Introduction
The possibility of vertical transmission of SARS-CoV-2 from the mother to the fetus is one of the most crucial issues regarding the COVID-19 effects on pregnancy. In this study, we aimed to explore the risk of maternal-fetal transmission before 24 weeks of gestation, through analysis of abortion materials collected from PCR-positive women with pregnancy loss. To the best of our knowledge, apart from case reports, this study is the first prospective work on the vertical transmission of SARS-CoV-2 in early pregnancy.
Methods
The patients who had attended our clinic with the diagnosis of pregnancy loss before 24 weeks of gestation were screened for COVİD-19. Vertical transmission in PCR-positive women was assessed through the presence of SARS-CoV-2 RNA in fetal-placental tissues by rt-PCR test.
Results
24 of 210 (%11,4) pregnant women participating in the study had positive rt-PCR results. Placenta and curettage material samples of these PCR-positive patients were analyzed and all valid test results (21 samples) were negative for SARS CoV-2 RNA. In three cases, the rt-PCR results were invalid due to failed internal controls.
Amaç: Çalışmamızda 2005-2012 yılları arasındaki sezaryenlerin yıllara göre dağılımını, sezaryen endikasyonlarını ve epidemiyolojik değişimleri karşı-laştırarak, geleceğe yönelik yapılması gerekenleri tartışmak amaçlanmıştır.Yöntemler: İstanbul Eğitim Araştırma Hastanesi Kadın Hastalıkları ve Doğum Kliniği'nde 2005-2012 yılları arasındaki 10499 doğum içinden sezaryen uygulanan 4137 hastanın dosyaları retrospektif olarak incelendi. Yılla-ra göre sezaryenle doğum yapmış hastalar sezaryen endikasyonlarına, yaş gruplarına, gebelik haftalarına, doğum ağırlıklarına, bebek cinsiyetlerine, sezaryende tercih edilen anestezi türüne ve sezaryenin normal doğuma oranlarına göre yıllık bazda değerlendirildi ve karşılaştırıldı. Results: Cesarean section was performed for 32.5% and 40.1% patients in 2005 and 2012, respectively. The main indications were previous uterine surgery (44.5%), fetal distress (18.3%) and cephalopelvic disproportion (33.7%). There was no statistical difference in terms of gravida, parity, anesthesia, and birth weight in either year. However, cesarean rates were significantly increased in the last four years of the study period in comparison with the first four years.
Conclusion:Rates of caesarean section are increasing. To counteract this trend, patients should be informed about the benefits of vaginal delivery and be encouraged to attempt vaginal delivery after cesarean section now that the skills of staff in delivery clinics are improving. Clinicians and patients must be aware of side effects of elective cesarean sections. Pain management during delivery may be considered as a means of reversing the increasing cesarean rates.
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