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Impact of the COVID-19 outbreak on routine obstetrical management: a cohort study
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  • Raanan Meyer,
  • Gabriel Levin,
  • Natav Hendin,
  • Eldad Katorza
Raanan Meyer
The Chaim Sheba Medical Center
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Gabriel Levin
hadassah
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Natav Hendin
Tel Aviv University Sackler Faculty of Medicine
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Eldad Katorza
Sheba Medical Center
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Abstract

Objectives: our department was the first in Israel to construct a separate, designated complex for its COVID-19-exposed patients. We aimed to evaluate the effect of the COVID-19 pandemic infection control measures on obstetrical care in the emergency department and delivery unit. Design: cohort study. Setting: tertiary medical center. Population: pregnant women attending the obstetrical emergency department (ED). Methods: February-March 2020 data were collected and compared to a parallel period in 2019. Main outcome measure: rate of referrals, deliveries, mode of delivery, neonatal outcomes. Results: During February-March 2020, 3,897 women were referred to the ED, compared to 4,067 in the previous year. Mean duration of treatment until decision and referral indications did not differ between 2020 and 2019 (207 vs. 220 minutes, p=0.26; urgent referrals: 58.8% vs. 59.2%, p=0.83). Per-week comparison showed a significant reduction in ED referrals only in the last week of the period [337 (2020) vs. 515 (2019), p<0.001]. The proportion of women admitted to the delivery unit in active labor was higher in the last three weeks (39.1% vs. 28.2%, p=0.005), and the rate of discharge was inversely correlated (45.8% vs. 56.7%, p=0.01). Deliveries number and proportions of spontaneous onset of labor, trials of labor, preterm delivery, post-term deliveries, operative vaginal and cesarean deliveries did not differ between February-March of 2020 and 2019. In the per-week comparison, the number of deliveries did not differ between the periods. Conclusion: With timely preparation and proper management, high-level routine obstetrical care during the COVID-19 outbreak can be maintained.