Obstetric and perinatal care units functioning during the COVID-19 pandemic

Abstract

The rapid spread of COVID-19 and the large number of cases put a significant burden on the health systems of any developed country. Specialists in natural disasters and military medicine should be involved in the provision of medical care and observance of anti-epidemic measures. In some countries, including Italy, they were involved only after the situation was dramatically worsening with many clinical units and hospitals overloaded by infected patients. To curb the spread of COVID-19, most countries declared a state of emergency, and unprecedented measures have been taken to strengthen quarantine in suspected or positive symptomatic subjects. Nevertheless, the crisis associated with the unexpectedly global scale and tragedy of the pandemic and the inconsistency of actions of both society and individuals and specialized medical services, lead to insufficient effectiveness of the measures taken in a number of regions. In the present day, it is vital for every person to change its mindset ― relying on personal responsibility to comply with all recommendations of quarantine and anti-epidemic measures, and to reorganize departments and resources of medical institutions at all levels in order to withstand the spread of infection and at the same time provide all those in need with the necessary and appropriate medical care. Particular attention should be paid to the obstetric care service, given that even in normal times, the obstetric hospital is an area of increased responsibility for the life and health of mother and child and future mankind. Fulfillment of existing orders, instructions of national and regional committees, international and national protocols and clinical protocols should undoubtedly lead to a positive result, but this requires additional training of medical personnel at all levels. The purpose of this review is to propose quick key strategies for reassessing the maternity and neonatal wards/ hospitals based on the experience of health systems and organizations which faced the spread of this new coronavirus; this advice may be applied along with binding tight instructions in obstetric hospitals in order to proactively respond to a likely wave of growth in COVID-19.

COVID-19 in pregnant women of Siberia and the Far East. Article

“…Полученные результаты согласуются с данными, опубликованными ранее в Китае и Италии, о том, что течение COVID-19 у беременных не является более тяжелым, чем в популяции женщин репродуктивного возраста [6,[12][13][14][15][16][17].…”

“…Одним из наиболее противоречивых и нерешенных аспектов проблемы COVID-19 остаются аспекты заболевания у беременных. Во многих опубликованных литературных источниках обсуждаются вопросы особенностей течения инфекции у беременных и риска вертикальной передачи инфекции, вопросы организации медицинской, в том числе акушерской помощи беременным, роженицам и родильницам с этим заболеванием, показания к госпитализации в стационар, вопросы лучевой диагностики вирусной пневмонии, возможности проведения и показания к этиотропной терапии, а также вопрос разлучения с ребенком и грудного вскармливания [1,12]. Однако в настоящее время имеются про-тиворечивые данные относительно большей подверженности беременных коронавирусной инфекции из-за изменений в организме (прежде всего, в органах дыхательной и иммунной системы) [2,4].…”

COVID-19, neutrophil extracellular traps and vascular complications in obstetric practice

“…In severe cases of the disease manifested up to 12 weeks of gestation due to the high risk of perinatal complications associated with both the indirect effect of a viral infection (hyperthermia) and the potential embryotoxic effect of drugs, pregnancy termination during or after treatment of the infection is an option. If the patient does not intend to terminate pregnancy, chorionic villus sampling before 12-14 weeks or amniocentesis at 16 weeks of gestation may be offered in order to detect fetal chromosomal abnormalities [53].…”