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. 2022 Feb 11;22(1):119.
doi: 10.1186/s12884-022-04409-4.

Adapting obstetric and neonatal services during the COVID-19 pandemic: a scoping review

Shira Gold  1 , Lauren Clarfield  2 , Jennie Johnstone  3 , Yenge Diambomba  4 , Prakesh S Shah  4 , Wendy Whittle  1 , Nimrah Abbasi  1 , Cristian Arzola  2 , Rizwana Ashraf  1 , Anne Biringer  5 , David Chitayat  1 , Marie Czikk  1 , Milena Forte  5 , Tracy Franklin  6 , Michelle Jacobson  1 , Johannes Keunen  1 , John Kingdom  1 , Stephen Lapinsky  2 , Joanne MacKenzie  7 , Cynthia Maxwell  1 , Mary Preisman  8 , Greg Ryan  1 , Amanda Selk  1 , Mathew Sermer  1 , Candice Silversides  1 , John Snelgrove  1 , Nancy Watts  1 , Beverly Young  8 , Charmaine De Castro  9 , Rohan D'Souza  10
Affiliations

Adapting obstetric and neonatal services during the COVID-19 pandemic: a scoping review

Shira Gold et al. BMC Pregnancy Childbirth. .

Abstract

Background: The provision of care to pregnant persons and neonates must continue through pandemics. To maintain quality of care, while minimizing physical contact during the Severe Acute Respiratory Syndrome-related Coronavirus-2 (SARS-CoV2) pandemic, hospitals and international organizations issued recommendations on maternity and neonatal care delivery and restructuring of clinical and academic services. Early in the pandemic, recommendations relied on expert opinion, and offered a one-size-fits-all set of guidelines. Our aim was to examine these recommendations and provide the rationale and context to guide clinicians, administrators, educators, and researchers, on how to adapt maternity and neonatal services during the pandemic, regardless of jurisdiction.

Method: Our initial database search used Medical subject headings and free-text search terms related to coronavirus infections, pregnancy and neonatology, and summarized relevant recommendations from international society guidelines. Subsequent targeted searches to December 30, 2020, included relevant publications in general medical and obstetric journals, and updated society recommendations.

Results: We identified 846 titles and abstracts, of which 105 English-language publications fulfilled eligibility criteria and were included in our study. A multidisciplinary team representing clinicians from various disciplines, academics, administrators and training program directors critically appraised the literature to collate recommendations by multiple jurisdictions, including a quaternary care Canadian hospital, to provide context and rationale for viable options.

Interpretation: There are different schools of thought regarding effective practices in obstetric and neonatal services. Our critical review presents the rationale to effectively modify services, based on the phase of the pandemic, the prevalence of infection in the population, and resource availability.

Keywords: Algorithms; Ambulatory care; Anaesthesia; COVID-19; Clinical protocols; Coronavirus; Health planning guidelines; Hospital planning; Hospital restructuring; Maternity; Medical education; Medical staff; Neonatology; Obstetrical; Obstetrics; Pandemics; Patient care planning; Perinatal care; Perinatology; Personnel management; Postnatal care; Pregnancy; Quality improvement; Residency training; SARS-CoV-2; Severe acute respiratory syndrome-related coronavirus 2; Simulation training; Ultrasonography.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Timeline depicting global events and local response in Toronto with regard to planning for the pandemic
Fig. 2
Fig. 2
Modifications to the low-risk prenatal clinic schedule during the COVID-19 pandemic
Fig. 3
Fig. 3
Algorithm for the management of persons with suspected or confirmed COVID-19 infection in pregnancy in the outpatient setting
Fig. 4
Fig. 4
Algorithm for the management of persons with suspected or confirmed COVID-19 infection in pregnancy in the inpatient setting
Fig. 5
Fig. 5
Neonatal Unit Algorithms
See this image and copyright information in PMC

References

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    1. ACOG. COVID-19 FAQs for Obstetrician-Gynecologists, Obstetrics. 2020. https://www.acog.org/clinical-information/physician-faqs/covid-19-faqs-f.... Accessed 10 Oct 2020.
    1. RCOG. Coronavirus infection and pregnancy. 2020. https://www.rcog.org.uk/en/guidelines-research-services/guidelines/coron.... Accessed 3 Oct 2020.

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