Introduction: To review published studies related to the association of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections with pregnancy, foetal, and neonatal outcomes during coronavirus disease 2019 (COVID-19) pandemic in a systematic manner. Methods: A comprehensive electronic search was done through PubMed, Scopus, Medline, Cochrane database, and Google Scholar from December 01, 2019, to May 22, 2020, along with the reference list of all included studies. All cohort studies that reported on outcomes of COVID-19 during pregnancy were included. Qualitative assessment of included studies was performed using the Newcastle-Ottawa scale. Results: Upon admission, most pregnant women underwent a low-dose radiation CT scan; the reports of which included unilateral/bilateral pneumonia in most patients. A marked lymphopenia was also noted in many patients with COVID-19. 513 titles were screened, and 22 studies were included, which identified 156 pregnant women with COVID-19 and 108 neonatal outcomes. The most common maternal/foetal complications included intrauterine/foetal distress (14%) and premature rupture of membranes (8%). The neonatal clinical manifestations of COVID-19 commonly included shortness of breath (6%), gastrointestinal symptoms (4%), and fever (3%). Conclusion: COVID-19 infection in pregnancy leads to increased risk in pregnancy complications such as preterm birth, PPROM, and may possibly lead to maternal death in rare cases. There is no evidence to support vertical transmission of SARS-CoV-2 infection to the unborn child. Due to a paucity of inconsistent data regarding the impact of COVID-19 on the newborn, caution should be undertaken to further investigate and monitor possible infection in the neonates born to COVID-19-infected mothers.

uring any given year, influenza epidemics kill 500,000 to 1,000,000 people worldwide, and an unpredictable pandemic could kill millions more. Yet such statistics do not reflect influenza's full impact: millions of hospitalizations, secondary bacterial pneumonias, and middle ear infections in infants and young children. The World Health Organization (WHO) Influenza Program was established in 1948 to deal with these public health threats. Today, 111 national centers in 83 countries collect and screen about 175,000 samples each year from an estimated 600 to 1200 million cases of influenza worldwide, and four WHO collaborating centers receive about 6500 samples for further immunologic and genetic characterizations. Twice yearly, WHO organizes formal meetings to identify circulating strains that new vaccine formulations should target. After review by national health authorities, vaccine manufacturers have roughly 6 months for scale-up, production, and distribution. Health care services then have another 3 months to administer about 200 million doses of trivalent vaccine worldwide. Despite its sophistication, however, the WHO Influenza Program has limitations. First, current lab methods for characterizing influenza are timeconsuming and labor-intensive. Only a small fraction of influenza virus isolates undergo definitive characterization. Second, it could take weeks or months to detect and analyze an unusual or unexpected strain and to understand its significance. Delays can be costly or disastrous. A meeting* organized under the auspices of the Institute of Medicine and National Academy of Engineering has resulted in a plan that would expedite disease surveillance and intervention efforts on an international scale. It integrates biological, engineering, and informatic technologies into a centralized facility and makes them available via the Internet. WHO national centers would be able to collect samples, screen them on the spot with dipsticks, record epidemiologic observations on positives, select appropriate tests, and ship samples directly to the global lab. High-throughput automated systems for replicating, phenotyping, genotyping, and archiving influenza viruses would work together and, within days, epidemiologic observations and test results would appear in the lab's Web-enabled database for analysis. Within several years, such a global lab would generate a petabit-sized (about 10 15 bits) database on influenza viruses worldwide, allowing rapid and consistent monitoring of circulating strains for vaccine development, serving as a pandemic sentinel, and expanding surveillance to animals known to harbor strains that could spread to humans. The global lab could be implemented over 5 years at a projected cost of U.S. $45 million. Although this investment may seem high, it will pay for itself many times over in morbidity prevented and lives saved through influenza vaccines that are better matched to the circulating strains and thus more effective. The building block technologies to create the first global lab against ...

Cardiac disease is the leading cause of maternal mortality in the United Kingdom. Major causes of cardiac death in pregnant women include cardiomyopathies, myocardial infarction, ischemic heart disease, and aortic dissection. Uncorrected congenital heart disease and women who have had corrective or palliative surgery may have complicated pregnancies as well. Some women with significant cardiac disease are unable to meet the increased physiological demands of pregnancy. Of these, those who do not respond to medical treatment may require surgical correction such as coronary artery bypass grafting. The risk of cardiac operations for pregnant women is similar to that for nonpregnant women but the fetal mortality rate remains high. Contributing factors to high fetal mortality rates include timing, urgency of operation, and the fetal/fetoplacental response to cardiopulmonary bypass. The aim of this review is to summarize current evidence in utilizing the different management approaches of cardiac issues during pregnancy.

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