Radiologic imaging in the evaluation of pregnant patients has significantly grown with the outbreak of the severe acute respiratory syndrome related to SARS-CoV-2 pandemic. Lung ultrasound is an emerging non-invasive bedside technique used to diagnose interstitial lung syndrome through evaluation and quantitation of the number of B-lines, pleural irregularities and nodules or consolidations. In pregnant COVID-19 patients, lung ultrasound should be considered on account of its various strengths, such as its being easily carried out bedside by trained sonographers for the monitoring of lung involvement in follow-ups, and its repeatability and affordability. However, pregnant patients could need chest radiography or computed tomographic (CT) examinations for the diagnosis of pneumonia. Concerns and misconceptions about potential radiation-related risks for the embryo or fetus are still widespread among clinicians and can lead to excessive anxiety among patients. Several well-recognized guidance documents were published in the last years as to the safety of a single-phase CT or an X-ray chest and related carcinogenic and teratogenic risk. This paper summarizes the safety of radiological examination for pneumonia in pregnant women affected by COVID 19, based on the estimated embryo-fetal radiation absorption per procedure (mGy).
Objective. Some intrapartum obstetrical practices, such as episiotomy or Kristeller Maneuver, are highly controversial within the scientific community, from the ethical, political and social perspectives. Guidelines or recommendations for the management of intrapartum care, revolving around a thorough informed consent process, can be decisive to avoiding deeply conflicting situations, where the phrase "obstetric violence" has unfortunately become relatively widespread. In this paper, the authors aimed to highlight how the use of intrapartum obstetric practices is, at times, necessary and instrumental in ensuring the well-being of the mother as well as the foetus. Materials and Methods. A broad-ranging search has been conducted, using the scientific search engines PubMed, Google Scholar, Medscape, Medline Plus and Scopus, via the following search string: "obstetric violence", "gender violence", "intrapartum care", "episiotomy", "caesarean section", "Kristeller", "childbirth", "informed consent", taking into consideration the articles from 2015 to February 2021. Results. Results of our research point to the fact that the woman's need for information on obstetric procedures is often not adequately met by health professionals, and the informed consent process is therefore not thoroughly implemented. Conclusions. The authors argue in favour of adopting an informed consent model to be submitted to the pregnant women regarding any intrapartum obstetrical procedure that may become necessary before and during labour, in order to make professional conduct more transparent and protect health care personnel from claims and lawsuits arising from unwarranted practices.
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