Progesterone is a hormone responsible for pregnancy maintenance and the amount of progesterone increases in a woman’s body during pregnancy, as well as the level of female sex hormones, estrogens are also upregulated. Due to these changes the cutaneous sensitivity to external stimuli (meteorological factors, bacteria, etc.) increases. In general, all skin changes during pregnancy can be divided into three groups: physiological changes (hormone-associated), nonspecific or dermatoses that existed before pregnancy or were triggered by it, and specific pregnancy-related dermatoses, which appear during pregnancy and resolve in the postpartum period. In this brief review, we describe the dermatoses commonly seen in pregnancy and present our own clinical examples. We hope the review will be of some practical help for dermatologists and obstetricians.
The pandemic of a new coronavirus infection COVID-19 has become a real challenge to humanity and the medical community and has raised a number of medical and social issues. From the currently available information on clinical cases of COVID-19, it follows that COVID-19 patients in critical condition have a clinical picture of disseminated intravascular coagulation (DIC), septic shock with the development of multiple organ failure, which justifies the anticoagulant therapy use in patients with COVID-19. In addition to isolating virus DNA from biological material and diagnosing SARS-CoV-2, the use of simple and easily accessible laboratory markers in the blood is necessary for the management of patients with COVID. If the activation of coagulation processes is sufficient enough, the consumption of platelets and blood clotting factors can be diagnosed by laboratory methods in the form of prolongation of routine blood clotting tests and increasing thrombocytopenia. Hyperfibrinogenemia, increased D-dimer, prolonged prothrombin time, thrombocytopenia, lymphopenia, leukocytopenia, increased interleukin 6, and ferritin are observed in most COVID-19 patients. The degree of increase in these changes correlates with the severity of the inflammatory process and is a prognostically unfavorable sign. In the article authors discuss laboratory monitoring that plays an essential role in this crisis, contributing to patient screening, diagnosis, as well as monitoring, treatment and rehabilitation.
The pathogenesis of bleeding in such patients has mixed pattern: besides vascular wall pathology coagulation deficiency plays some role. The preferred delivery method for such patients is caesarean section. Deep vaginal ruptures and serious hemorrhage accompany vaginal delivery.
Zika virus (ZIKV) is an arthropod-borne virus (arbovirus) in the genus Flavivirus and the family Flaviviridae. ZIKV was first isolated from a nonhuman primate in 1947 and from mosquitoes in 1948 in Africa. ZIKV infections in humans were sporadic for half a century before pandemic propagation in 2015–2016. Transmission of ZIKV from mother to fetus can occur in all trimesters of pregnancy, even if the mother is an asymptomatic carrier. The clinical signs ZIKV infection are nonspecific and can be misdiagnosed as other infectious diseases, especially those due to arboviruses such as Dengue and Chikungunya. ZIKV infection was associated with only mild illness prior to the large French Polynesian and Brasil outbreaks, when severe neurological complications, Guillain–Barre syndrome and dramatic increase in severe congenital malformations (including microcephaly) were reported. The adaptation of ZIKV to an urban cycle in endemic areas suggests that the incidence of ZIKV infections may be underestimated. The pandemic of novel coronavirus infection (COVID-19) demonstrates that lessons from ZIKV pandemic propagation has not been learned properly.
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