(1) Background: A considerable number of systematic reviews, with substantial heterogeneity regarding their methods and included populations, on the impact of COVID-19 on infected pregnant women and their neonates, has emerged. The aim was to describe the obstetric-perinatal and neonatal outcome of infected pregnant women and their newborns during the COVID-19 pandemic; (2) Methods: Three bibliographical databases were searched (last search: 10 September 2020). Quality assessment was performed using the AMSTAR-2 tool. Primary outcomes included mode of delivery, preterm delivery/labor, premature rupture of membranes (PROM/pPROM) and abortions/miscarriages. Outcomes were mainly presented as ranges. A separate analysis, including only moderate and high-quality systematic reviews, was also conducted. The protocol was registered with PROSPERO (CRD42020214447); (3) Results: Thirty-nine reviews were analyzed. Reported rates, regarding both preterm and term gestations, varied between 52.3 and 95.8% for cesarean sections; 4.2–44.7% for vaginal deliveries; 14.3–63.8% specifically for preterm deliveries and 22.7–32.2% for preterm labor; 5.3–12.7% for PROM and 6.4–16.1% for pPROM. Maternal anxiety for potential fetal infection contributed to abortion decisions, while SARS-CoV-2-related miscarriages could not be excluded. Maternal ICU admission and mechanical ventilation rates were 3–28.5% and 1.4–12%, respectively. Maternal mortality rate was <2%, while stillbirth, neonatal ICU admission and mortality rates were <2.5%, 3.1–76.9% and <3%, respectively. Neonatal PCR positivity rates ranged between 1.6% and 10%. After accounting for quality of studies, ranges of our primary outcomes remained almost unchanged, while among our secondary outcomes, maternal ICU admission (3–10%) and mechanical ventilation rates (1.4–5.5%) were found to be relatively lower; (4) Conclusions: Increased rates of cesarean sections and preterm birth rates were found, with iatrogenic reasons potentially involved. In cases of symptomatic women with confirmed infection, high maternal and neonatal ICU admission rates should raise some concerns. The probability of vertical transmission cannot be excluded. Further original studies on women from all trimesters are warranted.
Current guidelines advocate 3–4 passes with a fine-needle aspiration (FNA) to achieve high rates of diagnostic samples for malignancy when performing endoscopic ultrasound (EUS)-guided sampling of solid pancreatic lesions, in the absence of on-site cytologic evaluation. The aim of this study is to compare 2 vs. 3 needle passes in EUS-FNA for solid pancreatic lesions in terms of incremental diagnostic yield and to identify factors associated with the procedure’s outcome. In this retrospective study, 2 passes of EUS-FNA were found to have similar diagnostic yield compared to 3 passes for the diagnosis of solid pancreatic masses, suggesting that there might be no significant incremental tissue yield when 3 passes are performed.
In the era of evidence-based medicine, physicians worldwide should abide by universally approved practices and healthcare units should seek quality control and operational improvement. This audit evaluates the degree of compliance with the European Academy of Allergy and Clinical Immunology guidelines for the diagnosis and treatment of anaphylaxis in a pediatric Allergy Department. Medical records of 248 children with food-induced allergic reactions who presented both on emergency and outpatient basis were reviewed. Data were also collected from the e-prescription database and anaphylaxis severity was graded according to Sampson’s criteria. An accuracy metric was used to calculate the consistency rate. Anaphylaxis was documented in 188/423 allergic reactions. The degree of agreement for the classification of the reactions as anaphylactic was 88.3%, while the respective rate for non-anaphylactic was 58.7%. In the anaphylactic cases, adrenaline was prescribed in 84.8%, while the respective rates for other drugs were: antihistamines: 27.6%; corticosteroids: 26.1%; inhaled β2-agonists: 11.8%. This study, through the example of pediatric food-induced anaphylaxis, underlines the significance of compliance to guidelines, organized documentation in healthcare units using specially formulated medical history forms and continuous medical stuff training. Thus, diagnosis and treatment practices can be improved for the benefit of patients.
About Me
Medical Doctor, recently graduated from the School of Medicine of the National and Kapodistrian University of Athens.
Medical Doctor, recently graduated from the School of Medicine of the National and Kapodistrian University of Athens.