciardo, L., Esposito, V., Vena, F., Giancotti, A., Brunelli, R., Muzii, L., Nappi, L., Sorrentino, F., Liberati, M., Buca, D., Leombroni, M., Di Sebastiano, F., Franchi, M., Ianniciello, Q. C., Garzon, S., Petriglia, G., Borrello, L., Nieto-Calvache, A. J., Burgos-Luna, J. M., Kadji, C., Carlin, A., Bevilacqua, E., Moucho, M., Viana Pinto, P., Figueiredo, R., Morales Rosello, J., Loscalzo, G., Martinez-Varea, A., Diago, V., Jimenez Lopez, J. S., Aykanat, A. Y., Cosma, S., Carosso, A., Benedetto, C., Bermejo, A., Feuerschuette, O. H. M., Uyaniklar, O., Ocakouglu, S. R., Atak, Z., Gunduz, R., Haberal, E. T., Froessler, B., Parange, A., Palm, P., Samardjiski, I., Taccaliti, C., Okuyan, E., Daskalakis, G., de Sa, R. A. M., Pittaro, A., Gonzalez-Duran, M. L., Guisan, A. C., Genc, S. O., Zlatohlavkova, B., Piqueras, A. L., Oliva, D. E., Cil, A. P., Api, O., Antsaklis, P., Ples, L., Kyvernitakis, I., Maul, H., Malan, M., Lila, A., Granese, R., Ercoli, A., Zoccali, G., Villasco, A., Biglia, N., Madalina, C., Costa, E., Daelemans, C., Pintiaux, A., Cueto, E., Hadar, E., Dollinger, S., Brzezinski-Sinai, N. A., Huertas, E., Arango, P., Sanchez, A., Schvartzman, J. A., Cojocaru, L., Turan, S., Turan, O., Di Dedda, M. C., Molpeceres, R. G., Zdjelar, S., Premru-Srsen, T., Kornhauser-Cerar, L., Druskovic, M., De Robertis, V., Stefanovic, V., Nupponen, I., Nelskyla, K., Khodjaeva, Z., Gorina, K. A., Sukhikh, G. T., Maruotti, G. M., Visentin, S., Cosmi, E., Ferrari, J., Gatti, A., Luvero, D., Angioli, R., Puri, L., Palumbo, M., D'Urso, G., Colaleo, F., Rapisarda, A. M. C., Carbone, I. F., Manzoli, L., Flacco, M. E., Nazzaro, G., Locci, M., Guida, M., Sardo, A. D. S., Panici, P. B., Khalil, A., Berghella, V., Bifulco, G., Scambia, G., Zullo, F., D'Antonio, F., José Rodríguez Suárez, María, Maria Gambacorti-Passerini, Zita, de Los Angeles Anaya Baz, María, Vanessa Aguilar Galán, Esther, Cuñarro López, Yolanda, Antonio De León Luis, Juan, Cueto Hernández, Ignacio, Battista Luca Schera, Giovanni, Nunzia Della Gatta, Anna, Catello Di Donna, Mariano, Giulia Lombana Marino, Maria, Simone Laganà, Antonio, Laurita Longo, Valentina, Mercado-Olivares, Felipe, Della Sala, Francesca, Cristina Rovellotti, Maria, Cesare Ianniciello, Quintino, Josè Nieto-Calvache, Albaro, Manuel Burgos-Luna, Juan, Viana, Pedro, Martinez-Varea, Alicia, S Jimenez Lopez, Jesú, Yeliz Aykanat, Alicia, DI BENEDETTO, Chiara, Henrique May Feuerschuette, Otto, Rahimli Ocakouglu, Sakine, Tustas Haberal, Esra, Augusto Moreira de Sa, Renato, Luisa Gonzalez-Duran, Maria, Concheiro Guisan, Ana, Özlem Genç, Şerife, Luengo Piqueras, Anna, Esteban Oliva, Dolore, Pelin Cil, Aylin, Gül Yapar Eyi, Elif, A Brzezinski-Sinai, Noa, Alfonso Schvartzman, Javier, Carmela Di Dedda, Maria, Garrote Molpeceres, Rebeca, Premru-Srsen, Tanja, Kornhauser-Cerar, Lilijana, A Gorina, Ksenia, T Sukhikh, Gennady, Maruotti, GIUSEPPE MARIA, Maria Chiara Rapisarda, Agnese, Floriana Carbone, Ilma, Elena Flacco, Maria, DI SPIEZIO SARDO, Attilio, Benedetti Panici, Pierluigi, Saccone G., Sen C., Di Mascio D., Galindo A., Grunebaum A., Yoshimatsu J., Stanojevic M., Kurjak A., Chervenak F., Suarez M.J.R., Gambacorti-Passerini Z.M., de los Angeles Anaya Baz M., Galan E.V.A., Lopez Y.C., Luis J.A.D.L., Hernandez I.C., Herraiz I., Villalain C., Venturella R., Rizzo G., Mappa I., Gerosolima G., Hellmeyer L., Konigbauer J., Ameli G., Frusca T., Volpe N., Schera G.B.L., Fieni S., Esposito E., Simonazzi G., Di Donna G., Youssef A., Gatta A.N.D., Di Donna M.C., Chiantera V., Buono N., Sozzi G., Greco P., Morano D., Bianchi B., Marino M.G.L., Laraud F., Ramone A., Cagnacci A., Barra F., Gustavino C., Ferrero S., Ghezzi F., Cromi A., Lagana A.S., Longo V.L., Stollagli F., Sirico A., Lanzone A., Driul L., Cecchini F., Xodo S., Rodriguez B., Mercado-Olivares F., Elkafrawi D., Sisti G., Esposito R., Coviello A., Cerbone M., Morlando M., Schiattarella A., Colacurci N., De Franciscis P., Cataneo I., Lenzi M., Sandri F., Buscemi R., Gattei G., Sala F.D., Valori E., Rovellotti M.C., Done E., Faron G., Gucciardo L., Esposito V., Vena F., Giancotti A., Brunelli R., Muzii L., Nappi L., Sorrentino F., Liberati M., Buca D., Leombroni M., Di Sebastiano F., Franchi M., Ianniciello Q.C., Garzon S., Petriglia G., Borrello L., Nieto-Calvache A.J., Burgos-Luna J.M., Kadji C., Carlin A., Bevilacqua E., Moucho M., Viana Pinto P., Figueiredo R., Morales Rosello J., Loscalzo G., Martinez-Varea A., Diago V., Jimenez Lopez J.S., Aykanat A.Y., Cosma S., Carosso A., Benedetto C., Bermejo A., Feuerschuette O.H.M., Uyaniklar O., Ocakouglu S.R., Atak Z., Gunduz R., Haberal E.T., Froessler B., Parange A., Palm P., Samardjiski I., Taccaliti C., Okuyan E., Daskalakis G., de Sa R.A.M., Pittaro A., Gonzalez-Duran M.L., Guisan A.C., Genc S.O., Zlatohlavkova B., Piqueras A.L., Oliva D.E., Cil A.P., Api O., Antsaklis P., Ples L., Kyvernitakis I., Maul H., Malan M., Lila A., Granese R., Ercoli A., Zoccali G., Villasco A., Biglia N., Madalina C., Costa E., Daelemans C., Pintiaux A., Cueto E., Hadar E., Dollinger S., Brzezinski-Sinai N.A., Huertas E., Arango P., Sanchez A., Schvartzman J.A., Cojocaru L., Turan S., Turan O., Di Dedda M.C., Molpeceres R.G., Zdjelar S., Premru-Srsen T., Kornhauser-Cerar L., Druskovic M., De Robertis V., Stefanovic V., Nupponen I., Nelskyla K., Khodjaeva Z., Gorina K.A., Sukhikh G.T., Maruotti G.M., Visentin S., Cosmi E., Ferrari J., Gatti A., Luvero D., Angioli R., Puri L., Palumbo M., D'Urso G., Colaleo F., Rapisarda A.M.C., Carbone I.F., Manzoli L., Flacco M.E., Nazzaro G., Locci M., Guida M., Sardo A.D.S., Panici P.B., Khalil A., Berghella V., Bifulco G., Scambia G., Zullo F., D'Antonio F., Mother and Child, Surgical clinical sciences, Obstetrics, and Clinical sciences

Subjects
COVID19, medicine.medical_treatment, coronavirus, COVID-19, infection, pregnancy, SARS-CoV-2, Abortion, infectious diseases, law.invention, Cohort Studies, 0302 clinical medicine, law, 3123 Gynaecology and paediatrics, Pregnancy, Obstetrics and Gynaecology, 030212 general & internal medicine, Pregnancy Complications, Infectious, 030219 obstetrics & reproductive medicine, Radiological and Ultrasound Technology, Transmission (medicine), Obstetrics, Pregnancy Outcome, Obstetrics and Gynecology, Coronavirus, SARS-COV-2, General Medicine, Disease 2019 Covid-19, Intensive care unit, 3. Good health, Hospitalization, Intensive Care Units, Maternal Mortality, Settore MED/40, Radiology Nuclear Medicine and imaging, Gestation, Female, coronavirus, Pandemics, Pregnancy, Pregnancy Complications, Infectious, Pregnancy Outcome, Respiration, Artificial, Retrospective Studies, SARS-CoV-2, COVID-19, Infant, Newborn, Intensive Care Units,Maternal Mortality, Infection, Cohort study, Adult, medicine.medical_specialty, NO, 03 medical and health sciences, medicine, Humans, Radiology, Nuclear Medicine and imaging, Pandemics, Retrospective Studies, Mechanical ventilation, business.industry, Infant, Newborn, Infant, Retrospective cohort study, medicine.disease, Respiration, Artificial, coronaviru, Reproductive Medicine, business
Abstract

WOS:000613461600006 PubMed ID: 32926494 Objectives To evaluate the maternal and perinatal outcomes of pregnancies affected by SARS-CoV-2 infection. Methods This was a multinational retrospective cohort study including women with a singleton pregnancy and laboratory-confirmed SARS-CoV-2 infection, conducted in 72 centers in 22 different countries in Europe, the USA, South America, Asia and Australia, between 1 February 2020 and 30 April 2020. Confirmed SARS-CoV-2 infection was defined as a positive result on real-time reverse-transcription polymerase chain reaction (RT-PCR) assay of nasopharyngeal swab specimens. The primary outcome was a composite measure of maternal mortality and morbidity, including admission to the intensive care unit (ICU), use of mechanical ventilation and death. Results In total, 388 women with a singleton pregnancy tested positive for SARS-CoV-2 on RT-PCR of a nasopharyngeal swab and were included in the study. Composite adverse maternal outcome was observed in 47/388 (12.1%) women; 43 (11.1%) women were admitted to the ICU, 36 (9.3%) required mechanical ventilation and three (0.8%) died. Of the 388 women included in the study, 122 (31.4%) were still pregnant at the time of data analysis. Among the other 266 women, six (19.4% of the 31 women with first-trimester infection) had miscarriage, three (1.1%) had termination of pregnancy, six (2.3%) had stillbirth and 251 (94.4%) delivered a liveborn infant. The rate of preterm birth before 37 weeks' gestation was 26.3% (70/266). Of the 251 liveborn infants, 69/251(27.5%) were admitted to the neonatal ICU, and there were five (2.0%) neonatal deaths. The overall rate of perinatal death was 4.1% (11/266). Only one (1/251, 0.4%) infant, born to a mother who tested positive during the third trimester, was found to be positive for SARS-CoV-2 on RT-PCR. Conclusions SARS-CoV-2 infection in pregnant women is associated with a 0.8% rate of maternal mortality, but an 11.1% rate of admission to the ICU. The risk of vertical transmission seems to be negligible. (C) 2020 International Society of Ultrasound in Obstetrics and Gynecology.

Published
2021

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