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Eriç Horasanlı J, Alp EC, Bülbül R. Evaluation of Complete Blood Cell Count Parameters in the Diagnosis of Threatened Preterm Labor and Premature Rupture of Membranes. DUBAI MEDICAL JOURNAL 2022. [DOI: 10.1159/000524968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
<b><i>Purpose:</i></b> The purpose of this study was to investigate a possible relationship between systemic inflammatory markers such as neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte monocyte ratio (LMR), threatened preterm labor (TPL), and preterm premature rupture of membranes (PPROM), using complete blood cell count (CBC) parameters. <b><i>Method:</i></b> The study was carried out prospectively with patients admitted to our university hospital due to preterm labor and at risk of PPROM. The cases were divided into three groups according to their pregnancy status. Group 1 consisted of 90 patients with PPROM between 24th and 36th gestational weeks; group 2, 115 patients diagnosed with TPL between 24th and 36th gestational weeks; group 3, 101 patients over 36 weeks of gestation (control) who were not in labor. In addition to the demographic data of the patients, CBC parameters (white blood cell (WBC), Hg, Hct, Plt, lymphocyte, monocyte, mean platelet volume, PLR, LMR, and NLR) and C-reactive protein (CRP) values were examined and compared in each of the three groups. <b><i>Results:</i></b> CRP and WBC values of group 1 (PPROM) were higher than group 2 (TPL) and group 3 (control) (<i>p</i> < 0.05 for both). Pearson correlation between the gestational age and PLR and NLR values was significant (<i>r</i> and <i>p</i> values for PLR and NLR, respectively, <i>r</i> = −0.18, <i>p</i> < 0.001; <i>r</i> = −0.23, <i>p</i> < 0.001). However, there was no significant difference between the groups regarding PLR, NLR, LMR, platelet, monocytes, and lymphocyte counts. <b><i>Conclusions:</i></b> Only WBC was a valuable parameter in predicting preterm labor and PPROM. Although there was no significant difference between the groups in PLR and NLR, a negative correlation was found with gestational age at delivery. CRP value is still a helpful parameter in PPROM and TPL prediction.
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Hill M, Miles A, Flanagan B, Mills B, Hopper L. Out-of-hospital births and the experiences of emergency ambulance clinicians and birthing parents: a scoping review protocol. BMJ Open 2022; 12:e062313. [PMID: 35613757 PMCID: PMC9134164 DOI: 10.1136/bmjopen-2022-062313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Emergency ambulance clinicians attend a wide range of prehospital emergencies, including out-of-hospital births (OOHBs). Intrapartum care comprises approximately 0.05% of emergency medical services' caseload, with only ~10% of intrapartum cases progressing to birth in emergency ambulance clinician care. However, this low exposure rate potentially allows obstetric clinical skills and knowledge to decay, which may impact on patient care. Additionally, unplanned OOHBs are known to have a higher incidence of complications and adverse outcomes than their counterparts born in hospital, such as postpartum haemorrhage or hypothermia. This scoping review will explore OOHBs and associated complications in emergency ambulance clinician care, investigate birth parent, significant partner and clinician experiences regarding OOHBs, and consider barriers and challenges to optimal patient care, to identify future research opportunities and associated knowledge gaps for this patient cohort. METHODS AND ANALYSIS This scoping review will follow the nine-step methodological framework suggested by the Joanna Briggs Institute and use the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Five electronic databases (MEDLINE via EBSCO, CINAHL, Embase, Web of Science and Wiley Online) will be searched to identify articles for inclusion. The 'participant, concept, context' criteria will be used to identify suitable search words regarding OOHBs in emergency ambulance clinician care. The review will include peer-reviewed and preprint literature. Two reviewers will independently assess articles based on title and abstract for inclusion in the review. Data will be charted using a data extraction tool for consistency and provide a succinct descriptive summary of the results. ETHICS AND DISSEMINATION This study does not require ethical review as all the information obtained will come from publicly available resources. Results will be disseminated via a peer-reviewed publication. This scoping review is preregistered with the Open Science Framework (https://osf.io/ta35q).
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Affiliation(s)
- Michella Hill
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- Western Australian Academy of Performing Arts (WAAPA), Edith Cowan University, Mt Lawley, Western Australia, Australia
| | - Alecka Miles
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Belinda Flanagan
- Tasmanian School of Medicine, University of Tasmania, Alexandria, New South Wales, Australia
| | - Brennen Mills
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Luke Hopper
- Western Australian Academy of Performing Arts (WAAPA), Edith Cowan University, Mt Lawley, Western Australia, Australia
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Prophylactic or emergent cervical cerclage for women with different medical indications for cervical cerclage. Taiwan J Obstet Gynecol 2022; 61:193-194. [DOI: 10.1016/j.tjog.2022.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/24/2021] [Indexed: 11/23/2022] Open
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Lee WL, Chang WH, Wang PH. Risk factors associated with preterm premature rupture of membranes (PPROM). Taiwan J Obstet Gynecol 2021; 60:805-806. [PMID: 34507652 DOI: 10.1016/j.tjog.2021.07.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2021] [Indexed: 11/17/2022] Open
Affiliation(s)
- Wen-Ling Lee
- Department of Medicine, Cheng-Hsin General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Nursing, Oriental Institute of Technology, New Taipei City, Taiwan
| | - Wen-Hsun Chang
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Peng-Hui Wang
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Female Cancer Foundation, Taipei, Taiwan; Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
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Wang PH, Lee WL, Yang ST, Tsui KH, Chang CC, Lee FK. The impact of COVID-19 in pregnancy: Part I. Clinical presentations and untoward outcomes of pregnant women with COVID-19. J Chin Med Assoc 2021; 84:813-820. [PMID: 34369462 DOI: 10.1097/jcma.0000000000000595] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease 2019, COVID-19) is a pandemic disease with rapidly and widely disseminating to the world. Based on experiences about the H1N1, Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) coronavirus pandemics, pregnant women who are infected are disproportionately more likely to develop severe illness and need more hospitalizations, intensive care, and finally die of diseases compared with those nonpregnant counterparts or those pregnant women without infection. Although more than one half of pregnant women with COVID-19 are asymptomatic, and as well as their symptoms are frequently mild, this observation presents a further challenge regarding service provision, prevention, and management, in which this may result in overlooking the risk of COVID-19 during pregnancy. As predictable, despite much advance in critical care in recent decades, during the 2020 COVID-19 pandemic, pregnant women with COVID-19 are really at higher risk to progress to severe illness; require hospitalization; need intensive care, such as the use of mechanical ventilation as well as extracorporeal membrane oxygenation (ECMO), and of most important, die than their nonpregnant counterparts and pregnant women without COVID-19. The magnitude of the risk to pregnant women further extend to their newborn from COVID-19 with resultant significantly increasing perinatal and neonatal morbidity and mortality rates. The heightened risk of untoward outcomes in pregnant women emphasizes an urgent need of national or international recommendations and guidelines to optimize prevention and management strategies for COVID-19 in pregnancy. Active and passive prevention of COVID-19 is approved as effective strategies for women who attempt to be pregnant or during pregnancy. Understanding that pregnant women who are a vulnerable population is essential to improve the care in the novel and urgent COVID-19 pandemic. The current review is a part I to summarize the up-to-date information about the impact of laboratory-confirmed SARS-CoV-2 infection on pregnant women and focus on clinical presentations and untoward pregnancy outcomes of these pregnant women infected with SARS-CoV-2.
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Affiliation(s)
- Peng-Hui Wang
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, ROC
- Female Cancer Foundation, Taipei, Taiwan, ROC
| | - Wen-Ling Lee
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Medicine, Cheng-Hsin General Hospital, Taipei, Taiwan, ROC
| | - Szu-Ting Yang
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Kuan-Hao Tsui
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Obstetrics and Gynaecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC
- Institute of BioPharmaceutical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan, ROC
- Department of Pharmacy and Master Program, College of Pharmacy and Health Care, Tajen University, Pingtung, Taiwan, ROC
| | - Cheng-Chang Chang
- Department of Obstetrics and Gynecology, Tri-service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Fa-Kung Lee
- Department of Obstetrics and Gynecology, Cathy General Hospital, Taipei, Taiwan, ROC
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Sun HD, Yeh CC, Wang PH. Additional risks for preterm delivery in highly risky women: Identification and prevention. Taiwan J Obstet Gynecol 2021; 59:479-480. [PMID: 32653116 DOI: 10.1016/j.tjog.2020.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2020] [Indexed: 12/19/2022] Open
Affiliation(s)
- Hsu-Dong Sun
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chang-Ching Yeh
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Peng-Hui Wang
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Female Cancer Foundation, Taipei, Taiwan; Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
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Lai YJ, Chang CM, Lin CK, Yang YP, Chien CS, Wang PH, Chang CC. Severe acute respiratory syndrome coronavirus-2 and the deduction effect of angiotensin-converting enzyme 2 in pregnancy. J Chin Med Assoc 2020; 83:812-816. [PMID: 32902940 PMCID: PMC7434025 DOI: 10.1097/jcma.0000000000000362] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 05/14/2020] [Indexed: 12/17/2022] Open
Abstract
The 2019 novel coronavirus (2019-nCoV, later named SARS-CoV-2) is a pandemic disease worldwide. The spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is continuing at a rapid speed. Till May 4, 2020, there have been 3,407,747 confirmed cases and 238,198 deaths globally. The common symptoms in pregnant women are fever, cough, and dyspnea. Angiotensin-converting enzyme 2 (ACE2) has transient overexpression and increased activity during pregnancy, which is now confirmed as the receptor of SARS-CoV-2 and plays essential roles in human infection and transmission. There is no evidence that pregnant women are more susceptible to SARS-CoV-2. To date, there is no valid medication or vaccination. The immune suppression or modulation during pregnancy increases the risk of severe pneumonia. Remdesivir is an antiviral medication targeting ribonucleic acid (RNA) synthesis that has clinical improvement in the treatment of SARS-CoV-2. Chloroquine is controversial in its effectiveness and safety to treat SARS-CoV-2. Remdesivir is safe in pregnancy. Chloroquine has not been formally assigned to a pregnancy category by the Food and Drug Administration (FDA). The management strategy includes monitoring fetal heart rate and uterine contractions; early oxygenation if O2 saturation is less than 95%; empiric antibiotics for prevention of secondary infection; corticosteroid to treat maternal SARS-CoV-2 disease routinely is not suggested, only for fetal lung maturation in selected cases; and consideration of delivery is according to the obstetric indication, gestational age, and severity of the disease. During epidemics, delivery at 32-34 weeks is considered. The indication for the Cesarean section should be flexible to minimize the risk of infection during the delivery. The newborn should be in isolation ward immediately after birth; breastfeeding is not contraindicated but should avoid direct transmission infection.
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Affiliation(s)
- Yu-Ju Lai
- Department of Obstetrics and Gynecology, Tri-service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Chia-Ming Chang
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Chi-Kung Lin
- Department of Obstetrics and Gynecology, Tri-service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Yi-Ping Yang
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Chian-Shiu Chien
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Peng-Hui Wang
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, ROC
- Female Cancer Foundation, Taipei, Taiwan, ROC
| | - Cheng-Chang Chang
- Department of Obstetrics and Gynecology, Tri-service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
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Affiliation(s)
- Hsu-Dong Sun
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei City, Taiwan, ROC
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Ying-Hui Yang
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Peng-Hui Wang
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Female Cancer Foundation, Taipei, Taiwan, ROC
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, ROC
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Lo PF, Lin YL, Chang WH, Wang PH. Prophylactic cervical cerclage for cervical insufficiency. Taiwan J Obstet Gynecol 2020; 59:473-474. [DOI: 10.1016/j.tjog.2020.03.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2020] [Indexed: 10/24/2022] Open
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