The Rare Case of a COVID-19 Pregnant Patient with Quadruplets and Postpartum Severe Pneumonia. Case Report and Review of the Literature

Recovery of post-arthrodesis hand function in the interphalan-geal joint - Case presentation

Objectives. The paper highlights the importance of the kinetic recovery program used to regain post-arthrodesis hand function in the interphalangeal joint. Also, during the paper we will present both the techniques used and the methods applied in order to reduce pain and recover the remaining functional. Materials and method. During the study, a patient with open intra-articular communicative fractures AIFP D3, 4 in the right hand with bone-operated defect was analyzed. The patient was evaluated functionally postoperatively, during the recovery program and at the end of it. Results. During the recovery program, a progress and a good evolution of the hand functionality could be observed. Thus, the patient observed the kinetic program initially established by the physiotherapist and also it was possible to observe the increase of the mobility of the joints in the vicinity of the joints affected by the immobilization of the hand. During the recovery program, a decrease in edema was observed locally and an increase in the strength of the muscles of the hand. Conclusions. The physiotherapy program used to restore the functionality of the hand following arthrodesis at the level of the interphalangeal joints must be preceded by an appropriate evaluation and must include techniques adapted to the patient's abilities. An essential condition is a good collaboration between patient-physiotherapist-orthopedic surgeon, so that complications and recurrences can be avoided.

COVID-19 in Pregnant Patients at Term: Evolution of Coagulation Factors in Mild Forms throughout the Pandemic: Conventional Analysis and Logistic Regression

Aim: The evolution of coagulation factors in pregnant patients infected with SARS-CoV-2 during the pandemic is still debated. However, few studies have been carried out to evaluate the silent alterations of blood values in mild forms of the disease. Methods:A total of 153 pregnant patients with an asymptomatic form of COVID-19 and 306 healthy pregnant patients, who were admitted for delivery in our hospital between April 1, 2020 and March 1, 2022, were studied. The blood values harvested closest to the time of delivery were considered. Results:There was a significant variability in values of fibrinogen, prothrombin time, though these were still within normal limits. Conclusions:Pregnant patients with mild forms of COVID-19 displayed some blood alterations, even if they were asymptomatic for COVID-19.

The Risk of Spontaneous Abortion Does Not Increase Following First Trimester mRNA COVID-19 Vaccination

Clinical trials for COVID-19 vaccines initially excluded pregnant women due to safety concerns, and when the vaccines were authorized for emergency use, they were not recommended for this population. However, observational studies discovered that pregnant women infected with COVID-19 have higher risks of negative pregnancy and delivery outcomes compared to non-pregnant women, raising the question of the risks–benefits of administering COVID-19 vaccines to pregnant women. By mid-2021, there was general consensus on the relative safety of COVID-19 vaccination during pregnancy; therefore, it is critical to investigate the safety issues related to these vaccines, considering the increasing acceptance among pregnant women. To address these concerns, we developed a research project to study the short-term effects and outcomes of COVID-19 vaccination during the first trimester of pregnancy. Our research followed an observational retrospective design for 12 months from the beginning of the vaccination campaign, and included 124 cases of spontaneous abortions and 927 ongoing pregnancies. The odds of spontaneous abortion were non-significant for both versions of the mRNA vaccine (Pfizer BNT162b2 AOR = 1.04, CI = 0.91–1.12; Moderna mRNA-1273 AOR = 1.02, CI = 0.89–1.08). Overall, our data indicated that the risk of spontaneous abortion after mRNA COVID-19 immunization during the first trimester of pregnancy is commensurate with the predicted risk in non-vaccinated pregnant women. These findings contribute to the growing body of information regarding the safety of mRNA COVID-19 vaccination during pregnancy.