Labor and delivery guidance for COVID-19

Am J Obstet Gynecol MFM. 2020 May;2(2):100110. doi: 10.1016/j.ajogmf.2020.100110. Epub 2020 Mar 25.

Abstract

This document addresses the current coronavirus disease 2019 (COVID-19) pandemic for providers and patients in labor and delivery (L&D). The goals are to provide guidance regarding methods to appropriately screen and test pregnant patients for COVID-19 prior to, and at admission to L&D reduce risk of maternal and neonatal COVID-19 disease through minimizing hospital contact and appropriate isolation; and provide specific guidance for management of L&D of the COVID-19-positive woman, as well as the critically ill COVID-19-positive woman. The first 5 sections deal with L&D issues in general, for all women, during the COVID-19 pandemic. These include Section 1: Appropriate screening, testing, and preparation of pregnant women for COVID-19 before visit and/or admission to L&D Section 2: Screening of patients coming to L&D triage; Section 3: General changes to routine L&D work flow; Section 4: Intrapartum care; Section 5: Postpartum care; Section 6 deals with special care for the COVID-19-positive or suspected pregnant woman in L&D and Section 7 deals with the COVID-19-positive/suspected woman who is critically ill. These are suggestions, which can be adapted to local needs and capabilities.

Keywords: COVID-19; coronavirus; obstetric protocol; pandemic.

Publication types

  • Review

MeSH terms

  • Anesthesia, Epidural / methods
  • Anesthesia, Obstetrical / methods
  • COVID-19 / diagnosis
  • COVID-19 / prevention & control*
  • COVID-19 / therapy
  • Critical Illness
  • Delivery, Obstetric / methods*
  • Female
  • Humans
  • Labor, Induced / methods
  • Labor, Obstetric
  • Length of Stay
  • Mass Screening
  • Patient Discharge
  • Patient Isolation
  • Personal Protective Equipment
  • Postnatal Care / methods*
  • Practice Guidelines as Topic*
  • Pregnancy
  • Pregnancy Complications, Infectious / diagnosis
  • Pregnancy Complications, Infectious / prevention & control*
  • Pregnancy Complications, Infectious / therapy
  • SARS-CoV-2
  • Triage / methods
  • Workflow*