Good clinical practice advice for the management of pregnant women with suspected or confirmed COVID‐19 in Nigeria

Abstract

The impact on healthcare services in settings with under-resourced health systems, such as Nigeria, is likely to be substantial in the coming months due to the COVID-19 pandemic, and maternity services still need to be prioritized as an essential core health service. The healthcare system should ensure the provision of safe and quality care to women during pregnancy, labor, and childbirth, and at the same time, maternity care providers including obstetricians and midwives must be protected and prioritized to continue providing care to childbearing women and their babies during the pandemic. This practical guideline was developed for the management of pregnant women with suspected or confirmed COVID-19 in Nigeria and other low-resource countries.

Utilization cost of maternity services for childbirth among pregnant women with coronavirus disease 2019 in Nigeria’s epicenter

“…In Africa, 97% of mothers are delivered by spontaneous vaginal delivery (SVD) or cesarean delivery (CD) 6 . Guidelines have been published on how both SVD and CD should be provided to pregnant women with COVID‐19 in Nigeria in line with global guidance 7 . However, do the revamped services resulting from the guideline come at an additional cost to women?…”

COVID‐19 guidelines for pregnant women and new mothers: A systematic evidence review

“…There was also an emphasis on how proper infection precautions—particularly around aerosol generating procedures—are vital to making breastfeeding and SSC safer for the mother, the newborn, and any close contacts visiting them 22,70 . These precautions included the use of appropriate techniques such as autoclaving and/or solutions such as hydrogen peroxide or sodium hypochlorite to disinfect surfaces, as well as leaving any required equipment, such as breast pumps, in the hospital to decrease the risk of infection 9,23,24,69,74 …”

A Cost Analysis of Childbirth for Pregnant Women with COVID-19 in Nigeria’s Epicentre

“…With such prohibitive costs associated with care of pregnant women with COVID-19, our findings suggest that the age-old adage “prevention is better than cure” might have substantial cost savings implication for pregnant women and indeed for LMIC governments who are still choosing to bear the cost of service utilization. While current guidance proposes telemedicine as a platform to provide ante-natal care (ANC) for pregnant women with suspected or confirmed COVID-19 (Okunade et al ., 2020), scaling this up to include all pregnant women requiring ANC while counselling them to minimize risk of infection around them might help forestall additional cost required to manage COVID-19 in pregnancy. However, this should not be applied as a one-size-fits-all solution, especially for high-risk pregnancies, who need to be seen physically, and those who do not have ‘smart’ phones’ enabled with telemedicine capacity (Green et al ., 2020).…”

“…In Africa, almost all women (97%) are delivered by spontaneous vaginal delivery (SVD) or caesarean delivery (CD), which can be elective (planned) or emergency (Bailey et al ., 2017). Guidelines have been published on how both SVD and CD should be provided to pregnant women with suspected or confirmed COVID-19 in Nigeria in line with global guidance (Okunade et al ., 2020). However, do these revamped services, which are deemed essential to be maintained even during the pandemic (WHO, 2020c), come at an additional cost to women?…”