Classification processing to the pregnant women according to the
epidemiological history and clinical symptoms
The proportion of COVID-19 patients without fever is higher than that of
SARS-CoV (1%) and MERS-CoV (2%) infection112.Zumla A, Hui DS,
Perlman S. Middle East respiratory syndrome. Lancet 2015;386:995-1007.,
so if the definition of surveillance cases focuses on detecting fever,
patients without fever may be missed223.World Health
Organization. Clinical management of severe acute respiratory
infection when novel coronavirus (2019-nCoV) infection is suspected:
interim guidance. January 28, 2020
(https://www.who.int/docs/default-source/coronaviruse/clinical-management-of-novel-cov.pdf).
Therefore, epidemiological history is particularly important in
screening COVID-19 patient. We classify pregnant women into three groups
according to the history of epidemiology and clinical symptoms.
- First group: Routine obstetrical examination for normal
pregnant women. Pregnant women who have no history of epidemiological
exposure and no clinical symptoms will undergo routine obstetrical
examination. If there are no pregnancy complications, antenatal
examination can be appropriately reduced in frequency; high-risk
pregnant women with pregnancy complications should appropriately
increase the frequency of obstetrical examinations. Pregnant women can
self-monitor blood pressure, blood sugar, weight, fetal movement at
home. Free online consultation and guidance was used for pregnant
women.
- Second group: Pregnant woman with a history of epidemiological
exposure but without symptoms such as fever or respiratory symptoms
should be isolated at home and under medical observation. It is
recommended that home isolation of the pregnant women and monitoring
of maternal health should be maintained for at least 14 days in
accordance with the ”guidelines for the Prevention and Control of
novel coronavirus’s pneumonia at Home isolation Medical observation
and infection Prevention and Control (trial)”334.National
Health Commission of the People’s Republic of China. Guidelines for
the Prevention and Control of COVID-19 in Home isolation Medical
observation (trial) [EB/OL].
[2020-02-18]. (http://www.nhc.gov.cn/yzygj/s7659/202002/cf80b05048584f8da9b4a54871c44b26.shtml.).
In addition to self-monitoring of body temperature, fever and other
symptoms, pregnant women can also self-monitor their blood pressure,
blood sugar, weight, fetal movement at home and have free online
consultation from doctor. For pregnant women approaching the due date,
relevant laboratory examination, chest CT test and nucleic acid test
can be carried at outpatient obstetrical department.
- Third group: Pregnant women with a history of epidemiological
contact and with fever or respiratory symptoms should go to the fever
clinic. They should be considered as suspected cases and isolated in
a single room. Medical staff and patients should take protective
measures and the multidisciplinary consultation should be conducted
simultaneously. Blood routine examination, chest CT examination and
the COVID-19 nucleic acid test should be finished in time. CT
examination has important reference value for the evaluation of
COVID-19 ’s pregnant woman’s condition, so we should fully communicate
with pregnant women of the necessity of chest CT examination, sign the
informed consent form, and take necessary abdominal protective
measures during CT scan. The suspected cases should be reported
directly through the network within 2 hours, and they should be
transferred to the designated hospital immediately on the premise of
ensuring the safety of transportation.