Expert consensus for managing pregnant women and neonates born to mothers with suspected or confirmed novel coronavirus (<scp>COVID</scp>‐19) infection

International Journal of Gynecology & Obstetrics - Tập 149 Số 2 - Trang 130-136 - 2020
Dunjin Chen1, Huixia Yang2, Yun Cao3, Weiwei Cheng4, Tao Duan5, Cuifang Fan6, Shang­rong Fan7, Ling Feng8, Yuanmei Gao9, Fang He1, Jing He10, Yali Hu11, Yi Jiang12, Yimin Li13, Jiafu Li14, Xiaotian Li15, Xuelan Li16, Kangguang Lin17, Caixia Liu18, Juntao Liu19, Xinghui Liu20, Xingfei Pan21, Qiumei Pang22, Meihua Pu23, Hongbo Qi24, Chun­yan Shi2, Yu Sun2, Jingxia Sun25, Xietong Wang26, Yichun Wang9, Zilian Wang27, Zhijian Wang28, Chen Wang2, Suqiu Wu29, Hong Xin30, Jian­ying Yan31, Yangyu Zhao32, Jun Zheng33, Yi‐Hua Zhou34, Li Zou35, Yingchun Zeng1, Yuanzhen Zhang14, Xiaoming Guan36
1Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou City, Guangdong Province, China
2Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
3Department of Neonatology, Children's Hospital Affiliated of Fudan University, Shanghai, China
4Department of Obstetrics, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
5Department of Obstetrics and Gynecology, Shanghai First Maternity and Infant Hospital, Shanghai, China
6Department of Obstetrics and Gynecology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
7Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, Guangdong Province, China
8Department of Perinatal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
9Department of Critical Care Unit, the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
10Department of Obstetrics and Gynecology, Women's Hospital, Zhejiang University School of Medicine Hangzhou, Hangzhou, Zhejiang Province, China
11Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, JiangSu Province, China
12Department of Pediatrics, Peking University First Hospital, Beijing, China
13Department of Critical Care Unit, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
14Department of Obstetrics and Gynecology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei Province, China
15Department of Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
16Department of Obstetrics and Gynecology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi Province, China
17Department of Affective Disorder, Brain Hospital Affiliated of Guangzhou Medical University, Guangzhou, Guangdong Province, China
18Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, , Liaoning Province, China
19Department of Obstetrics and Gynecology Chinese Academy of Medical Sciences &amp; Peking Union Medical college Hospital Beijing China
20Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan province, China
21Department of Infectious Diseases, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
22Department of Obstetrics and Gynecology, You'an Hospital, Capital Medical University, Beijing, China
23Department of Pediatrics, Peking University Third Hospital, Beijing, China
24Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
25Department of Obstetrics and Gynecology, The First Affiliated Hospital of Harbin Medical University, Harbin, Helongjiang Province, China
26Department of Obstetrics and Gynecology, Provincial Hospital Affiliated to Shandong University, Shandong Province, China
27Department of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China
28Department of Gynecology and Obstetrics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China
29School of Health Education of Wuhan University, Wuhan, Hubei Province, China
30Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Hebei Medical University, Hebei Province, China
31Department of Obstetrics, Fujian Provincial Maternity and Children Hospital, Fuzhou, Fujian Province, China
32Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
33Department of Neonatology, Tianjin Central Hospital of Gynecology Obstetrics, Tianjin, China
34Department of Infectious Diseases, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, China
35Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
36Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA

Tóm tắt

AbstractObjectiveTo provide clinical management guidelines for novel coronavirus (COVID‐19) in pregnancy.MethodsOn February 5, 2020, a multidisciplinary teleconference comprising Chinese physicians and researchers was held and medical management strategies of COVID‐19 infection in pregnancy were discussed.ResultsTen key recommendations were provided for the management of COVID‐19 infections in pregnancy.ConclusionCurrently, there is no clear evidence regarding optimal delivery timing, the safety of vaginal delivery, or whether cesarean delivery prevents vertical transmission at the time of delivery; therefore, route of delivery and delivery timing should be individualized based on obstetrical indications and maternal–fetal status.

Từ khóa


Tài liệu tham khảo

World Health Organization.Novel coronavirus‐China[WHO website].2020.http://www.who.int/csr/don/12-Janua​ry-2020-novel-coron​avirus-china/​en/. Accessed March 18 2020.

10.1056/NEJMoa030781

10.1056/NEJMoa1211721

World Health Organization.Summary of probable SARS cases with onset of illness from 1 November 2002 to 31 July 2003[WHO website]. 2004.https://www.who.int/csr/sars/count​ry/table2004_04_21/en/. Accessed March 18 2020.

World Health Organization.Middle East respiratory syndrome coronavirus(MERS‐CoV) [WHO website].2019.http://www.who.int/emerg​encie​s/mers-cov/en/. Accessed March 18 2020.

10.1016/j.ajog.2003.11.019

10.1016/S0140-6736(20)30360-3

Diagnosis and treatment guideline for COVID‐19 infection(trial version 6) [in Chinese]. National Health Commission of the People's Republic of China website.http://www.nhc.gov.cn. Accessed March 18 2020.

10.2214/AJR.07.3336

10.4049/jimmunol.1900888

Pasley MV, 2013, Safety and efficacy of lopinavir/ritonavir during pregnancy: A systematic review, AIDS Rev, 15, 38

10.3851/IMP2739

10.1093/jac/dkv080

10.1016/j.clp.2019.02.009

Committee Opinion No, 2017, 723: Guidelines for diagnostic imaging during pregnancy and lactation, Obstet Gynecol, 130, e210–210e216

American College of Radiology.ACR‐SPR practice parameter for imaging pregnant or potentially pregnant adolescents and women with ionizing radiation[American College of Radiology website].2020.https://www.acr.org/-/media/​ACR/Files/​Pract​ice-Param​eters/​Pregn​ant-Pts.pdf. Accessed March 18 2020.

10.1148/rg.323115120

10.1016/j.suc.2008.01.005

10.1148/rg.276075002

Gadopentetate: Drugs and lactation database(LactMed).2015.https://www.ncbi.nlm.nih.gov/books/​NBK50​1398/. Accessed March 18 2020.

10.1148/106.3.617

American College of Radiology.ACR‐SPR practice parameter for imaging pregnant or potentially pregnant adolescents and women with ionizing radiation. Resolution 39 2018.https://www.acr.org/-/media/​ACR/Files/​Pract​ice-Param​eters/​Pregn​ant-Pts.pdf. Accessed March 18 2020.

2017, Guidelines for diagnostic imaging during pregnancy and lactation. Committee Opinion No. 723. American College of Obstetricians and Gynecologists, Obstet Gynecol, 130, e210–6

10.1002/(SICI)1096-9926(199904)59:4<234::AID-TERA8>3.0.CO;2-B

10.1002/jmri.24011

10.1007/s00330-004-2583-y

10.1016/j.jcrc.2017.03.010

10.1007/s00134-017-4683-6

10.1016/j.ajog.2019.01.216

10.1007/s00134-017-4750-z

10.1007/s00134-010-2051-x

10.4103/0970-9185.194779

World Health Organization.Clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspected[WHO website].2020.https://www.who.int/publi​catio​ns-detai​l/clini​cal-manag​ement-of-severe-acute-respi​ratory-infec​tion-when-novel-coron​avirus-(ncov)-infec​tion-is-suspe​cted. Accessed March 18 2020.

10.1503/cmaj.160570

10.1111/crj.12772

10.1183/13993003.02426-2016

10.1186/s13613-017-0350-x

10.1080/14767058.2018.1439471

ELSO Guidelines for Adult Respiratory Failure v1.4[EB/OL]. (2017‐08)[2020‐01‐25].https://www.elso.org/Porta​ls/0/ELSO%20Gui​delin​es%20For​%20Adu​lt%20Res​pirat​ory%20Fai​lure%201_4.pdf.

10.1016/j.jogc.2017.04.024

10.1016/0002-9378(89)90373-6

10.1046/j.1471-0528.2003.03008.x

Li LJ, 2018, Infectious Diseases, 132

National Health Commission of the People's Republic of China.No. 1 Notice of 2020[in Chinese].http://www.nhc.gov.cn/xcs/zheng​cwj/20200​1/44a3b​8245e​8049d​2837a​4f275​29cd3​86.shtml. Accessed March 18 2020.