Background: The first reports of the Chinese experience in the management of newborns of mothers with SARS-CoV 2 infection did not recommend mother-baby contact or breastfeeding. At present, the most important International Societies, such as WHO and UNICEF, promote breastfeeding and mother-baby contact as long as adequate measures to control COVID-19 infection are followed. In cases where maternal general health conditions impede direct breastfeeding or in cases of separation between mother and baby, health organizations encourage and support expressing milk and safely providing it to the infants. Methods: A series of 22 case studies of newborns to mothers with COVID-19 infection from March 14th to April 14th, 2020 was conducted. Mothers and newborns were followed for a median period of 1.8 consecutive months. Results: Out of 22 mothers, 20 (90.9%) chose to breastfeed their babies during hospital admission. Timely initiation and skin to skin contact at delivery room was performed in 54.5 and 59.1%, respectively. Eighty two percent of newborns to mothers with COVID-19 were fed with breast milk after 1 month, decreasing to 77% at 1.8 months. Six of 22 (37.5%) mothers with COVID-19 required transitory complementary feeding until exclusive breastfeeding was achieved. During follow-up period, there were no major complications, and no neonates were infected during breastfeeding. Conclusions: Our experience shows that breastfeeding in newborns of mothers with COVID-19 is safe with the adequate infection control measures to avoid mother-baby contagion. Supplementing feeding with pasteurized donor human milk or infant formula may be effective, until exclusive breastfeeding is achieved.

Aim: The objective of our study was to determine whether the SARS-CoV-2–positive mothers transmit the virus to their hand-expressed colostrum. Methods: This is an observational prospective study that included pregnant women who tested positive for SARS-CoV-2 by PCR test on a nasopharyngeal swab at the moment of childbirth and who wanted to breastfeed their newborns. A colostrum sample was obtained from the mothers by manual self-extraction. To collect the samples, the mothers wore surgical masks, washed their hands with an 85% alcohol-based gel, and washed their breast with gauze that was saturated with soap and water. Results: We obtained seven colostrum samples from different mothers in the first hours postdelivery. SARS-CoV-2 was not detected in any of the colostrum samples obtained in our study. Conclusion: In our study, breast milk was not a source of SARS-CoV-2 transmission. Hand expression (assuring that a mask is used and that appropriate hygienic measures are used for the hands and the breast), when direct breastfeeding is not possible, appears to be a safe way of feeding newborns of mothers with COVID-19.

Objective: To evaluate whether transvaginal radiofrequency (RF) ablation of fi broids is a technique that can be offered to women with reproductive desires. Design: Unicentric, prospective, observational study. Setting: University Hospital. Patient(s): Twenty-seven individuals who desired to become mothers after undergoing RF ablation for symptomatic fi broids. Intervention(s): Transvaginal RF ablation for symptomatic fi broids with a maximum total volume of 145 cm3. Main Outcome Measure(s): The reduction in the size of the fi broids, improvement of symptoms, and reproductive outcomes during the 24 months after the ablation. For patients who achieved pregnancy, we assessed the type of conception, course of gestation, type of delivery, neonatal outcomes, and occurrence of both maternal and fetal complications. Result(s): A statistically significant reduction in symptoms related to the fi broids 6 months after the ablation was demonstrated through the implementation of the Symptom Severity Scale. No patient required hospitalization after the procedure, and on average from the third day after intervention, they resumed their work activities without the need for analgesics. Among those patients who attempted pregnancy during the 24-month follow-up period, 73.68 % (14/19) achieved motherhood. There were no cases of uterine rupture, premature birth, or intrauterine fetal death. Conclusion(s): Radiofrequency ablation for fi broids seems to be a promising, safe, and low-complexity alternative that does not appear to interfere with the development of a normal term gestation. (F S Rep (R) 2024;5:320-7. (c) 2024 by American Society for Reproductive Medicine.)

To evaluate transvaginal radiofrequency ablation (TRFA) as a preoperative strategy to facilitate hysteroscopic resection in patients with complex submucosal fibroids desiring uterine preservation. Prospective case series. Single tertiary hospital (Puerta de Hierro University Hospital, Madrid, Spain), January 2021-June 2023. Thirteen women with a single symptomatic fibroid containing a submucosal component, Lasmar-STEPW score ≥ 5, and no pregnancy desire for at least one year. TRFA was performed under general anaesthesia in an outpatient setting. Hysteroscopic myomectomy was scheduled from the sixth month onward. Outcomes included fibroid volume reduction, symptom improvement (Uterine Fibroid Symptom and Quality of Life questionnaire [UFS-QoL]), and hysteroscopic resection feasibility. Median age was 43 years. All TRFA procedures were completed successfully. At 6 months, median fibroid volume reduction was 76.8 %. UFS-QoL significantly improved (median from 32 to 14; p = 0.004). Complete hysteroscopic resection was achieved in 12 of 13 patients (92.3 %). One patient without fibroid regression required laparotomic myomectomy, with final diagnosis of adenomyoma. No serious complications or symptom recurrence were observed at follow-up. TRFA is a safe, effective outpatient technique that significantly reduces fibroid volume and facilitates complete hysteroscopic resection in women with complex submucosal fibroids. This combined approach may expand the role of conservative vaginal surgery in selected patients.