Ankita Jain

Abstract

Objectives: To study the effect of SARS-CoV-2 Infection on maternal, fetal and neonatal outcomes. Materials and Methods: A retrospective cohort study was undertaken in a tertiary Covid Care Centre (CCC), Ahmedabad, Gujarat, India. The study was conducted from 1st April 2021 to 30th June 2021. A total of 22 symptomatic antenatal patients diagnosed with SARS-CoV-2 by RT-PCR method were included. Results: The mean age of the mothers was 30.2 ± 4.0 years and the mean gestational age was 29.7 ± 9.1 weeks. Six (27.3%) patients required intensive care unit (ICU) admission. 63.7% of the subjects required respiratory support i.e. 40.9% with nasal oxygen therapy and 22.7% with invasive ventilation. Six Intrauterine fetal death were also recorded. Only two neonates (born at 37 and 38 weeks of gestation, respectively) both with low Apgar scores at 1st minute & 5th minute experienced respiratory distress and required neonatal ICU (NICU) admission. Among them, only one neonatal death was recorded because of the diffuse exudative lesions & lung whiteout. The current study had the maternal mortality rate of 13.6% (3/22) owing to various medical complications with two of them succumbing to multiple organ failure with Disseminated intravascular coagulation (DIC) & one patient to sepsis with DIC. Conclusion: The clinical course of COVID?19 during pregnancy appears to be unique to each patient, with a higher incidence of DIC and multiorgan failure. Hence, a multidisciplinary team approach is vital in individualising the timing, mode for delivery, and course of management in these patients.   Keywords: COVID- 19 infection in pregnancy, Maternal and perinatal outcome, Obstetric complications

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Abstract

Introduction: The studies on In-Hospital Cardiac Arrest are limited by the fact that most of them are carried out for patient admitted in ICU. Particularly for ward patients, there lies a big void in literature and hence this research study was undertaken in order to study the clinical outcome of in-hospital cardiac arrest for the patients admitted in ward. Materials and Methods: A hospital based observational study among 119 patients was undertaken to evaluate the clinical outcome of In-Hospital cardiac arrest in patients presented to Deenanath Mangeshkar Hospital & Research Centre, Pune over a period of 2 years. Results: Male to female ratio of cardiac arrest patients was 1.8:1 with higher incidence in age group 61-70 years (28.6%). 44 patients that were admitted in ward in first place, 25% (11 patients) survived 24 hours post resuscitation and a total of 4 patients were discharged from the hospital. Rest 75 patients required ICU admission initially and were later sent to ward where they sustained a cardiac arrest. 24 patients (32%) from this group survived 24 hours post cardiopulmonary resuscitation and 12 patients (16%) were discharged from the hospital later.Out of 119 patients, 55.5% patients had revival immediately post resuscitation and 44.5% patients died post resuscitation. Conclusion: Patient with shockable initial rhythm on monitor had better outcomes than non-shockable rhythm so early defibrillation is advised in shockable rhythm. Of all the patients who had a cardiac arrest, those with cardiac causes and electrolytes disturbance as a preceding cause of arrest had a better outcome.   Keywords: Institutional outcome, Emergency department CPR, Cardiac arrest outcome

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