Dr Samar Qasem

Clinical profile and outcome of group B streptococcal colonization in mothers and neonates in Ras Al Khaimah, United Arab Emirates: A prospective observational study

Background: Maternal Group B Streptococcus (GBS)/Streptococcus agalactiae colonization rates vary worldwide; however, no such recent data are available from the United Arab Emirates (UAE). Objective: The objective of this study was to determine the prevalence of GBS colonization among pregnant women attending an antenatal clinic of a hospital in Ras Al Khaimah, UAE, along with the antibiotic sensitivity pattern, the clinical profile and pregnancy (maternal and fetal) outcome. Methods: This prospective observational study routinely offered rectovaginal swab for GBS to all women attending the antenatal clinic at 35-37 weeks of pregnancy between January and December 2019. MASTASTREP kit and Vitek-2 identification system was used for culture and identification. Women with positive cultures were followed up for any maternal and neonatal complications and the use of intrapartum antibiotic prophylaxis (IAP). Results: A total of 2295 women were included, of which 158 (6.9%) had positive cultures for GBS colonization. The carriage rate was higher in women without any risk factors for early-onset GBS disease (EOGBS) (P < 0.01). The GBS isolates were about 97% susceptible to linezolid and vancomycin, 90% to benzyl penicillin and 95% to ampicillin. Resistance to trimethoprim/sulfamethoxazole, clindamycin, erythromycin, and levofloxacin were about 77%, 57%, 57%, and 10%, respectively. Urinary tract infection in GBS colonized women were more common in those aged ≤30 years (P = 0.009). Fetal outcome was favorable in women receiving IAP for GBS colonization. No neonate had culture proven EOGBS. Conclusion: The prevalence of GBS colonization in pregnant women as well as the overall maternal and neonatal complications is low in Ras Al Khaimah, UAE. IAP is effective in preventing early-onset sepsis in newborn, and thus should be initiated in those with GBS colonization. The cultured GBS showed sensitivity to most antibiotics.

Chorioangioma of Placenta: A Case of Incidental Finding in Cesarean Section | Biores Scientia

Background: Chorioangioma is a benign angioma of placenta arising from chorionic tissue. Large chorioangioma are known to have adverse effects on both mother and fetus. The incidence is 1% of all pregnancies. Large chorioangioma can result in polyhydramnios, hydrops fetalis, intrauterine growth retardation, sudden intrauterine fetal death, preterm labor and neonatal death associated with congestive cardiac failure. Case: We report a case of incidental finding of chorioangioma of placenta in a 42 years old female with intrauterine growth restriction, and fetal distress at 39 weeks gestation that necessitated on emergency lower segment cesarean section at 39 weeks gestation. postpartum period was uneventful. Conclusion: The high risk of morbidity and mortality associated with large chorioangiomas warrants institutional antenatal care and timely delivery. Keywords: placenta; intrauterine growth restriction; fetal distress; emergency lower segment cesarean section