Abstract

Pregnant women seem to be at risk for developing complications from COVID-19. Given the limited knowledge about the impact of COVID-19 on pregnancy, management guidelines are fundamental. Our aim was to examine the obstetrics guidelines released from December 2019 to April 2020 to compare their recommendations and to assess how useful they could be to maternal health workers. We reviewed 11 guidelines on obstetrics management, assessing four domains: (1) timeliness: the time between the declaration of pandemics by WHO and a guideline release and update; (2) accessibility: the readiness to access a guideline by searching it on a common browser; (3) completeness: the amount of foundational topics covered; and (4) consistency: the agreement among different guidelines. In terms of timeliness, the Royal College of Obstetricians and Gynaecologists (RCOG) was the first organization to release their recommendation. Only four guidelines were accessible with one click, while only 6/11 guidelines covered more than 80% of the 30 foundational topics we identified. For consistency, the study highlights the existence of 10 points of conflict among the recommendations. The present research revealed a lack of uniformity and consistency, resulting in potentially challenging decisions for healthcare providers.

Highlights

  • COVID-19 is an infectious disease caused by SARS-CoV-2, the seventh coronavirus with proven inter-human transmission [1]

  • A substantial global effort has been put into limiting the spread of COVID-19, and tremendous work has been done by the main international and national health institutions and obstetrics and gynecology (OB-GYN) societies to produce and update material on the management of pregnant women from the antenatal to postnatal/postpartum periods based on limited and evolving scientific knowledge

  • A closer evaluation of the guidance provided to both patients and healthcare providers worldwide has revealed a lack of uniformity and consistency, resulting in challenging decisions for healthcare providers

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Summary

Introduction

COVID-19 is an infectious disease caused by SARS-CoV-2, the seventh coronavirus with proven inter-human transmission [1]. At the end of December 2019, the virus spread rapidly from China to the entire world, with 215 countries affected at the time of this writing (compared to 29 countries affected by the 2003 SARS pandemic). The World Health Organization (WHO) declared COVID-19 a global pandemic on March 11, 2020 [2,3]. Our data collection stopped at the end of April 2020, at which time almost two million people worldwide had a confirmed SARS-CoV2 infection and 130,000 had died of COVID-19. As of August 2020, the number of individuals infected had risen to a total of more than 22 million and 778,000 had died of COVID-19 [4]. Pregnant women have a higher risk of viral infectious diseases because of the physiological changes occurring during pregnancy in the respiratory, reproductive, endocrine, and immune systems [5]

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