Pregnancy course, obstetric and therapeutic tactics for novel coronavirus infection (COVID-19) in pregnant women
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Introduction. The novel coronavirus pandemic makes the issue of iron deficiency in pregnancy even more urgent and forces multidisciplinary clinicians to search for modern ways to correct disorders caused by this infection.Objective. To assess the features of the course of post-covid anemia associated with combination therapy, as well as the effect of therapy on the dental health status in pregnant women.Materials and methods. 30 pregnant women (treatment group 1) in the third trimester who had coronavirus infection with mild IDA during gestation were enrolled in the prospective study. Comparison group 2: included 15 patients with mild IDA who did not have coronavirus infection during gestation. Control group 3: included 15 conditionally healthy pregnant women without IDA who did not have a novel coronavirus infection during gestation.Results. Pregnant women who had COVID-19 during gestation were significantly more likely to suffer from gum bleeding, angular cheilitis, oral erosive and ulcerative lesions. Gum bleeding was significantly more common in pregnant women with IDA against the background of coronavirus infection, than in the women in the comparison and control groups (SBI index, p < 0.05). The decrease in the normal microflora suggests the presence of dysbiotic changes in all pregnant women against the background of IDA, however, the patients after the COVID-19 infection had the most significant changes in it.Conclusions. The novel coronavirus infection, which the women had during gestation, aggravates the course of IDA, reduces the quality of life of patients with characteristic complaints (gum bleeding, angular cheilitis, oral erosive and ulcerative lesions), leads to dysbiotic oral microbiome changes. The management of this group of patients requires a systemic correction of the microflora balance, the introduction of individual oral hygiene regimens and adequate treatment of IDA using high-technology medicinal products
Introduction. The novel coronavirus pandemic makes the issue of iron deficiency in pregnancy even more urgent and forces multidisciplinary clinicians to search for modern ways to correct disorders caused by this infection.Objective. To assess the features of the course of post-covid anemia associated with combination therapy, as well as the effect of therapy on the dental health status in pregnant women.Materials and methods. 30 pregnant women (treatment group 1) in the third trimester who had coronavirus infection with mild IDA during gestation were enrolled in the prospective study. Comparison group 2: included 15 patients with mild IDA who did not have coronavirus infection during gestation. Control group 3: included 15 conditionally healthy pregnant women without IDA who did not have a novel coronavirus infection during gestation.Results. Pregnant women who had COVID-19 during gestation were significantly more likely to suffer from gum bleeding, angular cheilitis, oral erosive and ulcerative lesions. Gum bleeding was significantly more common in pregnant women with IDA against the background of coronavirus infection, than in the women in the comparison and control groups (SBI index, p < 0.05). The decrease in the normal microflora suggests the presence of dysbiotic changes in all pregnant women against the background of IDA, however, the patients after the COVID-19 infection had the most significant changes in it.Conclusions. The novel coronavirus infection, which the women had during gestation, aggravates the course of IDA, reduces the quality of life of patients with characteristic complaints (gum bleeding, angular cheilitis, oral erosive and ulcerative lesions), leads to dysbiotic oral microbiome changes. The management of this group of patients requires a systemic correction of the microflora balance, the introduction of individual oral hygiene regimens and adequate treatment of IDA using high-technology medicinal products
Introduction. According to domestic and foreign authors, most women have a greater or lesser level of iron deficiency by the end of pregnancy and deplete their depot iron reserves, and anaemia develops by the time of delivery. Erythrocyte destruction occurs in presence of acute inflammation, including that caused by COVID-19, which leads to a chaotic distribution of iron within tissues and a pronounced loss of its reserves and aggravation of the existing deficiency. Due to overlapping changes with underlying novel coronavirus infection, iron deficiency creates favourable conditions for the development of infectious and inflammatory complications in the postpartum period by the time of delivery.Aim. To assess the features of the postpartum period and hematological status in puerperas with post-COVID anemia, who receive the combination therapy including an anti-anemic ferrous iron drug.Materials and methods. The prospective study included 30 puerperas (treatment group) in the postpartum period, who had a coronavirus infection with a mild degree of IDA during the gestation period. Group 2 (comparison group) included 15 puerperas with mild IDA, who did not have a coronavirus infection during the gestation period. Group 3 (control group) included 15 conditionally healthy puerperas, who had no novel coronavirus infection and did not suffer from IDA during the gestation period.Results and discussion. The puerperas, who had COVID-19 in pregnancy, developed infectious and inflammatory diseases significantly more often in the postpartum period. Subinvolution of the uterus, postpartum endometritis and thyroiditis, disruption of perineal stitches and seromas (hematomas) of the suture after cesarean section, vaginal dysbiotic conditions occurred significantly more often in puerperas with IDA, who came through coronavirus infection, than in women from the comparison group and control group (SBI index, p < 0.05).Conclusion. Women who had COVID-19 in pregnancy should be spinned off into a separate infectious risk group due to the possibility of postpartum complications and timely management of concomitant pathologies and appropriate treatment of IDA.
Obstetric and perinatal outcomes after a new coronavirus infection in the first and second trimesters of pregnancy
Introduction. The management of pregnant women in the conditions of the spread of a new coronavirus infection has become a priority task for doctors of all specialties, since it is with this pathology that an increase in the frequency of unfavorable gestation outcomes is currently associated.The aim of the study: to study obstetric and perinatal outcomes after a new coronavirus infection in the I and II trimesters of pregnancy.Objective. To study the features of the course of pregnancy, childbirth and perinatal outcomes in ICI, depending on the method of delivery.Materials and methods. A comparative study of the birth histories of women after coronavirus infection in 2021 was carried out. Group 1 (n = 26) consisted of patients with COVID-19 infection in the first trimester, group 2 (n = 30) – in the second trimester. The 3rd group is represented by relatively healthy women (n = 35). Statistical analysis was performed using the Statistica 7.0, SPSS 17 packages, as well as the statistical functions of MS Excel 2013.Results and discussion. The course of pregnancy after COVID-19 infection suffered in the first and second trimesters is associated with an increased risk of placental insufficiency (26.9 and 30%, respectively), the development of sympthoms of threatening termination (61.5 and 46.7%), anemia (38.5 and 43.3%), gestational hypertension (15.4 and 16.7%), bacterial vaginosis (19.2 and 20.0%), premature rupture of fetal membranes (34.6 and 16.7%), with the prevalence of urgent labor, but an increase in premature (13.3%) and operative labor (36.7%) with the manifestation of the disease in the second trimester. Newborns of mothers with COVID-19 infection are more often born in a state of asphyxia (65.4 and 53.3%). The structure of perinatal pathology is dominated by cerebral ischemia (42.3 and 40%), perinatal hypoxic damage to the central nervous system (19.2 and 23.3%), neonatal jaundice (11.5 and 23.3%), intrauterine pneumonia (15.4 and 10.0%), congenital malformations (7.7 and 30.0%; p1-2 = 0.04).Conclusion. The results of the study once again have confirmed the need for further study of the problem in order to find measures to reduce obstetric and perinatal complications in women after COVID-19 infection.
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