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Obstetric services in the UK during the COVID-19 pandemic: A national survey - 10/09/22

Doi : 10.1016/j.accpm.2022.101137 
James Edward O’Carroll a, , Liana Zucco b, Eleanor Warwick c, Gill Arbane b, Ramani Moonesinghe d, Kariem El-Boghdadly b, N Guo a, Brendan Carvalho a, Pervez Sultan a

on behalf of the ObsQoR Collaborators

a Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA 
b Guy’s and St Thomas’ NHS Foundation Trust, London, UK 
c University College Hospitals, London, London, UK 
d Surgical Outcomes Research Centre, Centre for Peri-Operative Medicine, University College London, London, UK 

Corresponding author at: 300 Pasteur Drive, Stanford University School of Medicine, Stanford, USA.Stanford University School of Medicine300 Pasteur DriveStanfordUSA

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Highlights

Variation across United Kingdom in care delivered and adherence to guidelines during the COVID-19 pandemic.
Alteration of guidelines and birth plans dependant on institution.
Referral pathways are lacking to ensure COVID-19 vaccination during pregnancy.

Il testo completo di questo articolo è disponibile in PDF.

Abstract

Background

The management of obstetric patients with coronavirus disease 2019 (COVID-19) due to human-to-human transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) requires unique considerations. Many aspects of labour and delivery practice required adaptation in response to the global pandemic and were supported by guidelines from the Royal College of Obstetrics and Gynaecologists. The adoption and adherence to these guidelines is unknown.

Methods

Participating centres in “Quality of Recovery in Obstetric Anaesthesia study—a multicentre study” (ObsQoR) completed an electronic survey based on the provision of services and care related to COVID-19 in October 2021. The survey was designed against the Royal College of Obstetricians and Gynaecologists COVID-19 guidelines.

Results

One hundred and five of the 107 participating centres completed the survey (98% response rate representing 54% of all UK obstetric units). The median [IQR] annual number of deliveries among the included sites was 4389 [3000–5325]. Ninety-nine of the 103 (94.3%) sites had guidelines for the management of peripartum women with COVID-19. Sixty-one of 105 (58.1%) sites had specific guidance for venous thromboembolism (VTE) prophylaxis. Thirty-seven of 104 (35.6%) centres restricted parturient birthing plans if a positive diagnosis of COVID-19 was made. A COVID-19 vaccination referral pathway encouraging full vaccination for all pregnant women was present in 63/103 centres (61.2%).

Conclusion

We found variability in care delivered and adherence to guidelines related to COVID-19. The clinical implications for this related to quality of peripartum care is unclear, however there remains scope to improve pathways for immunisation, birth plans and VTE prophylaxis.

Il testo completo di questo articolo è disponibile in PDF.

Keywords : COVID-19, Obstetric guidelines, Survey, Quality of recovery, Vaccination, Personal protective equipment


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© 2022  Société française d'anesthésie et de réanimation (Sfar). Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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Vol 41 - N° 5

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