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Article ; Online: Monkeypox and pregnancy.

Carvajal, Ana / Vigil-De Gracia, Paulino

American journal of obstetrics & gynecology MFM

2022 Volume 4, Issue 6, Page(s) 100746

Abstract: In May 2022, the World Health Organization reported an emerging global outbreak of monkeypox virus infection. Clinical manifestations of monkeypox allow us to quickly suspect the disease. Until now, no pregnant women infected with this virus have been ... ...

Abstract	In May 2022, the World Health Organization reported an emerging global outbreak of monkeypox virus infection. Clinical manifestations of monkeypox allow us to quickly suspect the disease. Until now, no pregnant women infected with this virus have been reported; however, because of its speed of spread worldwide, it is possible that we will soon observe such cases. Thus, it is necessary for obstetrician-gynecologists to know the disease, its clinical manifestations, and the experiences reported in the few previous cases in pregnant women.
MeSH term(s)	Female ; Humans ; Pregnancy ; Health Personnel ; Mpox (monkeypox)/diagnosis ; Mpox (monkeypox)/epidemiology ; Mpox (monkeypox)/prevention & control ; Premature Birth ; Stillbirth ; Abortion, Spontaneous ; Pregnancy Complications, Infectious ; Pregnancy Outcome
Language	English
Publishing date	2022-09-06
Publishing country	United States
Document type	Journal Article
ISSN	2589-9333
ISSN (online)	2589-9333
DOI	10.1016/j.ajogmf.2022.100746
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Preeclampsia: Narrative review for clinical use

Vigil-De Gracia, Paulino / Vargas, C. / Sánchez, Joanne / Collantes-Cubas, Jorge

Heliyon. 2023 Mar. 01, p.e14187-

2023

Abstract: Preeclampsia is a very complex multisystem disorder characterized by mild to severe hypertension. PubMed and the Cochrane Library were searched from January 1, 2002 to March 31, 2022, with the search terms "pre-eclampsia" and "hypertensive disorders in ... ...

Abstract	Preeclampsia is a very complex multisystem disorder characterized by mild to severe hypertension. PubMed and the Cochrane Library were searched from January 1, 2002 to March 31, 2022, with the search terms "pre-eclampsia" and "hypertensive disorders in pregnancy". We also look for guidelines from international societies and clinical specialty colleges and we focused on publications made after 2015. The primary issue associated with this physiopathology is a reduction in utero-placental perfusion and ischemia. Preeclampsia has a multifactorial genesis, its focus in prevention consists of the identification of high and moderate-risk clinical factors. The clinical manifestations of preeclampsia vary from asymptomatic to fatal complications for both the fetus and the mother. In severe cases, the mother may present renal, neurological, hepatic, or vascular disease. The main prevention strategy is the use of aspirin at low doses, started from the beginning to the end of the second trimester and maintained until the end of pregnancy. Preeclampsia is a multisystem disorder; we do not know how to predict it accurately. Acetylsalicylic acid at low doses to prevent a low percentage, especially in patients with far from term preeclampsia. There is evidence that exercising for at least 140 min per week reduces gestational hypertension and preeclampsia. Currently, the safest approach is the termination of pregnancy. It is necessary to improve the prediction and prevention of preeclampsia, in addition, better research is needed in the long-term postpartum follow-up.
Keywords	aspirin ; fetus ; hypertension ; ischemia ; pathophysiology ; pre-eclampsia ; prediction ; pregnancy ; High risk ; Eclampsia ; Preeclampsia ; Prevention ; Exercise and pregnancy
Language	English
Dates of publication	2023-0301
Publishing place	Elsevier Ltd
Document type	Article ; Online
Note	Pre-press version ; Use and reproduction
ZDB-ID	2835763-2
ISSN	2405-8440
ISSN	2405-8440
DOI	10.1016/j.heliyon.2023.e14187
Database	NAL-Catalogue (AGRICOLA)

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Article: Preeclampsia: Narrative review for clinical use.

Vigil-De Gracia, Paulino / Vargas, Carlos / Sánchez, Joanne / Collantes-Cubas, Jorge

Heliyon

2023 Volume 9, Issue 3, Page(s) e14187

Abstract: Aim: Preeclampsia is a very complex multisystem disorder characterized by mild to severe hypertension.: Methods: PubMed and the Cochrane Library were searched from January 1, 2002 to March 31, 2022, with the search terms "pre-eclampsia" and " ... ...

Abstract	Aim: Preeclampsia is a very complex multisystem disorder characterized by mild to severe hypertension. Methods: PubMed and the Cochrane Library were searched from January 1, 2002 to March 31, 2022, with the search terms "pre-eclampsia" and "hypertensive disorders in pregnancy". We also look for guidelines from international societies and clinical specialty colleges and we focused on publications made after 2015. Results: The primary issue associated with this physiopathology is a reduction in utero-placental perfusion and ischemia. Preeclampsia has a multifactorial genesis, its focus in prevention consists of the identification of high and moderate-risk clinical factors. The clinical manifestations of preeclampsia vary from asymptomatic to fatal complications for both the fetus and the mother. In severe cases, the mother may present renal, neurological, hepatic, or vascular disease. The main prevention strategy is the use of aspirin at low doses, started from the beginning to the end of the second trimester and maintained until the end of pregnancy. Conclusion: Preeclampsia is a multisystem disorder; we do not know how to predict it accurately. Acetylsalicylic acid at low doses to prevent a low percentage, especially in patients with far from term preeclampsia. There is evidence that exercising for at least 140 min per week reduces gestational hypertension and preeclampsia. Currently, the safest approach is the termination of pregnancy. It is necessary to improve the prediction and prevention of preeclampsia, in addition, better research is needed in the long-term postpartum follow-up.
Language	English
Publishing date	2023-03-01
Publishing country	England
Document type	Journal Article
ZDB-ID	2835763-2
ISSN	2405-8440
ISSN	2405-8440
DOI	10.1016/j.heliyon.2023.e14187
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Article ; Online: COVID-19 epidemic in Panama

Paulino Vigil-De Gracia / Ilan Delgado / Elias Saban / Pablo Vigil-Vargas / Roberto C. Cerrud-Rodríguez

Heliyon, Vol 10, Iss 1, Pp e23630- (2024)

1481

Abstract: Objective: It is necessary to establish the evolution that the pandemic has had in Panama by weeks and months and to clearly establish the existence of surges or peaks, according to cases and deaths and the relationship with age groups. Methodology: We ... ...

Abstract	Objective: It is necessary to establish the evolution that the pandemic has had in Panama by weeks and months and to clearly establish the existence of surges or peaks, according to cases and deaths and the relationship with age groups. Methodology: We conducted a retrospective cohort study of all confirmed COVID-19 cases reported by the Ministry of Health of Panama during the first 3 years of the epidemic (March 9, 2020, March 11, 2023). All cases were obtained from information provided by the Ministry of Health. We obtained daily information of the population at the national level reported as new cases, deaths, admission to hospitals, admission to intensive care units and by age groups. The information is classified by epidemiological week and by month from the diagnosis of the first case until March 2023. Results: During the three years of the study, 1,032,316 cases of COVID-19 were registered in the Republic of Panama, and the number of deaths reported was 8,621, for a fatality rate of 0.83 % throughout that period. The number of deaths decreased over the 3 years of the pandemic; however, similar to the cases, there were periods of surges (peaks) per year in June/July and in December/January. The lethality progressively increased according to the age of the affected patients. During the first year, the lethality in those under 20 years of age was 0.05 %, and in those over 80 years old, it was 17.54 %. This pattern was maintained during the second year; however, there was a large decrease in all age groups. Conclusion: the highest lethality rate in Panama occurred in the first year of the pandemic, with a great decrease in the third year; the impact of lethality is proportional to the age of the individual, with a high possibility of death in those over 80 years of age. During each pandemic year, there are two peaks (surges of new cases and deaths) per year, which are important times to take into account to generate strategies aimed at reducing the impact.
Keywords	COVID-19 ; Panamá ; Infection disease ; Deaths ; Lethality rate ; Science (General) ; Q1-390 ; Social sciences (General) ; H1-99
Language	English
Publishing date	2024-01-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
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Article: COVID-19 epidemic in Panama.

Vigil-De Gracia, Paulino / Delgado, Ilan / Saban, Elias / Vigil-Vargas, Pablo / Cerrud-Rodríguez, Roberto C

Heliyon

2023 Volume 10, Issue 1, Page(s) e23630

Abstract	Objective: It is necessary to establish the evolution that the pandemic has had in Panama by weeks and months and to clearly establish the existence of surges or peaks, according to cases and deaths and the relationship with age groups. Methodology: We conducted a retrospective cohort study of all confirmed COVID-19 cases reported by the Ministry of Health of Panama during the first 3 years of the epidemic (March 9, 2020, March 11, 2023). All cases were obtained from information provided by the Ministry of Health. We obtained daily information of the population at the national level reported as new cases, deaths, admission to hospitals, admission to intensive care units and by age groups. The information is classified by epidemiological week and by month from the diagnosis of the first case until March 2023. Results: During the three years of the study, 1,032,316 cases of COVID-19 were registered in the Republic of Panama, and the number of deaths reported was 8,621, for a fatality rate of 0.83 % throughout that period. The number of deaths decreased over the 3 years of the pandemic; however, similar to the cases, there were periods of surges (peaks) per year in June/July and in December/January Conclusion: the highest lethality rate in Panama occurred in the first year of the pandemic, with a great decrease in the third year; the impact of lethality is proportional to the age of the individual, with a high possibility of death in those over 80 years of age. During each pandemic year, there are two peaks (surges of new cases and deaths) per year, which are important times to take into account to generate strategies aimed at reducing the impact.
Language	English
Publishing date	2023-12-16
Publishing country	England
Document type	Journal Article
ZDB-ID	2835763-2
ISSN	2405-8440
ISSN	2405-8440
DOI	10.1016/j.heliyon.2023.e23630
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Article ; Online: Conservative management of early-onset severe preeclampsia: comparison between randomized and observational studies a systematic review.

Vigil-De Gracia, Paulino / Ludmir, Jack

The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians

2020 Volume 35, Issue 16, Page(s) 3182–3189

Abstract: Objective: To compare maternal and perinatal outcomes between randomized trials and observational studies in which conservative management was performed for more than 48 h in patients with early-onset severe preeclampsia.: Methodology: We searched ... ...

Abstract	Objective: To compare maternal and perinatal outcomes between randomized trials and observational studies in which conservative management was performed for more than 48 h in patients with early-onset severe preeclampsia. Methodology: We searched PubMed, LILACS, Cochrane and Google Scholar. The studies were divided in two groups: randomized and observational studies, from 1990 to 2018 that included patients with severe preeclampsia before 34 weeks of gestation with pregnancy prolongation ≥48 h but that did not include fetal growth restriction or HELLP syndrome at the beginning. The main variables recorded were maternal and perinatal complications. Main results: Forty-four studies met the inclusion criteria, and 5 of these were randomized. The average pregnancy prolongation was 9 days, with no difference between groups. Maternal complications were significantly more common in observational studies, RR = 0.71, 95% CI (0.54-0.93), Conclusion: Observational studies in which conservative management of early-onset preeclampsia is performed and do not include patients with fetal growth restriction or patients with HELLP syndrome and where at least 2 days of pregnancy prolongation is achieved are associated with significantly more maternal and perinatal complications.
MeSH term(s)	Cesarean Section ; Conservative Treatment ; Female ; Fetal Growth Retardation ; HELLP Syndrome/epidemiology ; HELLP Syndrome/therapy ; Humans ; Infant, Newborn ; Pre-Eclampsia/epidemiology ; Pre-Eclampsia/therapy ; Pregnancy
Keywords	covid19
Language	English
Publishing date	2020-09-10
Publishing country	England
Document type	Journal Article ; Systematic Review
ZDB-ID	2077261-0
ISSN	1476-4954 ; 1057-0802 ; 1476-7058
ISSN (online)	1476-4954
ISSN	1057-0802 ; 1476-7058
DOI	10.1080/14767058.2020.1814249
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Article ; Online: Preeclampsia

Paulino Vigil-De Gracia / Carlos Vargas / Joanne Sánchez / Jorge Collantes-Cubas

Heliyon, Vol 9, Iss 3, Pp e14187- (2023)

Narrative review for clinical use

2023

Abstract: Aim: Preeclampsia is a very complex multisystem disorder characterized by mild to severe hypertension. Methods: PubMed and the Cochrane Library were searched from January 1, 2002 to March 31, 2022, with the search terms “pre-eclampsia” and “hypertensive ... ...

Abstract	Aim: Preeclampsia is a very complex multisystem disorder characterized by mild to severe hypertension. Methods: PubMed and the Cochrane Library were searched from January 1, 2002 to March 31, 2022, with the search terms “pre-eclampsia” and “hypertensive disorders in pregnancy”. We also look for guidelines from international societies and clinical specialty colleges and we focused on publications made after 2015. Results: The primary issue associated with this physiopathology is a reduction in utero-placental perfusion and ischemia. Preeclampsia has a multifactorial genesis, its focus in prevention consists of the identification of high and moderate-risk clinical factors. The clinical manifestations of preeclampsia vary from asymptomatic to fatal complications for both the fetus and the mother. In severe cases, the mother may present renal, neurological, hepatic, or vascular disease. The main prevention strategy is the use of aspirin at low doses, started from the beginning to the end of the second trimester and maintained until the end of pregnancy. Conclusion: Preeclampsia is a multisystem disorder; we do not know how to predict it accurately. Acetylsalicylic acid at low doses to prevent a low percentage, especially in patients with far from term preeclampsia. There is evidence that exercising for at least 140 min per week reduces gestational hypertension and preeclampsia. Currently, the safest approach is the termination of pregnancy. It is necessary to improve the prediction and prevention of preeclampsia, in addition, better research is needed in the long-term postpartum follow-up.
Keywords	Aspirin ; High risk ; Eclampsia ; Preeclampsia ; Prevention ; Exercise and pregnancy ; Science (General) ; Q1-390 ; Social sciences (General) ; H1-99
Subject code	610
Language	English
Publishing date	2023-03-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Perinatal transmission with SARS-CoV-2 and route of pregnancy termination: a narrative review.

Vigil-De Gracia, Paulino / Luo, Carlos / Epifanio Malpassi, Roberto

2020 Volume 35, Issue 15, Page(s) 2949–2953

Abstract: Objective: Analyze newborns diagnosed with SARS-CoV-2 performed with RT-PCR at birth or during the first days of birth and to look for an association with the route of birth.: Methods: We conducted a comprehensive literature search for newborns ... ...

Abstract	Objective: Analyze newborns diagnosed with SARS-CoV-2 performed with RT-PCR at birth or during the first days of birth and to look for an association with the route of birth. Methods: We conducted a comprehensive literature search for newborns diagnosed with COVID-19 using PubMed, LILACS and Google scholar until May 15, 2020, looking for published articles with pregnancy, vertical transmission, intrauterine transmission, neonates, delivery. Results: There were found 10 articles with a total of 15 newborn infected with SARS-CoV-2 according to positive PCR at birth or in the first days of birth. Eleven newborn birth by cesarean section and 4 vaginally. Of the 11 cases with cesarean section, two presented premature rupture of the membranes. Seven newborns developed pneumonia, of which two had ruptured membranes and one was born by vaginal delivery. Conclusion: This review shows that there is perinatal or neonatal infection with SARS-CoV-2 by finding a positive PCR in the first days of birth. In addition, that there is more possibility of neonatal infection if the birth is vaginal or if there is premature rupture of the membranes before cesarean section. Vaginal delivery and premature rupture of membranes should be considered as risk factors for perinatal infection.
MeSH term(s)	Abortion, Induced ; COVID-19 ; Cesarean Section ; Female ; Humans ; Infant, Newborn ; Infectious Disease Transmission, Vertical ; Pregnancy ; Pregnancy Complications, Infectious/diagnosis ; Pregnancy Complications, Infectious/epidemiology ; Pregnancy Outcome ; Premature Birth ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-07-26
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2077261-0
ISSN	1476-4954 ; 1057-0802 ; 1476-7058
ISSN (online)	1476-4954
ISSN	1057-0802 ; 1476-7058
DOI	10.1080/14767058.2020.1788533
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Article ; Online: Expectant management of mild preeclampsia.

Vigil-De Gracia, Paulino

American journal of obstetrics and gynecology

2015 Volume 213, Issue 5, Page(s) 749–750

MeSH term(s)	Female ; Hospitalization ; Humans ; Hypertension/therapy ; Pre-Eclampsia/therapy ; Pregnancy ; Pregnancy Complications, Cardiovascular/therapy ; Watchful Waiting
Language	English
Publishing date	2015-11
Publishing country	United States
Document type	Comment ; Letter
ZDB-ID	80016-8
ISSN	1097-6868 ; 0002-9378
ISSN (online)	1097-6868
ISSN	0002-9378
DOI	10.1016/j.ajog.2015.07.006
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Article ; Online: Dexamethasone in HELLP syndrome: experience in Bolivia.

Añez-Aguayo, María Yuly / Vigil-De Gracia, Paulino

2018 Volume 33, Issue 1, Page(s) 1–4

Abstract: Objective: ...

Abstract	Objective:
MeSH term(s)	Adult ; Blood Platelets/drug effects ; Blood Platelets/pathology ; Bolivia/epidemiology ; Cross-Sectional Studies ; Dexamethasone/administration & dosage ; Dexamethasone/therapeutic use ; Drug Administration Schedule ; Female ; HELLP Syndrome/drug therapy ; HELLP Syndrome/epidemiology ; Humans ; Platelet Count ; Postnatal Care/methods ; Postpartum Period/blood ; Postpartum Period/drug effects ; Practice Patterns, Physicians'/statistics & numerical data ; Pregnancy ; Treatment Outcome ; Young Adult
Chemical Substances	Dexamethasone (7S5I7G3JQL)
Language	English
Publishing date	2018-07-18
Publishing country	England
Document type	Journal Article
ZDB-ID	2077261-0
ISSN	1476-4954 ; 1057-0802 ; 1476-7058
ISSN (online)	1476-4954
ISSN	1057-0802 ; 1476-7058
DOI	10.1080/14767058.2018.1482272
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