Background and Aim: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rapid emergence postured significant challenges on the health system in recent years. The early detection of cases is thought to be critical in preventing this pandemic by coronavirus disease (COVID-19), especially important in the obstetrical population due to theirs numerous interactions with another parturient when hospitalized for delivery. Therefore, the present study aimed to assess the COVID antigen test performance in COVID-positive obstetrics patients. Materials and Methods: This cross-sectional study was conducted on 1296 Covid-19 asymptomatic women admitted to the Obstetrics and Gynaecology Department of Muhammad Teaching Hospital & Medical College, Peshawar and Fauji Foundation Hospital, Rawalpindi for the duration of six months from February 2021 to July 2021. Antigen-based test rapid diagnostic test (RDT) was used for screening out COVID-19 positive obstetrics patients or women through nasopharyngeal swabs. Women with negative rapid antigen test results were confirmed with RT-polymers chain reaction test of nucleic acid amplification tests (NAAT). Ethical approval and informed consent were taken from the hospital ethical committee and each individual respectively. All the known positive COVID-19 patients during admission were excluded. SPSS version 24 was used for data analysis. Results: The overall prevalence of rapid antigen-positive tested patients was 13.2% (171/1296). The prevalence of positive tested women through rapid antigen test, Nucleic Acid Amplification Test (NAAT), and RT-PCR were 27 (2.1%), 51 (3.9%), and 93 (7.2%) respectively. Of the total 1296 rapid antigen tests, 27 were positive, and the false-negative confirmed positive by NAAT was 144.Thus the sensitivity of the rapid antigen test was 15.8% and the negative predictive value was 93.7%. Of the total 298 Nucleic Acid Amplification Tested had sensitivity and negative predictive value of 89.6% and 99.06% respectively. RT-PCR was carried out on 972 patients, positive diagnosed cases were 36 while 15 were initially negative and were positive with the test was repeated. The sensitivity and negative predictive value was 71.45% and 95.8% respectively. Conclusion: Our study found that Ag-RDT plays a significant role in SARS-CoV-2 early detection in infected individuals, with high specificity and sensitivity to disease infectious stage, whether symptomatic or asymptomatic, and can be used as a decision supported tool. Early detection of COVID-19 status in women admitted for delivery could benefit neonatal protection care. Keywords: Covid-19; Rapid antigen test; RT-PCR test
Aim: To determine the importance of intermittent cardiotocographic monitoring during misoprostol-assisted induction of labour in pregnancies lasting weeks or more. Methods: This descriptive study was carried out in the Obstetrics and Gynecology department of Combined Military Hospital, Kharian Cantt for the duration from January 2022 to August 2022 among 130 primigravida patients underwent CTG before receiving transvaginal dose of misoprostol. Neonatal admissions, the mode of delivery, the Apgar score, and indications of induction were the variables examined. Results: Forty-two (70%) of the C-section patients had reassuring CTG and significantly low Apgar scores at 1 minute. Seven (8.5%) of the patients with thick meconium had non-reassuring CTG. Twelve neonates (9.2%) in total required resuscitation, 9 (75%) of whom had reassuring CTGs while 3(25%) had non-reassuring CTGs. The overall admission rate in NICU was 10%, and 38.5% of neonates that required resuscitation had non-reassuring CTG. Neonatal mortality was nil during the study time. Conclusions: Patients who had their labour induced with misoprostol had non-reassuring CTG among 50% of cases and had thick meconium stained liquor. Therefore, we can lower neonatal morbidity and mortality by early foetal impairment detection. Neonatal mortality was nil during the study time. Keywords: cardiotocography, induction, resuscitation, Apgar score and caesarean section
Background and Aim: Maternal morbidity is a major health problem affecting approximately millions of women annually and had a substantial influence on fetal and infant health that might lead to maternal mortality. Maternal mortality is an indicator of the quality of obstetric care in a community directly reflecting the utilization of health care services available. The present study was conducted in order to analyze the maternal morbidity and mortality cases referred to a tertiary care hospital. Methodology: This cross-sectional study was conducted on 89 maternal deaths out of 9874 obstetrical admissions or births referred to department of Gynae/Obs of tertiary care hospitals i.e Makran Medical College, Turbat/ Teaching Hospital, Kech and Dow University of Health Sciences, Karachi over a period of five years from 2017 to 2021. All the pregnant women with gestation age >24 weeks admitted for any obstetrical emergencies were enrolled in this study. Patient’s demographic characteristics, clinical features during admission, and maternal relevant information were collected on pre-designed proforma. SPSS version 21 was used for data analysis. Results: Out of total 9874 births, maternal deaths were 89; the mortality incidence with prevalence was hemorrhage 7 (7.9%), hypertensive disorders 34 (38.2%), anesthetic issue 2 (2.2%), sepsis 14 (15.7%), and medical complications 31 (34.8%). The occurrence of direct and indirect maternal death was 55 (61.8%) and 34 (38.2%) respectively. The incidence of the mortality rate was 22.9%. Of the total 387 morbidity cases, hypertensive disorders were the prevalent cause with 295 (76.2%) cases followed by obstetric hemorrhage 55 (14.2%), medical complications 25 (6.5%), sepsis 11 (2.8%), and anesthetic complications 1 (0.3%). The incidence of morbidity was 77.4 per year. Conclusion: Medical complications, sepsis, and hemorrhage are the leading causes of maternal mortality, followed by hypertensive disorders. Mortality and morbidity rates were 22.9% and 3.9% respectively. All of these causes can be avoided with proper antenatal care facilitation. Keywords: Hemorrhage, Maternal mortality, Sepsis
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