The rate of failure to achieve vaginal delivery within 24 h was lower with Foley's balloon and oral misoprostol as compared to oral misoprostol alone.
INTRODUCTION Data regarding pregnancy and related outcomes with COVID-19 are inconsistent, which leads to difficulties in counselling pregnant women. This brings uncertainty to pregnant women regarding mode of birth, transmission and issues that may occur in case they contract the disease. We conducted this study to assess the knowledge about COVID-19 risk during pregnancy and childbirth and to assess the concerns, attitudes, and practices of pregnant women during the pandemic. METHODS A cross-sectional survey was carried out among 376 consenting pregnant women attending antenatal clinics in Karachi, Pakistan, between 1 July and 16 July 2020, using pretested questionnaires. RESULTS A total of 376 pregnant women participated in the survey. Participants had inadequate knowledge about COVID-19 risk during pregnancy, including potential vertical transmission (58.5%), preferred route of delivery (52%), safety of breastfeeding (50%), birth defects (44.7%), rooming in and skin-to-skin contact (58.5%). The majority (85.1%) had a high concern score, and negative attitude (62.8%). Only 43.6% said that they would not hide their symptoms, while 37.2% stated that they will deliver at hospital if they tested positive. Only 30.9% of respondents had good practices. During visits, 39.4% maintained social distancing and sanitized hands while only 37.2% said that they did not bring more than one person with them. CONCLUSIONS The study population had inadequate knowledge, negative attitude, and poor practices regarding pregnancy during the COVID-19 pandemic. More than half of the respondents thought that concealing symptoms and delivering at home would be better. Awareness programs are urgently needed.
INTRODUCTION While all healthcare services across the globe deferred non-urgent surgeries, labor wards provided maternity care during the pandemic continuously. This study assesses the knowledge and practices of obstetricians and midwives about personal protective equipment (PPE), their risk perception of COVID-19 and satisfaction with the preventive measures adopted at their workplace. METHODS A questionnaire, designed according to the World Health Organization’s advice on rational use of personal protective equipment for COVID-19, was administered to 452 Pakistani maternity care providers between 1 July and 30 July 2020. RESULTS Only 32% of pregnant women had a good compliance to their routine antenatal drugs while forgetfulness (27.2%) and vomiting as a side effect of a drug (25.7%) were the major barriers to compliance with routine drugs. Furthermore, there was a statistically significant association between respondents’ compliance with antenatal drugs and number of children as well as level of income (p<0.001). No statistically significant association was found between education level and compliance. CONCLUSIONS Nurses and other health workers should support pregnant women to set reminders for taking their medications and prescribe alternative dosage forms or products that will not induce vomiting. In addition, antenatal education should emphasize the benefits of adherence to routine taking of medications at every stage of pregnancy and the possible negative consequences of non-compliance.
Objective: To assess the effect of antenatal diagnosis of placenta accreta spectrum (PAS) on fetomaternal outcomes. Material and Methods: This was a retrospective cohort study conducted from January 2017 to December 2018. Women with PAS diagnosed antenatally were designated as group A and those where diagnosis was suspected during operation and confirmed on histopathology (PAS diagnosed perioperatively) were designated as group B. Outcome in terms of uterine conservation, maternal death, admission of mother to intensive care unit (ICU), perinatal death and neonatal ICU (NICU) admission were recorded. Results: During the study, PAS was confirmed in 96 cases which were included. Out of these, 34 (35.4%) cases were included in group A while 62 (64.6%) were diagnosed intraoperatively (group B). The median number of units of blood transfused was lower in group A compared to group B (4 vs 6, p<0.001). The uterus was conserved more often in group A compared with group B (67.6% vs 43.5%, p=0.024) while admission to ICU occurred significantly more often in group B (26.5% vs 59.7%, p=0.002). Maternal death (p=0.038) and perinatal death (p=0.008) were also significantly higher in group B. More neonates delivered to mothers in group B were admitted to NICU (85.7% vs 24%, p=0.033). Survival analysis showed a statistically significant increase in uterine conservation rate in group A compared with group B (log rank, p=0.04). Conclusion: PAS diagnosed antenatally has better fetomaternal outcome than intraoperative detection of PAS. Diagnosing PAS antenatally is therefore crucial to improve management and achieve a better outcome. (
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