Precautions in Perinatal Period
The physiological changes of pulmonary function during pregnancy increase the susceptibility and severity of pneumonia10. Early studies have shown that prenatal pneumonia is associated with high perinatal mortality and therefore requires active treatment to prevent and correct maternal hypoxia, which include: oxygen inhalation to keep oxygen saturation above 95%; hydration support; timely considering delivery to improve maternal oxygenation; empirical antibiotics to prevent secondary bacterial infections. Administration of Betamethasone 12mg intramuscularly followed by another dose 24 hours later to promote fetal lung maturity when preterm delivery is anticipated.
At present, there is no study on the vaginal mucosa or secretion samples of pregnant women infected with COVID-19, but based on the previous study results on tubular virus (HCoV), we should try to avoid the exposure of newborns with all maternal body fluids. The specific measures include: Individualize the mode of delivery according to the specific conditions of the gestational age and delivery conditions; sucking the nasopharynx before the first breath of the baby; no delayed cord ligation and clean the mother’s blood and amniotic fluid as soon as possible; infected or suspected mothers should avoid breastfeeding until recover completely or has been confirmed not to have COVID-19.
Management of Gynecological Cancer Patient s
The novel coronavirus is more susceptible to infection in gynecological cancer patients due to the systemic immunosuppressive state caused by the malignancy itself, or surgery/radiotherapy and chemotherapy. Standardized management should be implemented for gynecological cancer patients to achieve scientific and accurate protection.
Patients who need surgery should be individualized according to their condition. In case of life-threatening conditions, such as rupture or bleeding of gynecological tumor, emergency operation and treatment should be carried out on the premise of adequate protection. The epidemic investigation should be further improved when the condition is stable. Patients with advanced tumor or rapid progress of disease should be treated as early as possible and those with precancerous lesions, such as cervical intraepithelial lesions, should be treated as soon as possible after the epidemic situation is stable.
For patients with severe myelosuppression, fever or the elderly and other high-risk groups receiving chemotherapy for malignant tumors, G-CSF and GM-CSF can be used prophylactically after chemotherapy to avoid leucopenia and improve immunity. Fever after operation or chemotherapy should be differentiated fromovel coronavirus infection. CT examination should be performed again if necessary and with isolation of the infected patients as soon as possible.