Viral infections are common complications of pregnancy, with a wide range of obstetric and neonatal sequelae. Currently, there are limited data on whether SARS-CoV-2 is vertically transmitted in pregnant women tested positive for the virus. Here we describe a case of a known SARS-CoV-2-positive woman giving preterm birth to two fetuses with SARS-CoV-2 positive testing in placental tissue and amniotic fluid. The placental histological examinations showed chronic intervillositis and extensive intervillous fibrin depositions with ischemic necrosis of the surrounding villi.

20 LC-MS/MS 21 Vancomycin 22Tandem mass spectrometry 23Therapeutic drug monitoring 24 Background: Accurate quantification of vancomycin in plasma is important for adequate dose-adjustment.25 As literature suggests between-method differences, our first objective was to develop a novel liquid 26 chromatography-tandem mass spectrometry (LC-MS/MS) method for total vancomycin in human plasma and to 27 compare frequently used immunoassays with this method. Secondly, we investigated the clinical impact of 28 between-method quantification differences.29 Methods: For LC-MS/MS, lithium heparin plasma was extracted by adding a precipitation reagent containing the in-30 ternal standard (vancomycin-des-leucine). Analysis was performed on an Acquity TQD mass spectrometer 31 equipped with an Acquity UPLC 2795 separations module. Our method was analytically validated and compared 32 with four frequently used immunoassays from four different manufacturers. Vancomycin concentrations were 33 clinically classified as toxic, therapeutic and sub-therapeutic. Clinical discordance was calculated using LC-MS/MS 34 as a reference.35 Results: A novel LC-MS/MS method using protein precipitation as sole pretreatment and an analysis time of 5.0 min 36 was developed. The assay had a total imprecision of 2.6-8.5%, a limit of quantification of 0.3 mg/L and an accuracy 37 ranging from 101.4 to 111.2%. Using LC-MS/MS as reference, three immunoassays showed a mean proportional 38 difference within 10% and one showed a substantial mean proportional difference of N 20%. Clinical discordant 39 interpretation of the obtained concentrations ranged from 6.1 to 22.2%. 40 Conclusions: We developed a novel LC-MS/MS method for rapid analysis of total vancomycin concentrations in 41 human plasma. Correlation of the method with immunoassays showed a mean proportional difference N20% for 42 one of the assays, causing discordant clinical interpretation in more than 1 out of 5 samples.Q4 43

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Lower throughput CZE using the Sebia Minicap Flex Piercing can be used for precise and accurate first line screening and follow-up of hemoglobinopathies.

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