Reducing the risk of infection to patients and staff during gynaecological outpatient and ambulatory appointments

Abstract

This chapter explores ways of reducing the risk of SARS-CoV-2 transmission to women and staff within gynaecology outpatient clinics. The likely routes of transmission are discussed, namely via droplets, aerosols and fomites. Using the 'hierarchy of control' categories, elimination, substitution, engineering, administration and personal protective equipment (PPE), practical strategies for modifying virus exposure are presented. The management of specific clinical conditions are reviewed based upon advice prepared by the Specialist Societies in conjunction with each other and the Royal College of Obstetricians and Gynaecologists. The need to maintain at least a minimal level of gynaecological services is recognised and that this should provide safe, equitable and effective care. Ways of reducing clinic attendance are discussed with the substitution of face-to-face with remote consultations and when this is relevant. Current recommendations for ambulatory procedures, including colposcopy and hysteroscopy, are considered so that best use is made of reduced resources.

Elevated Perinatal Depression during the COVID-19 Pandemic: A National Study among Jewish and Arab Women in Israel

“…Substantial changes in the delivery of healthcare services have been made in several other countries as well, in an effort to minimize transmission risks [61]. Such changes include minimizing face-to-face care, physical-distancing restrictions, reducing care, limiting women's escorts during appointments and childbirth, and restricting visitors to maternity wards [62,63]. Additional studies have reported that perinatal women experience high levels of concern about birth expectations, as well as report feelings of fear and loneliness [64], while postpartum women are concerned about breastfeeding and infant weight gain due to lack of face-to-face contact with health professionals [65].…”