The novel coronavirus disease 2019 (COVID-19) has been declared as a "pandemic outbreak" and public health emergency of utmost international concern. 1 With over 37 million confirmed cases and 1 million deaths (as of 12/10/2020), the pandemic continues to harm significant number of people worldwide. Approximately, 5% of the infected cases are

Background: Over 4.2 million confirmed cases and more than 285,000 deaths, COVID-19 pandemic continues to harm significant number of people worldwide. Several studies have reported the impact of COVID-19 in general population; however, there is scarcity of information related to pharmacological management and maternal and perinatal outcomes during the pandemic. Altered physiological, anatomical, and immunological response during pregnancy makes it more susceptible to infections. Furthermore, during pregnancy, a woman undergoes multiple interactions with the health care system that increases her chance of getting infected; therefore, managing pregnant population presents a unique challenge. Research questions: This systematic review seeks to answer the following questions in relation to COVID-19: What are the different clinical characteristics presented in maternal and perinatal population? What are the different maternal and perinatal outcome measures reported? What are the distinct therapeutic interventions reported to treat COVID-19? Is it safe to use "medications" used in the treatment of COVID-19 during antenatal, perinatal, postnatal, and breastfeeding?

BackgroundOver 4.2 million confirmed cases and more than 285,000 deaths, COVID-19 pandemic continues to harm significant number of people worldwide. Several studies have reported the impact of COVID-19 in general population, however, there is scarcity of information related to pharmacological management, maternal and perinatal outcomes during the pandemic. Altered physiological, anatomical and immunological response during pregnancy makes it more susceptible to infections. Furthermore, during pregnancy, a woman undergoes multiple interactions with the health care system that increases her chance of getting infected, therefore managing pregnant population presents a unique challenge. Research Question(s)This systematic review seeks to answer the following questions in relation to COVID-19,What are the different clinical characteristics presented in maternal and perinatal population?What are the different maternal and perinatal outcome measures reported?What are the distinct therapeutic interventions reported to treat Covid-19?Is it safe to use ‘medications’ used in the treatment of COVID-19 during antenatal, perinatal, postnatal and breastfeeding?Method The search will follow a comprehensive, sequential three step search strategy. Several databases relevant to COVID-19 and its impact on pregnancy including Medline, CINAHL, LitCovid etc. will be searched from the inception of the disease until the completion of data collection. The quality of this search strategy will be assessed using Peer Review of Electronic Search Strategies Evidence-Based Checklist (PRESS EBC). An eligibility form will be developed for a transparent screening and inclusion/exclusion of studies. All studies will be sent to Refworks and abstraction will be independently performed by two researchers. Risk of bias will be assessed using Cochrane Risk of Bias tool for randomized controlled trials, Newcastle–Ottawa Quality Assessment Scale for non-randomized studies and for case reports Murad et al tool will be used. Decision to conduct metanalysis will be based on several factors including homogeneity and outcome measures reported, otherwise a narrative synthesis will be deemed appropriate. Discussion This systematic review will summarise the existing data on effect of COVID-19 on maternal and perinatal population. Furthermore, to the best of our knowledge, this is the first systematic review addressing therapeutic management and safety of medicines to treat COVID-19 during pregnancy and breastfeeding.Systematic review registrationProspero (CRD42020181163)

AbstractObjectivesTo explore the influence of ambient temperature and humidity on significant bacteriuria (SB) and urinary bacterial isolates in pregnant women.MethodsA retrospective observational study was conducted in the sole tertiary-care hospital in Doha, Qatar. A sample of 1588 pregnant women delivering between June 2012 and March 2013 was randomly selected. Meteorological variables including ambient average daily temperature and humidity were sourced from online meteorological data, and patient information such as demographic data, urine culture results and bacterial isolates were collected from patient files. The receptor operative curve (ROC) analysis was used to determine the cutoff for temperature and humidity. Statistical analyses of associations between SB and bacterial isolates with respect to the ambient temperature and humidity were performed using Pearson’s correlation, the chi-square (χ2) test and the Kruskal-Wallis test.ResultsOf the 21.24% positive cultures, 11.25% had SB. SB showed a significant strong positive (r = +0.677, n = 17, P = 0.003) and moderate negative (r = −0.587, n = 17, P = 0.013) correlation with average monthly temperature and humidity, respectively, with doubling of rates noted with temperatures ≥35°C (11.3% vs. 3.6%; P < 0.0001) and humidity ≤50% (10.6% vs. 3.2%; P < 0.0001). Escherichia coli and Group B Streptococcus (GBS) were the most common isolates.ConclusionThis is the first study in this region that demonstrates maternal risk with SB, with ambient temperatures of ≥35°C and humidity ≤50%. The effect of these variables on the growth of various urinary bacteria has also been shown.

BackgroundAs COVID-19 continues to infect women of all gestational ages; gravida in labor and the acutely ill parturient are particularly at higher risk of infection. No therapeutic agent or vaccine is approved to treat COVID-19 till date. Thus, managing COVID-19 and associated complications during pregnancy is often challenging and requires a multidisciplinary approach to treatment. Case PresentationWe narrate our perspectives on managing a 32-year-old, critically ill obstetric patient at 32-week gestation, diagnosed with acute respiratory distress syndrome (ARDS) secondary to COVID-19 pneumonia. Upon confirmation of COVID-19, as per the local protocol antivirals, antimalarial, and antibiotics were commenced. Due to rapidly exacerbating maternal respiratory functions, and potential chances of fetal hypoxemia emergency caesarian was performed. Following delivery, the maternal respiratory functions further deteriorated as she required prolonged mechanical ventilation and initiation of extracorporeal membrane oxygenation until she was clinically stable on day 23. The patient also received convalescent plasma and tocilizumab as a part of the treatment protocol. The newborn was shifted to neonatal intensive care for intubation for respiratory distress and was found negative for SARS-CoV-2 and COVID-19 immunoglobulin (Ig). At day 25, the patient was clinically stable and was transferred to step down unit and discharged thereafter. Conclusion Through this case, we present the thought process, multidisciplinary team-based strategy and sequel of managing a complex, critically ill obstetric patient with ARDS and COVID-19 pneumonia. We anticipate that this case report will assist other healthcare institutions to manage critically ill patients with COVID-19 pneumonia.Key words: COVID-19, maternal, pandemic, perinatal, ECMO, convalescent plasma, pharmacological interventions.