Increased rate of ruptured ectopic pregnancy in COVID‐19 pandemic: analysis from the North of Italy

Casadio, Paolo; Youssef, A.; Arena, Alessandro; Gamal, N.; Pilu, Gianluigi; Seracchioli, Renato

doi:10.1002/uog.22126

Cited by 27 publications

(49 citation statements)

References 5 publications

(5 reference statements)

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“…n a l P r e -p r o o fCOVID 19 or administration of oxygen therapy should not be an indication for premature extraction if stabilization of respiratory condition is possible. This was the case for two of our patients and another one reported by Federici et al[14].Many authors[21,22,23] alerted about collateral damage, deleterious effects caused by the restrictions taken to limit the spread of the pandemic. Pregnant women who have multiple interactions with the health care system can been greatly affected by these actions.…”

supporting

confidence: 60%

See 1 more Smart Citation

Maternal, fetal and neonatal outcomes of large series of SARS-CoV-2 positive pregnancies in peripartum period: A single-center prospective comparative study

Hcini

Maamri

Picone

et al. 2021

European Journal of Obstetrics & Gynecology and Reproductiv

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supporting

confidence: 60%

“…Many authors [ 21 , 22 , 23 ] alerted about collateral damage, deleterious effects caused by the restrictions taken to limit the spread of the pandemic. Pregnant women who have multiple interactions with the health care system can been greatly affected by these actions.…”

Section: Discussionmentioning

confidence: 99%

Maternal, fetal and neonatal outcomes of large series of SARS-CoV-2 positive pregnancies in peripartum period: A single-center prospective comparative study

Hcini

Maamri

Picone

et al. 2021

European Journal of Obstetrics & Gynecology and Reproductiv

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“…Similarly, at NH, the prevalence of EP among women presented with early pregnancy care with abdominal pain and/or vaginal bleeding in pre-pandemic (from 2016-2020) and pandemic period was 18.92% and 17.65% respectively. Recently published analysis from Italy demonstrated increased proportion of ruptured ectopic pregnancies during the lockdown in comparison with the pre-lockdown period [8]. In contrast to this, our hospital data does not show any increase in the incidence of ruptured EP when compared to prepandemic period.…”

Section: Discussioncontrasting

confidence: 99%

Should Open Surgery or Conservative Management be the Choice for Treatment of Ectopic Pregnancy during COVID-19 Pandemic in a Resource-Poor Setting? A Case Series from India.

Pednekar

Mahajan

Tirkey

et al. 2020

Preprint

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Background: As the COVID-19 pandemic is progressing, it is posing several challenges for management of health emergencies either by direct impact or through the restrictive policies adopted by several nations worldwide. Currently, there is no information on management of ectopic pregnancies associated with COVID-19 in low resource settings. We report the management of three cases of ectopic pregnancies in a limited resource setting and also describe the challenges we faced in managing these cases at a dedicated COVID-19 hospital in India.Case presentation: T.N. Medical College & B.Y.L. Nair Charitable Hospital (NH) received three asymptomatic, RT-PCR confirmed COVID-19 women with ectopic pregnancy (EP). One was caesarean scar pregnancy (CSP), diagnosed on ultrasound and CT examination and managed with multiple fixed dose methotrexate therapy. Other two cases were ruptured EP managed surgically by laparotomy avoiding laparoscopy to reduce the risk of possible viral transmission.Conclusions: Based on our experience, we recommend laparotomy as an option for surgical management of EP in resource poor settings. It is useful for prevention of possible transmission of SARS-CoV-2 infection to healthcare workers from surgical smoke and it is wiser to take a conservative approach in managing EP wherever possible. More studies are needed to completely disregard the possibility of presence of viable SARS-CoV-2 particles in surgical smoke. There is a need to formulate specific guidelines to address the collateral damage.

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“…Of 3592 abstracts screened, 192 were relevant for full-text review and 40 met the inclusion criteria for systematic review ( figure 1 ). 4 , 5 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 A list of excluded studies with reasons for exclusion is provided in the appendix (p 6) . Reporting on resource use or service reconfiguration outcomes is summarised in the appendix (p 27) .…”

Section: Resultsmentioning

confidence: 99%

“…Of the 40 included studies, 31 for which comparable outcomes were also reported in at least one other study were included in the meta-analysis. 4 , 12 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 24 , 25 , 26 , 27 , 28 , 30 , 31 , 32 , 33 , 34 , 37 , 38 , 40 , 42 , 45 , 46 , 47 , 48 , 49 Table 1 shows the characteristics of the 40 included studies, all of which used a historical cohort design. 17 countries were represented, with substantial variation in pandemic mitigation measures among countries.…”

Section: Resultsmentioning

confidence: 99%

Effects of the COVID-19 pandemic on maternal and perinatal outcomes: a systematic review and meta-analysis

Chmielewska

Barratt

Townsend

et al. 2021

The Lancet Global Health

794

820

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Background The COVID-19 pandemic has had a profound impact on health-care systems and potentially on pregnancy outcomes, but no systematic synthesis of evidence of this effect has been undertaken. We aimed to assess the collective evidence on the effects on maternal, fetal, and neonatal outcomes of the pandemic. Methods We did a systematic review and meta-analysis of studies on the effects of the pandemic on maternal, fetal, and neonatal outcomes. We searched MEDLINE and Embase in accordance with PRISMA guidelines, from Jan 1, 2020, to Jan 8, 2021, for case-control studies, cohort studies, and brief reports comparing maternal and perinatal mortality, maternal morbidity, pregnancy complications, and intrapartum and neonatal outcomes before and during the pandemic. We also planned to record any additional maternal and offspring outcomes identified. Studies of solely SARS-CoV-2-infected pregnant individuals, as well as case reports, studies without comparison groups, narrative or systematic literature reviews, preprints, and studies reporting on overlapping populations were excluded. Quantitative meta-analysis was done for an outcome when more than one study presented relevant data. Random-effects estimate of the pooled odds ratio (OR) of each outcome were generated with use of the Mantel-Haenszel method. This review was registered with PROSPERO (CRD42020211753). Findings The search identified 3592 citations, of which 40 studies were included. We identified significant increases in stillbirth (pooled OR 1·28 [95% CI 1·07–1·54]; I 2 =63%; 12 studies, 168 295 pregnancies during and 198 993 before the pandemic) and maternal death (1·37 [1·22–1·53; I 2 =0%, two studies [both from low-income and middle-income countries], 1 237 018 and 2 224 859 pregnancies) during versus before the pandemic. Preterm births before 37 weeks' gestation were not significantly changed overall (0·94 [0·87–1·02]; I 2 =75%; 15 studies, 170 640 and 656 423 pregnancies) but were decreased in high-income countries (0·91 [0·84–0·99]; I 2 =63%; 12 studies, 159 987 and 635 118 pregnancies), where spontaneous preterm birth was also decreased (0·81 [0·67–0·97]; two studies, 4204 and 6818 pregnancies). Mean Edinburgh Postnatal Depression Scale scores were higher, indicating poorer mental health, during versus before the pandemic (pooled mean difference 0·42 [95% CI 0·02–0·81; three studies, 2330 and 6517 pregnancies). Surgically managed ectopic pregnancies were increased during the pandemic (OR 5·81 [2·16–15·6]; I 2 =26%; three studies, 37 and 272 pregnancies). No overall significant effects were identified for other outcomes included in the quantitative analysis: maternal gestational diabetes; hypertensive disorders of pregnancy; preterm birth before 34 weeks', 32 weeks',...

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Increased rate of ruptured ectopic pregnancy in COVID‐19 pandemic: analysis from the North of Italy

Cited by 27 publications

References 5 publications

Maternal, fetal and neonatal outcomes of large series of SARS-CoV-2 positive pregnancies in peripartum period: A single-center prospective comparative study

Maternal, fetal and neonatal outcomes of large series of SARS-CoV-2 positive pregnancies in peripartum period: A single-center prospective comparative study

Should Open Surgery or Conservative Management be the Choice for Treatment of Ectopic Pregnancy during COVID-19 Pandemic in a Resource-Poor Setting? A Case Series from India.

Effects of the COVID-19 pandemic on maternal and perinatal outcomes: a systematic review and meta-analysis

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