Aim To evaluate the clinical factors associated with false‐negative RT‐PCR results and to report the outcome of a cohort of pregnant women with COVID‐19. Methods This cohort study was conducted in a tertiary referral pandemic hospital and included 56 pregnant women. A study including pregnant women with either a laboratory or clinical diagnosis for COVID‐19 were included in the study. The primary outcome was clinical factors associated with false‐negative RT‐PCR results defined as a positive immunoglobulin M assessed by rapid testing in clinically diagnosed patients. Clinical outcomes of laboratory diagnosed patients were also reported. Results In total, 56 women with either RT‐PCR or clinical COVID‐19 diagnosis were included in the study. Forty‐three women either had RT‐PCR positivity or IgM positivity. The clinical outcome of these pregnancies was as follows: mean maternal age 27.7, immunoglobulin M positive patients 76.7%, RT‐PCR positive patients 55.8%, maternal comorbidities 11.5%, complications in patients below 20 weeks 34.8%, complications in patients above 20 weeks 65.1%, elevated CRP 83.7%, lymphopenia 30.2%, time from hospital admission to final follow‐up days 37 and stillbirth 8.3%. The proportion of women who tested positive for SARS‐CoV‐2 immunoglobulin M was 100% in the RT‐PCR positive group and 56.5% in the clinical diagnosis group ( P = .002). The symptom onset to RT‐PCR testing interval longer than a week (risk ratio: 2.72, 95% CI: 1.14‐5.40, P = .003) and presence of dyspnoea (risk ratio: 0.38, 95% CI: 0.14‐0.89, P = .035) were associated with false‐negative RT‐PCR tests. The area under the curve of these parameters predicting false‐negative RT‐PCR was 0.73 (95% CI: 0.57‐0.89). Conclusions Symptomatic women with a negative RT‐PCR should not be dismissed as potential COVID‐19 patients, especially in the presence of prolonged symptom onset‐test interval and in women without dyspnoea.

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Background: Skin necrosis, following subcutaneously administered low-molecular-weight heparin (LMWH) is a rare but serious complication and has not been documented during pregnancy in the literature to the best of our knowledge. Therefore, we are of the opinion that reporting this case may guide clinicians when presented with such patients. Main observations: A 36-year-old woman with painful skin lesions was admitted to our clinic at 36 gestational weeks’ of her first pregnancy. There was nothing remarkable in her medical history other than using prophylactic regimen of “low-molecular-weight heparin” (enoxaparine) 4000 units anti-Xa subcutaneously because of heterozygous factor V Leiden mutation. Potential reasons of the lesions were considered to be immunological reaction between heparin and dermal cells and management considered with these findings. Conclusions: Heparin-induced skin necrosis (HISN) is a condition that should always be borne in mind when there are nonspecific results. Enoxaparine treatment during pregnancy has a rare potential risk of causing necrosis at the injection site and it is reversible with careful intervention.

Cervical fibroids are rare neoplasms of uterine origin whose management has not been standardized. Cervical fibroids, which can be challenging in surgical management, can become a difficult problem for the surgeon when neglected or asymptomatic and reach gigantic dimensions. Suspending the aorta abdominalis or arteria illiaca communis with vascular tapes and balloting the uterus with the help of vaginal taping while searching for the correct cleavage may reduce the risk of intraoperative hemorrhage and adjacent organ injury, as well as may be guide for the steps of the operation. Management of neglected giant cervical fibroids may not be suitable for testing alternative treatment methods to surgery used in the treatment of uterine neoplasms. However, surgical management will also be challenging. For this reason, the technique we describe can help the surgeon with clues that should be considered in the surgical management of these patients.

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