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DOI: 10.1055/s-0040-1716731
Response of an Obstetric Unit during the Coronavirus Disease of 2019 (COVID-19) Pandemic: Experiences from a Tertiary Care Center
Abstract
Objective To describe our experiences in preparing our obstetric unit in Westchester County, New York, during the COVID-19 (coronavirus disease of 2019) pandemic. We focus on describing our timeline, continuously evolving actions, observations, and challenges.
Methods With guidance from the New York State Department of Health (NYSDOH), our institutional epidemiologist, and key multidisciplinary faculty members, we evaluated emerging national data as well as expert opinions to identify issues and challenges to create action plans.
Results We created and modified policies for our patients presenting for obstetrical care on the labor and delivery unit to accommodate their unique needs during this pandemic.
Conclusion The COVID-19 pandemic has posed many unique challenges. Balancing communication, risks of infection to providers, patient autonomy and rights, and resources for testing and personal protective equipment were among the valuable lessons learnt. We have shared our experiences and described our observations and challenges in Westchester County, New York.
Publikationsverlauf
Eingereicht: 23. Juni 2020
Angenommen: 20. Juli 2020
Artikel online veröffentlicht:
23. September 2020
© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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References
- 1 Sutton D, Fuchs K, D'Alton M, Goffman D. Universal screening for SARS-CoV-2 in women admitted for delivery. N Engl J Med 2020; 382 (22) 2163-2164
- 2 Xu R, Cui B, Duan X, Zhang P, Zhou X, Yuan Q. Saliva: potential diagnostic value and transmission of 2019-nCoV. Int J Oral Sci 2020; 12 (01) 11
- 3 Centers for Disease Control and Prevention. How to Protect Yourself & Others. Accessed 16 May, 2020 https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html
- 4 World Health Organization. Rational use of personal protective equipment for coronavirus disease 2019 (COVID-19). Accessed 25 June, 2020 https://apps.who.int/iris/bitstream/handle/10665/331215/WHO-2019-nCov-IPCPPE_use-2020.1-eng.pdf
- 5 Setti L, Passarini F, De Gennaro G. et al. Airborne transmission route of COVID-19: why 2 meters/6 feet of inter-personal distance could not be enough. Int J Environ Res Public Health 2020; 17 (08) E2932
- 6 Narla S, Lyons AB, Kohli I. et al. The importance of the minimum dosage necessary for UVC decontamination of N95 respirators during the COVID-19 pandemic. Photodermatol Photoimmunol Photomed 2020; 36 (04) 324-325
- 7 Ma QX, Shan H, Zhang CM. et al. Decontamination of face masks with steam for mask reuse in fighting the pandemic COVID-19: Experimental supports. J Med Virol 2020; (e-pub ahead of print). DOI: 10.1002/jmv.25921.
- 8 Okamoto K, Rhee Y, Schoeny M. Centers for Disease Control and Prevention Epicenters Program. et al. Impact of doffing errors on healthcare worker self-contamination when caring for patients on contact precautions. Infect Control Hosp Epidemiol 2019; 40 (05) 559-565
- 9 Tomas ME, Kundrapu S, Thota P. et al. Contamination of health care personnel during removal of personal protective equipment. JAMA Intern Med 2015; 175 (12) 1904-1910
- 10 Verbeek JH, Rajamaki B, Ijaz S. et al. Personal protective equipment for preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare staff. Cochrane Database Syst Rev 2020; 4: CD011621
- 11 John TJ, Hassan K, Weich H. Donning and doffing of personal protective equipment (PPE) for angiography during the COVID-19 crisis. Eur Heart J 2020; 41 (19) 1786-1787
- 12 Christensen L, Rasmussen CS, Benfield T, Franc JM. A randomized trial of instructor-led training versus video lesson in training health care providers in proper donning and doffing of personal protective equipment. Disaster Med Public Health Prep 2020; (e-pub ahead of print). DOI: 10.1017/dmp.2020.56.
- 13 Bajema KL, Oster AM, McGovern OL. 2019-nCoV Persons Under Investigation Team, 2019-CoV Persons Under Investigation Team. et al. Persons evaluated for 2019 novel coronavirus - United States, January 2020. MMWR Morb Mortal Wkly Rep 2020; 69 (06) 166-170
- 14 American College of Obstetricians and Gynecologists. Outpatient Assessment and Management for Pregnant Women with Suspected or Confirmed Novel Coronavirus (COVID-19). Accessed 17 May, 2020 https://www.acog.org/-/media/project/acog/acogorg/files/pdfs/clinical-guidance/practice-advisory/covid-19-algorithm.pdf
- 15 Breslin N, Baptiste C, Gyamfi-Bannerman C. et al. COVID-19 infection among asymptomatic and symptomatic pregnant women: Two weeks of confirmed presentations to an affiliated pair of New York City hospitals. Am J Obstet Gynecol MFM 2020; (e-pub ahead of print). DOI: 10.1016/j.ajogmf.2020.100118.
- 16 Lauer SA, Grantz KH, Bi Q. et al. The incubation period of coronavirus disease 2019 (COVID-19) from publicly reported confirmed cases: estimation and application. Ann Intern Med 2020; 172 (09) 577-582
- 17 Lee YL, Liao CH, Liu PY. et al. Dynamics of anti-SARS-Cov-2 IgM and IgG antibodies among COVID-19 patients. J Infect 2020; 81 (02) e55-e58
- 18 New York State Department of Health. Health Advisory: COVID-19 Guidance for Hospital Operators Regarding Visitation Updated Guidance regarding Obstetrical and Pediatric Settings. Accessed 17 May, 2020 https://coronavirus.health.ny.gov/system/files/documents/2020/03/doh_covid19_obpedsvisitation_032720.pdf
- 19 New York State Department of Health. Health Advisory: COVID-19 Updated Guidance for Hospital Operators Regarding Visitation. Accessed 17 May, 2020 https://coronavirus.health.ny.gov/system/files/documents/2020/04/doh_covid19_hospitalvisitation_041020-002.pdf
- 20 New York State Department of Health. ; New York State COVID-19 Maternity Task Force. Recommendations to the Governor to Promote Increased Choice and Access to Safe Maternity Care During the COVID-19 Pandemic. Accessed 17 May, 2020 https://www.governor.ny.gov/news/secretary-governor-melissa-derosa-issues-report-governor-cuomo-outlining-covid-19-maternity
- 21 Centers for Disease Control and Prevention. Clinical Questions about COVID-19: Questions and Answers. Accessed 17 May, 2020 https://www.cdc.gov/coronavirus/2019-ncov/hcp/faq.html
- 22 The Society for Maternal-Fetal Medicine. Labor and Delivery COVID-19 Considerations. 2020
- 23 Centers for Disease Control and Prevention. Guidelines for Environmental Infection Control in Health-Care Facilities. Accessed 23 May, 2020 https://www.cdc.gov/infectioncontrol/guidelines/environmental/background/air.html
- 24 Poon LC, Yang H, Lee JCS. et al. ISUOG Interim Guidance on 2019 novel coronavirus infection during pregnancy and puerperium: information for healthcare professionals. Ultrasound Obstet Gynecol 2020; 55 (05) 700-708
- 25 The American College of Obstetricians and Gynecologists. Novel Coronavirus 2019 (COVID-19) Practice advisory. Physician FAQs. Coronavirus 2019. Updated 23 April, 2020. Accessed May 17, 2020 at: https://www.acog.org:443/en/Clinical/ClinicalGuidance/PracticeAdvisory/Articles/2020/03/Novel
- 26 Jamieson DJ, Steinberg JP, Martinello RA, Perl TM, Rasmussen SA. Obstetricians on the coronavirus disease 2019 (COVID-19) front lines and the confusing world of personal protective equipment. Obstet Gynecol 2020; 135 (06) 1257-1263
- 27 Angioni S. Laparoscopy in the coronavirus disease 2019 (COVID-19) era. Gynecol Surg 2020; 17 (01) 3
- 28 Francis N, Dort J, Cho E. et al. SAGES and EAES recommendations for minimally invasive surgery during COVID-19 pandemic. Surg Endosc 2020; 34 (06) 2327-2331
- 29 American Urogynecologic Society. Joint Statement on Minimally Invasive Gynecologic Surgery during the COVID-19 Pandemic. Accessed 24 May, 2020 https://www.augs.org/joint-statement-on-minimally-invasive-gynecologic-surgery-during-the-covid-19-pandemic-/
- 30 Zheng MH, Boni L, Fingerhut A. Minimally invasive surgery and the novel coronavirus outbreak: lessons learned in China and Italy. Ann Surg 2020; 272 (01) e5-e6
- 31 Hakim AA, Kellish AS, Atabek U, Spitz FR, Hong YK. Implications for the use of telehealth in surgical patients during the COVID-19 pandemic. Am J Surg 2020; 220 (01) 48-49
- 32 Fathizadeh H, Maroufi P, Momen-Heravi M. et al. Protection and disinfection policies against SARS-CoV-2 (COVID-19). Infez Med 2020; 28 (02) 185-191
- 33 Bauer ME, Chiware R, Pancaro C. Neuraxial procedures in COVID-19 positive parturients: a review of current reports. Anesth Analg 2020; (e-pub ahead of print). DOI: 10.1213/ANE.0000000000004831.
- 34 Anesthesia Patient Safety Foundation. Perioperative Considerations for the 2019 Novel Coronavirus (COVID-19). Accessed 24 May, 2020 https://www.apsf.org/news-updates/perioperative-considerations-for-the-2019-novel-coronavirus-covid-19/
- 35 Biddle CJ, George-Gay B, Prasanna P, Hill EM, Davis TC, Verhulst B. Assessing a novel method to reduce anesthesia machine contamination: a prospective, observational trial. Can J Infect Dis Med Microbiol 2018; 2018: 1905360
- 36 American Society of Anesthesiologists. COVID-19 FAQs: anesthesia machine and equipment maintenance. Accessed 24 May, 2020 www.asahq.org/about-asa/governance-and-committees/asa-committees/committee-on-occupational-health/coronavirus/clinical-faqs
- 37 Mimouni F, Lakshminrusimha S, Pearlman SA, Raju T, Gallagher PG, Mendlovic J. Perinatal aspects on the covid-19 pandemic: a practical resource for perinatal-neonatal specialists. J Perinatol 2020; 40 (05) 820-826
- 38 Centers for Disease Control and Prevention. Coronavirus Disease 2019 (COVID-19) Considerations for Inpatient Obstetric Healthcare Settings. Reviewed 6 April, 2020. Accessed May 17, 2020 at: https://www.cdc.gov/coronavirus/2019-ncov/hcp/inpatient-obstetric-healthcare-guidance.html
- 39 Boelig RC, Manuck T, Oliver EA. et al. Labor and delivery guidance for COVID-19. Am J Obstet Gynecol MFM 2020. (e-pub ahead of print). Doi: 10.1016/j.ajogmf.2020.100110
- 40 American College of Obstetricians and Gynecologists. COVID-19 FAQs for Obstetricians-Gynecologists, Obstetrics. Accessed 24 May, 2020 https://www.acog.org/clinical-information/physician-faqs/covid-19-faqs-for-ob-gyns-obstetrics