Vaccination is preventing development of placental pathologies in SARS-CoV-2 infected pregnant patients

INTRODUCTION

The coronavirus disease (COVID-19) has created a serious health problem in pregnant people. We aimed to address whether vaccination can prevent development of placental disease in SARS-CoV-2 infected mothers.

METHODS

We reported the pathology findings obtained from routine histopathological examination of placentas of overall 38 cases.

RESULTS

We found low prevalence of placental pathology in vaccinated pregnant people with active SARS-CoV-2 infection in comparison to those unvaccinated cases.

CONCLUSION

Based on our findings, SARS-CoV-2 vaccination can prevent development of placental pathological lesions and may lower the risk of serious illness in pregnant people.

Do amniotic fluid leptin levels decrease in pregnancies with fetal trisomy 21?

The objective of this study was to find a possible correlation between Down syndrome and amniotic fluid leptin. We compared 2nd trimester amniotic fluid leptin levels of fetuses with normal karyotype and with trisomy 21. We retrospectively found 15 fetuses with Down syndrome and we randomly selected 48 fetuses with normal karyotype as controls from our perinatology record database, in order to analyse their 2nd trimester amniotic fluid leptin levels. Amniotic fluid leptin levels were analysed by enzyme-linked immunosorbent assay (ELISA). The results were evaluated by Mann-Whitney U test. It was found that amniotic fluid leptin levels did not show any significant difference between amniotic fluids of fetuses with normal karyotype and those with trisomy 21 (p = 0.061). Median level of leptin was 10.06 ng/ml (range 2.10-36.69) for trisomy 21 fetuses and 14.53 ng/ml (range 2.30-67.33) for normal fetuses. In conclusion, leptin levels were not found to change in the amniotic fluids of fetuses with trisomy 21. This excludes a possible involvement of leptin in pathogenic processes associated with trisomy 21 during the fetal period and its potential employment as a diagnostic tool.

A case of herpes simplex encephalitis revealed by decompressive craniectomy

A 15-year-old girl was referred to our hospital due to fever, headache, and vomiting of 7 days duration and focal motor convulsion at the day of referral. Her clinical signs and cerebral imaging findings were found to be compatible with herpes simplex encephalitis. In spite of prompt acyclovir administration, her consciousness deteriorated gradually. Emergent cranial magnetic resonance imaging demonstrated a shift of midline intracranial structures. Decompressive surgery resulted in partial improvement in the shift of midline intracranial structures and potentially saved the patient's life. This case report stresses the importance of proper management of increased intracranial pressure in patients with herpes simplex encephalitis.

A patient with rubella encephalitis and status epilepticus

Rubella is an important childhood disease that was historically widespread but is now very infrequent. It is an acute viral infection ordinarily characterized by mild constitutional symptoms. Complications are relatively uncommon in childhood. Encephalitis similar to that seen with measles occurs in about 1 in 6,000 cases. The severity is highly variable, and there is an overall mortality rate of 20%. Symptoms in survivors usually resolve within 1-3 week without neurologic sequelae. An 8.5-year-old boy presented with rubella encephalitis and status epilepticus. Five days before admission the patient had erythematous maculopapular rash on the face, spreading to the trunk and extremities. On the admission day, he had a generalized tonic-clonic seizure with loss of consciousness. Microscopic and cytologic examinations of cerebrospinal fluid showed nonspecific. Electro-encephalography (EEG) showed diffuse slowing. An enzyme linked immunosorbent assay (ELISA) revealed that rubella IgM antibody titer was positive in serum and in cerebrospinal fluid. One day later, the patient became conscious with normal physical condition. As a conclusion, it is possible to prevent the complications of rubella infection, especially the congenital rubella syndrome and encephalitis with a rapid and efficient vaccination program.