Interim Considerations for Infection Prevention and Control of Coronavirus Disease 2019 (COVID-19) in Inpatient Obstetric Healthcare Settings

These an infection prevention and management concerns are for healthcare amenities offering obstetric take care of pregnant sufferers with suspected1 or confirmed coronavirus illness (COVID-19) in inpatient obstetric healthcare settings together with obstetrical triage, labor and supply, restoration and inpatient postpartum settings.

This info is meant to help hospitals and clinicians in making use of broader CDC interim guidance on infection prevention and control for COVID-19.

Since maternity and new child care models fluctuate in bodily configuration, every facility ought to contemplate their applicable area and staffing wants to stop transmission of the virus that causes COVID-19. These concerns embrace applicable isolation of pregnant sufferers who’ve suspected1 or confirmed COVID-19; fundamental and refresher coaching for all healthcare personnel on these models to incorporate right adherence to an infection management practices and personal protective equipment (PPE) use and dealing with; and adequate and applicable PPE provides positioned in any respect factors of care.

These concerns are based mostly upon the restricted proof out there to this point about transmission of the virus that causes COVID-19. The approaches outlined under are deliberately cautious till extra knowledge develop into out there to refine suggestions for prevention of person-to-person transmission in inpatient obstetric care settings.

Based on what we all know at the moment, pregnant folks may be at an elevated danger for extreme sickness from COVID-19 in comparison with non-pregnant folks. Additionally, there could also be an elevated danger of opposed being pregnant outcomes, comparable to preterm beginning, amongst pregnant folks with COVID-19.

Prehospital Considerations

  • Pregnant sufferers with suspected1 or confirmed COVID-19 ought to notify the obstetric unit previous to arrival so the power could make applicable an infection management preparations comparable to: figuring out probably the most applicable room for labor and supply, making certain an infection prevention and management provides and PPE are accurately positioned, and informing all healthcare personnel who might be concerned within the affected person’s care of an infection management expectations earlier than the affected person’s arrival.
  • If a pregnant affected person who has suspected1 or confirmed COVID-19 is arriving through transport by emergency medical companies, the driving force ought to contact the receiving emergency division or healthcare facility and observe beforehand agreed-upon native or regional transport protocols. For extra info discuss with the Interim Guidance for Emergency Medical Services (EMS) Systems and 911 Public Safety Answering Points (PSAPs) for COVID-19 in the United States.
  • Healthcare suppliers ought to promptly notify an infection management personnel at their facility of the anticipated arrival of a pregnant affected person who has suspected1 or confirmed COVID-19.

During Hospitalization

  • Pregnant ladies admitted with suspected1 COVID-19 or who develop symptoms consistent with COVID-19 throughout admission ought to be prioritized for testing. Testing of asymptomatic pregnant ladies is on the discretion of the healthcare supplier and facility. Healthcare amenities ought to guarantee really helpful an infection management practices for hospitalized pregnant sufferers who’ve suspected or confirmed COVID-19 are according to Interim Infection Prevention and Control Recommendations.
  • All healthcare amenities that present obstetric care should be certain that their personnel are accurately skilled and able to implementing really helpful an infection management interventions, together with using private protecting gear. Individual healthcare personnel ought to guarantee they perceive and may adhere to an infection management necessities.
  • Healthcare amenities offering inpatient obstetrical care ought to restrict guests to pregnant ladies who’ve identified or suspected COVID-19 infections.
    • Visitors ought to be restricted to these important for the pregnant lady’s well-being and care (emotional help individuals).
      • Depending upon the extent of community-transmission, establishments could contemplate limiting guests to at least one important help particular person and having that particular person be the identical particular person all through the hospitalization.
      • Use of different mechanisms for affected person and customer interactions, comparable to video-call functions, could be inspired for any extra help individuals.
    • Any guests permitted to labor and supply ought to be screened for symptoms of COVID-19 and shouldn’t be allowed entry if fever or different signs are current.
    • Visitors ought to be knowledgeable about use of masks (together with fabric face coverings) for any particular person getting into the healthcare facility and about applicable use of private protecting gear in accordance with present facility customer coverage. Visitors ought to be instructed to solely go to the affected person room and shouldn’t go to different places throughout the facility, together with any new child nursery.

Considerations for Newborns and Breastfeeding

CDC has developed suggestions for healthcare suppliers caring for neonates (newborns) in danger for COVID-19, together with testing and an infection prevention and management concerns, in addition to steerage for care of breastfeeding moms. For extra info, go to Evaluation and Management Considerations for Neonates At Risk for COVID-19 and Guidance on Care for Breastfeeding Women.

Disposition

Patients with COVID-19 could be discharged from the healthcare facility at any time when clinically indicated. For extra info, see Discontinuation of Transmission-Based Precautions and Disposition of Patients with COVID-19 in Healthcare Settings. Meeting standards for discontinuation of Transmission-Based Precautions is just not a prerequisite for discharge.

Patients who’re capable of be discharged from the hospital however haven’t met standards to discontinue isolation and want to cut back the chance of transmission to their new child could proceed momentary separation at their place of residence (if possible) till cleared to discontinue residence isolation following both the symptom based mostly technique or testing based mostly technique. When momentary separation is being thought-about, its dangers and advantages ought to be mentioned by the mom and the healthcare group. Decisions about momentary separation ought to be made in accordance with the mom’s needs. For extra info, discuss with steerage within the Discontinuation of Home Isolation for Persons with COVID-19.

People who’re caring for infants and younger kids could expertise elevated stress, emotions of isolation, or loneliness due to social distancing measures throughout the COVID-19 outbreak or associated momentary separation. Postpartum depression signs could also be worsened due to COVID-19 social distancing measures. Providers are encourage to share assets with sufferers about coping with stress throughout the COVID-19 pandemic.

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