The pandemic caused by COVID-19 is affecting populations and healthcare systems worldwide. As we gain experience managing COVID-19, more data become available on disease severity, course, and treatment in patients infected with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). However, data in pregnancy remain limited. This narrative review of COVID-19 during pregnancy underscores key knowledge gaps in our understanding of the impact of this viral infection on reproductive health. Current data suggest that pregnant people have similar disease course and outcomes compared to nonpregnant people, with the majority experiencing mild disease; however, pregnant people may have increased risk of hospitalization and intensive care unit (ICU) admission. Among patients who develop severe and critical disease, major maternal morbidity and mortality have been described including cardiomyopathy, mechanical ventilation, extracorporeal membrane oxygenation, and death. Many questions remain regarding maternal severity of disease in COVID-19. Further research is needed to better understand disease course in pregnancy. Additionally, the inclusion of pregnant patients in therapeutic trials will provide vital data on treatment options for patients. As we continue to treat more patients affected by SARS-CoV-2, multidisciplinary care and continued research are both needed to achieve optimal outcomes for mother and fetus.

Group B Streptococcus (GBS), also known as Streptococcus agalactiae is a Gram-positive bacterium commonly encountered as part of the microbiota within the human gastrointestinal tract. A common cause of infections during pregnancy, GBS is responsible for invasive diseases ranging from urinary tract infections to chorioamnionitis and neonatal sepsis. Diabetes mellitus (DM) is a chronic disease resulting from impaired regulation of blood glucose levels. The incidence of DM has steadily increased worldwide to affecting over 450 million people. Poorly controlled DM is associated with multiple health comorbidities including an increased risk for infection. Epidemiologic studies have clearly demonstrated that DM correlates with an increased risk for invasive GBS infections, including skin and soft tissue infections and sepsis in non-pregnant adults. However, the impact of DM on risk for invasive GBS urogenital infections, particularly during the already vulnerable time of pregnancy, is less clear. We review the evolving epidemiology, immunology, and pathophysiology of GBS urogenital infections including rectovaginal colonization during pregnancy, neonatal infections of infants exposed to DM in utero, and urinary tract infections in pregnant and non-pregnant adults in the context of DM and highlight in vitro studies examining why DM might increase risk for GBS urogenital infection.

whereas at week 8, 56% reported no change in their meal enjoyment when following carbohydrate-last food order. CONCLUSION: The majority of patients adhered to carbohydrate-last food order intervention, with a neutral effect on meal enjoyment over time. Food order appears to be a feasible nutritional strategy in patients with GDM.

INTRODUCTION: Postpartum Hemorrhage (PPH) is the leading cause of maternal deaths worldwide. Visual estimation of blood loss (EBL) can result in underestimation of blood loss, causing delay and failure of early interventions for PPH, thus adversely affecting maternal morbidity and mortality. The California Maternal Quality Care Collaborative (CMQCC) hemorrhage toolkit suggests Quantitative Blood Loss (QBL) is a more accurate measure. The purpose of this study is to determine if QBL is a more accurate measure of blood loss than EBL at Community Regional Medical Center (CRMC) in order to standardize PPH management. METHODS: A retrospective cross sectional study was performed at CRMC on postpartum patients from February to June 2016. The variables investigated were pre- and post-delivery hemoglobin, EBL and QBL. The blood loss calculated from the difference between pre- and post-delivery hemoglobin levels was compared to the blood loss given by QBL and EBL. RESULTS: A total of 303 cases were reviewed. The mean QBL was 310.57mL and the mean EBL was 255.39mL. The difference was statistically significant (p=0.036). The Pearson correlation coefficient between change in hemoglobin and QBL was 0.28. For EBL, the correlation was 0.25. Both correlation coefficients were statistically significant (p<0.05). CONCLUSION: In our study, QBL appears to be a more accurate measure of blood loss than EBL. Additional data from deliveries at CRMC in 2017 are being reviewed given that the process of QBL has continued to improve with better education, compliance and changes in available resources. We hope to find a stronger correlation between QBL and blood loss.