Caring for Pregnant Patients with COVID-19: Practical Tips Getting from Policy to Practice

Abstract

Novel coronavirus disease 2019 (COVID-19) is a pandemic with most American cases in New York. As an institution residing in a high-prevalence zip code, with over 8,000 births annually, we have cared for over 80 COVID-19-infected pregnant women, and have encountered many challenges in applying new national standards for care. In this article, we review how to change outpatient and inpatient practices, develop, and disseminate new hospital protocols, and we highlight the psychosocial challenges for pregnant patients and their providers.

Maternal-embryonic approach at Covid-19:

“…18,21 It is also important to remember that virtual consultations can provide women with a feeling of decreased care, so a longer duration should be considered compared to face-to-face, in addition to explaining that face-to-face service will remain available for any complications. 18,22 According to London et al 22 first, the identification of patients with scheduled appointments for a tracking of symptoms and exposure to the virus must be done by telephone before their presentation at the office. When there is a positive detection of the questions, postponing the visit for 14 days and/or postponing it for at least eight days after the symptoms cease are indicated.…”

“…It is of great importance that all patients referred for screening or scheduled for cesarean section be screened, at least for symptoms related to Covid-19 before the presentation. 19,22 Ideally, hospitals should provide examinations at the entrance, including for visitors who accompany patients.…”

“…The waiting room may need to be readjusted, removing most chairs to prevent large groups from congregating or creating a closed space for patient entry. 22 It is advisable that the availability of specific recovery rooms for diagnosed patients, which may be one elective operating room that is not being used, for example, or another adaptable location. 19 One of the biggest challenges faced in Brazil is still the scarcity of the laboratory test for Covid-19 and/or the long waiting time for the result, which limits the ability to organize and protect patients.…”

“…So, if identified as possible, it should it is strongly advised that pregnant patients take a test near the end of pregnancy, thereby limiting exposure. 22 Strict screening of companions should be part of the protocol, including mandatory temperature measurement for all and allowing only one during the entire hospitalization. The technology can also help support systems during hospitalizations, such as virtual doulas, telephone and video connections, whose potential is significant to relieve the patient's anxiety.…”

During The Second Wave Of COVID-19, Don't Forget About Influenza. A Call to Action

“…Obstetricians at our institution have cared for well over 200 COVID-19-infected pregnant women, and are acutely aware of the herculean effort it took to reorganize the service to accommodate the needs of women infected with this new pathogen. 1 Many institutions, including ours, modified the frequency of prenatal visits, among other measures, to minimize in-person contacts, in an effort to reduce the likelihood of viral spread. However, it is those changes, along with our prior experience of treating women unimmunized against influenza that leads to our concern that a singular focus on COVID-19 could leave pregnant women at risk from a more familiar threat.…”