Preparing an obstetric unit in the heart of the epidemic strike of COVID-19: quick reorganization tips

Abstract

COVID-19 is placing considerable strain on healthcare systems. Disaster and military medicine specialists were involved in the outbreak in Italy, after many units were overwhelmed. Health providers were caught off guard and personnel was unprepared to face this unprecedented threat. Local decisions accelerated the rate of the spread. Many countries declared a state of emergency and lockdown to contain the exponential transmission of the disease. The purpose of this review is to suggest quick key points of strategies to implement in obstetric units without delay to respond to the oncoming wave, based on experience and feedback from the field. It is essential in an emergency situation to understand what is at stake and prepare maternity wards in the best possible way.

Coronavirus disease 2019 (COVID-19) and pregnancy: a systematic review

“…In this epidemic, it is essential to standardize screening, admission, and management of all suspected/confirmed pregnant women infected with COVID-19 and prepare maternity wards in the best possible way. Management should be performed in accordance with local, federal, and international guidelines, and strategies to quickly implement obstetric units have also been suggested [9,10]. Once a pregnant woman is suspected/confirmed COVID-19 infection, maternal care and childbirth would become complicated and challenging.…”

Improving the quality of care in pregnancy and childbirth with coronavirus (COVID-19): a systematic review

“…m. It is obligatory for all healthcare providers that self-protection, self-care and hand hygiene is important [21]. n. obstetric unit must be equipped to reusable, machine-washable instrument which can readily be disinfected [29].…”

Pregnancy and Childbirth During the Covid-19 Epidemic in Poland: Qualitative Evidence From Expert Interviews.

“…Corollary to other sectors and groups, the COVID-19 outbreak has signi cantly altered the provisions and shape of medical services for expecting mothers worldwide. Guidelines on delivery and care are constantly evolving as we learn more about the illness (3,4,5,6,7). COVID-19 reinvigorated the debates on telemedicine, agility of healthcare systems, as well as overcrowding and under-nancing of healthcare workers, all having an impact on expectant and rst-time mothers as a particularly vulnerable group.…”

“…As regards global context, it should be stated that early on in the COVID-19 epidemic, the issue of maternal health, particularly in the context of safety of delivery and vertical transmission, has been discussed in rapid response reactions (3,4,5,6,7). Based on the lessons of previous epidemiological threats, experts underscored that each case of a COVID-19 maternal infection will make subsequent prenatal, perinatal and postnatal care challenging, therefore sternly recommending emergency protocols, isolation and new-born quarantine (3,5,6). In early studies, clear guidelines on delivery were explicitly in focus, both to optimize the prognosis for mothers and children, and to prevent additional adverse outcomes.…”

“…In sum, studies on the one hand supplied con icting evidence on delivery timing, advice on the type of delivery and medical interventions during childbirth (e.g. anaesthesia), maternal ward organization and new-born care, including breastfeeding (5,7). On the other hand, little attention was paid to the wellbeing and psychological condition of the expecting and birthing mothers, foregrounding a very narrow view of medical safety.…”