Objective: To study the demographic characteristics of pregnant ladies and factors contributing towards rise in cesarean section on maternal request to aid the obstetricians in decision making.
Study Design: Cross sectional analytical survey.
Place and Duration: Gynecology Department of Pak Emirates Military Hospital, Rawalpindi, from Nov 2019 to Mar 2020.
Methodology: One hundred and fifteen women of child bearing age requesting cesarean section were included in the study. Demographic details were noted. A study proforma was filled for determinants of primary and secondary tocophobia and factors that may be improved for vaginal delivery.Results: A total of 115 patients with mean age of 27.99 years were included. Amongst them, 88 (76.5%) were Punjabi with 92 (80%) living in rural area. Primigravida were 11 (9.6%), 83 (72.2%) had previous lower segment cesarean section and 3 (2.6%) had vaginal delivery. For primary tocophobia, 22 ( 24.4%) experienced anxiety. Fear of labor pains was seen in 20 (19.2%) and lack of control in 27 (26%). For secondary tocophobia, 15 (37.5%) were fearful of prolonged labor and 5 (22.5%) of sub optimal birth outcome. In women with previous one cesarean section, 13 (14.8%) correlated negatively with birth experience and 20 (22.7%) found timed cesarean section convenient. For vaginal delivery, pain relief was preferred by 19 (20.2%) and 31 (33%)wanted pain relief and attendant.
Conclusion: Better understanding of fears behind maternal request for cesarean section can lead to improved attitudes towards vaginal delivery. The negative perceptions of pregnant ladies should be addressed in antenatal.........
Objective: To determine the clinical course and outcome of hospitalized pregnant patients with laboratory confirmed SARS CoV-2 (COVID-19) infection
Study Design: Prospective longitudinal study
Place and Duration of Study: Obstetrics Units of Pak Emirates Military Hospital and Combined Military Hospital, Rawalpindi Pakistan, from May to Jun 2020.
Methodology: All patients reporting for childbirth were tested for SARS-CoV-2, and those testing positive were included. The primary outcome was virus clearance time and categorization according to the severity of the disease into asymptomatic,mild, moderate, severe and critical. Furthermore, a comparison was made between the presence of comorbid conditions and symptoms in the category of COVID-19. In addition, neonatal sample evaluation for SARS-CoV-2 was done.
Results: Out of the 881 women giving birth, 41(4.6%) tested positive for SARS Cov-2. Majority were asymptomatic 28(68.3%)followed by mild 8(19.5%), moderate 4(9.8%) and severe 1(2.4%) category. There was a significant association of the COVID categories with symptoms (p-value<0.005) and comorbid condition (p-value<0.001). The mean virus clearance time was 8.20±1.66 days. During hospital stay 34(82.9%) delivered. All 34(100%) delivered babies had no evidence of vertical transmission.
Conclusion: Pregnant women with COVID-19 infection have a nearly similar clinical course to non-COVID women in this study. There is also no evidence of vertical transmission to the neonate.
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