Obstetrics and gynecology
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Obstetrics and gynecology · Oct 2020
Medical Education and Safety as Co-priorities in the Coronavirus Disease 2019 (COVID-19) Era: We Can Do Both.
As hospitals and medical schools confronted coronavirus disease 2019 (COVID-19), medical students were essentially restricted from all clinical work in an effort to prioritize their safety and the safety of others. One downstream effect of this decision was that students were designated as nonessential, in contrast to other members of health care teams. ⋯ In this commentary, we discuss factors that led to students' being excluded from this pandemic despite being required at the bedside during prior U. S. public health crises this past century, and we review educational principles that support maintaining students in clinical environments during this and future pandemics.
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Obstetrics and gynecology · Oct 2020
Corticosteroids in the Management of Pregnant Patients With Coronavirus Disease (COVID-19).
Recent evidence supports the use of an early, short course of glucocorticoids in patients with COVID-19 who require mechanical ventilation or oxygen support. As the number of coronavirus disease 2019 (COVID-19) cases continues to increase, the number of pregnant women with the disease is very likely to increase as well. Because pregnant women are at increased risk for hospitalization, intensive care unit admission, and mechanical ventilation support, obstetricians will be facing the dilemma of initiating maternal corticosteroid therapy while weighing its potential adverse effects on the fetus (or neonate if the patient is postpartum and breastfeeding). Our objective is to summarize the current evidence supporting steroid therapy in the management of patients with acute respiratory distress syndrome and COVID-19 and to elaborate on key modifications for the pregnant patient.
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Obstetrics and gynecology · Oct 2020
Case ReportsProlonged Detection of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) RNA in an Obstetric Patient With Antibody Seroconversion.
There is a growing understanding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 2019 (COVID-19) in the general population. The unique immunology of pregnancy may result in variations from the reported course of disease. ⋯ Prolonged viral shedding of SARS-CoV RNA may occur in the pregnant patient. If prevalent, this complicates the interpretation of a positive SARS-CoV-2 RT-PCR test result in the asymptomatic gravid patient.