Protecting Labor and Delivery Personnel from COVID-19 during the Second Stage of Labor
Protecting Labor and Delivery Personnel from COVID-19 during the Second Stage of Labor
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DOI：
10.1055/s-0040-1709689
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发表时间：
2020-06-01
影响因子：
2
通讯作者：
McIntosh, Jennifer J.
中科院分区：
文献类型：
--
作者：
Palatnik, Anna;McIntosh, Jennifer J.
2019新型冠状病毒病（COVID-19）正在快速传播，对临床工作者的影响比普通人群高得多。关于COVID-19对孕妇的影响知之甚少;然而，新出现的证据表明，她们可能处于无症状疾病的高风险之中。鉴于预计个人防护设备短缺，正在积极努力进行保护。在产科，关于PPE使用的指南是有争议的，并且在全球和国家的医院之间存在差异。疾病控制和预防中心（CDC）建议使用N95呼吸机，这是一种在执行或出现气溶胶生成程序（AGP）时提供更高级别保护的呼吸机，而不是面罩。然而，第二阶段的劳动不被认为是一个AGP。第二阶段的劳动力可以持续4个小时。在这段时间里，分娩和分娩人员与患者密切接触，患者在分娩过程中付出极大的努力，经常呼气、咳嗽、喊叫和呕吐，考虑到COVID-19通过咳嗽和打喷嚏产生的气溶胶传播，所有这些都使医疗保健团队处于危险之中。CDC和美国妇产科医师学会（ACOG）没有提供关于在第二阶段使用N95的说明。我们建议分娩和分娩人员保持最大的谨慎，并给予他们保护自己和其他患者所需的保护。这包括为第二产程提供劳动和分娩人员全套PPE，包括N95。这对于确保充分保护卫生保健工作者和防止传播给其他卫生保健工作者和患者至关重要。
The novel coronavirus disease 2019 (COVID-19) is spreading fast and is affecting the clinical workers at much higher risk than the general population. Little is known about COVID-19 effect on pregnant women; however, the emerging evidence suggests they may be at high risk of asymptomatic disease. In light of projected shortage of personal protective equipment (PPE), there is an aggressive attempt at conservation. In obstetrics, the guidelines on PPE use are controversial and differ among hospitals, globally, as well as nationally. The centers for disease control and prevention (CDC) recommend using N95 respirators, which are respirators that offer a higher level of protection instead of a facemask for when performing or present for an aerosol-generating procedures (AGP). However, the second stage of labor is not considered an AGP. The second stage of labor can last up to 4 hours. During that time, labor and delivery personnel is in close contact to patients, who are exerting extreme effort during and frequently blow out their breath, cough, shout, and vomit, all of which put the health care team at risk, considering that COVID-19 transmission occurs through aerosol generated by coughing and sneezing. The CDC and the American College of Obstetricians and Gynecologists (ACOG) do not provide clarification on the use of N95 during the second stage. We recommend that labor and delivery personnel have the utmost caution and be granted the protection they need to protect themselves and other patients. This includes providing labor and delivery personnel full PPE including N95 for the second stage of labor. This is critical to ensure the adequate protection for health care workers and to prevent spread to other health care workers and patients.