Recommendations for perinatal care in the context of the COVID-19 pandemic

Maysa Arlany De Oliveira,Weslla Karla Albuquerque Silva De Paula,Suzana Lins Da Silva,Natácia Élem Felix Silva,Rachel De Sá Barreto Luna Callou Cruz Cruz,Mayara Amanda De Oliveira,Glauberto Da Silva Quirino,Juliana De Castro Nunes Pereira,Maria De Fátima Costa Caminha,Dayanne Rakelly De Oliveira

doi:10.1590/1806-9304202100s100004

Abstract

Abstract Objectives: to present scientific recommendations for perinatal care in the context of the COVID-19 pandemic. Methods: a narrative review was carried out between March and September in 2020 from BIREME, the Scientific Electronic Library Online and the Virtual Health Library databases, based on the descriptors: “Perinatal Care''; “Coronavirus”; “Coronavirus Infection''; “Obstetrics”and “Newborns”. The information was grouped into four categories, namely, prenatal care; labor and birthcare; care for puerperal women and the newborn. Results: 14 publications were found, 9 scientific articles and 5 technical standards pursuant to the Ministry of Health in Brazil. In the first category, generally, it is recom-mended that prenatal consultations should be continued, if necessary, by means of telemedi-cine; hospitalization of positive pregnant women in case symptoms are severe and consid-ering pregnant women’s clinical and emotional aspects. In the second, screening and testing on suspected cases, discouraging skin-to-skin contact and breastfeeding in the first hour of life. In the third, change the arrangement of beds in shared accommodations and have early discharge. In the fourth category, it is also recommended late clamping of the umbilical cord and observe differences in laboratorial testing of asymptomatic neonates. Conclusions: scientific evidence based on studies with methodological designs and more robust analyzes are necessary to guide perinatal care in the context of the harm-free COVID-19 pandemic.

Highlights

COVID-19 is a disease caused by Severe Acute Respiratory Syndrome (SARS)-CoV-2, belonging to the family of coronavirus, which triggers respiratory and more rarely intestinal infections
This study aimed to present the scientific recommendations for perinatal care in the context of the COVID-19 pandemic
The summary of the main recommendations published in the Ministry of Health (MH) Technical Standards in the context of the COVID-19 pandemic is presented (Table 1)

Summary

Introduction

COVID-19 is a disease caused by SARS-CoV-2, belonging to the family of coronavirus, which triggers respiratory and more rarely intestinal infections. Discovered in 2019 in the province of Wuhan, China, and with rapid transmission, in a few months the new virus was installed and became a state of pandemic, which was declared by the World Health Organization (WHO) in March 2020. In the beginning it was considered a risk group, elderly people, over 59 years of age and carriers of comorbidities related to the immune system, such as hypertension, diabetes mellitus, respiratory tract diseases, pathologies associated with immune deficit, and among others.[1]. RT-PCR is considered the gold standard, associated with imaging exams such as computed tomography, chest radiography or pulmonary ultrasonography.[1,2]

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Conclusion