A New Multiplatform Model for Outpatient Prenatal and Postpartum Care in a Cohort of COVID-19-Affected Obstetric Patients.

Mar Muñoz-Chápuli Gutiérrez,Pilar Pintado Recarte,Ana Durán-Vila,Miguel A Ortega,Julia Bujan,Javier Ruiz-Labarta,Pilar Payá-Martínez,Juan De León-Luis

doi:10.3390/ijerph18105144

Abstract

Spain was one of the epicenters of the first wave of the COVID-19 pandemic. We describe in this article the design and results of a new telephone-and-telematic multiplatform model of systematic prenatal and postpartum follow-up for COVID-19-affected women implemented in a tertiary reference hospital in Madrid. We included patients with RT-PCR-confirmed COVID-19 during pregnancy or delivery from 10 March 2020 to 15 December 2020. We had a total of 211 obstetric patients: 148 (70.1%) were tested at the onset of suspicious clinical manifestations and 62 (29.4%) were tested in the context of routine screening. Of all the patients, 60 women (28.4%) were asymptomatic and 97 (46%) presented mild symptoms. Fifty-one women (24.2%) were admitted to our hospital for specific treatment because of moderate or severe symptoms. We had no missed cases and a good adherence. The mean number of calls per patient was 2.3. We performed 55 in-person visits. We analyzed the complexity of our program over time, showing a two-wave-like pattern. One patient was identified as needing hospitalization and we did not record major morbidity. Telemedicine programs are a strong and reproducible tool to reach to pregnant population affected by COVID-19, to assess its symptoms and severity, and to record for pregnancy-related symptoms both in an outpatient regime and after discharge from hospital.

Highlights

On 31 December 2019, the World Health Organization (WHO) China Country Office was informed by Chinese authorities of 27 cases of pneumonia of unknown etiology, including 7 severe cases related geographically to the Huanan seafood market in Wuhan city, Hubei
Our aim for this study was to describe this new multiplatform care model we developed during the rise of the pandemic to answer the needs of obstetric patients suffering from COVID-19 during pregnancy, labor, or postpartum, to evaluate its results as well as to assess its impact on health system organization sharing the lessons we learned from it
We could not compare our results to a control group as we developed our COVID-19 and Pregnancy program to give a response to every COVID-19 affected patient and this limited the interpretation of our results

Summary

Introduction

On 31 December 2019, the World Health Organization (WHO) China Country Office was informed by Chinese authorities of 27 cases of pneumonia of unknown etiology, including 7 severe cases related geographically to the Huanan seafood market in Wuhan city, Hubei. The causal agent was identified on 7 January by Chinese authorities as SARSCoV2 (severe acute respiratory syndrome-related coronavirus 2) responsible for the novel coronavirus disease 2019 (COVID-19). The WHO recognized the COVID-19 outbreak as a Public Health Emergency of International Concern on 30 January 2020, and on 11 March. 2020, it was characterized as a pandemic [1]. The first case outside China was reported in Thailand on 13 January, and soon after, cases were reported in at least 24 countries, mostly in South and Southeast Asia and in.

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