• Naftali Justman, Gilad Shahak, Ola Gutzeit, Dikla Ben Zvi, Yuval Ginsberg, Ido Solt, Dana Vitner, Ron Beloosesky, Zeev Weiner, and Yaniv Zipori.
• Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel.
• Isr Med Assoc J. 2020 Sep 1; 9 (22): 467-471.

BackgroundThe World Health Organization classified coronavirus disease-19 (COVID-19) as a pandemic and recommends strict restrictions regarding most aspects of daily activities.ObjectivesTo evaluate whether the pandemic has changed the prenatal care and pregnancy outcome in pregnant women without COVID-19.MethodsThe authors conducted a cross-sectional study to describe changes in outpatient clinic visits and to compare the rates of cesarean and instrumental deliveries between two periods of time: March-April 2020 (during the COVID-19 outbreak) with March-April of the preceding year, 2019.ResultsDuring the COVID-19 outbreak, visits to obstetric triage, gynecologic triage, high-risk clinic, and ultrasound units decreased by 36.4%, 34.7%, 32.8%, and 18.1%, respectively. The medical center experienced a 17.8% drop in the total number of births (610 births) compared with March and April 2019 (742 births). During the outbreak women were more likely to be nulliparous (33.3% vs. 27.6%, P = 0.02) and present with hypertensive disorders during pregnancy (7.5% vs. 4%, P = 0.005) or gestational diabetes (13% vs. 10%, P = 0.03). More epidural analgesia was used (83.1% vs. 77.1%, P = 0.006). There were more operative vaginal deliveries during the outbreak (16.7% vs. 6.8%, P = 0.01). All other maternal and neonatal outcomes were comparable between the two periods.ConclusionsThe medical facility experienced a major decline in all aspects of the routine obstetrics activities during the time of the pandemic. The higher rate of operative vaginal deliveries among nulliparous may be associated with the pandemic effect on the rate of high-risk patients.

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