American journal of perinatology
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Comparative Study
Antenatal Corticosteroids for Pregnant Women at High Risk of Preterm Delivery with COVID-19 Infection: A Decision Analysis.
Antenatal corticosteroids given prior to preterm deliveries reduce the risk of adverse neonatal outcomes. However, steroid administration in the setting of a viral respiratory infection can worsen maternal outcomes. Therefore, the decision to administer corticosteroids must balance the neonatal benefits with the potential harm to the mother if she is infected with the novel coronavirus disease 2019 (COVID-19). This study aimed to determine the gestational ages for which administering antenatal corticosteroids to women at high risk of preterm labor with concurrent COVID-19 infection results in improved combined maternal and infant outcomes. ⋯ · Antenatal steroids reduce adverse neonatal outcomes.. · Steroids worsen maternal outcomes in COVID-19.. · Steroids given < 32 weeks result in improved outcomes..
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The health care system has been struggling to find the optimal way to protect patients and staff from coronavirus disease 2019 (COVID-19). Our objective was to evaluate the impact of two strategies on transmission of COVID-19 to health care workers (HCW) on labor and delivery (L&D). ⋯ · Universal screening is the preferred strategy for labor.. · With high prevalence, universal PPE is cost-effective.. · For planned cesarean, universal PPE is cost saving..
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This study aimed to (1) determine to what degree prenatal care was able to be transitioned to telehealth at prenatal practices associated with two affiliated hospitals in New York City during the novel coronavirus disease 2019 (COVID-19) pandemic and (2) describe providers' experience with this transition. ⋯ · Telehealth uptake differed based on insurance.. · Medicaid patients may require increased assistance for telehealth.. · Quick adoption of telehealth is feasible..
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We describe our experience with three pregnant women with novel coronavirus disease 2019 (COVID-19) who required mechanical ventilation. Recent data suggest a mortality of 88% in nonpregnant patients with COVID-19 who require intubation and mechanical ventilation. ⋯ Our experience suggests that the mortality in pregnant women with COVID-19 requiring mechanical ventilation is not necessarily as high as in nonpregnant patients with COVID-19. KEY POINTS: · Coronavirus disease 2019 (COVID-19) is now a pandemic.. · COVID-19 may cause pneumonia or respiratory failure in pregnant women.. · Approximately 5% of women with COVID-19 will develop severe or critical disease.. · Mechanical ventilation in pregnant women may not necessarily result in high mortality rates..