Table 4: Strategies To Deal With Suspected and Confirmed Cases of COVID-19
Patients who develop respiratory symptoms should practice strict respiratory hygiene including coughing and sneezing on a tissue paper or a bent elbow. These patients should be wearing facemask and wait in a designated area, at least six feet from other patients.
Pregnant females should be isolated in a negative pressure room, regardless whether they are suspected or confirmed
Healthcare providers should take special care in wearing CDC instructed personal protective equipment including N-95 respirators, facial shields, gloves and gowns. The hospital’s infectious disease department should be kept in loop at all times.
Patient’s nasopharyngeal or oropharyngeal swabs should be collected and sent to institutes running the SARS-CoV-2 RT-PCR testing. Contact the designated COVID-19 government helpline for further information
Make sure that the patient has limited access to relatives and irrelevant staff in the isolation room
Close monitoring of mother’s vital signs and diagnostic testing should be done, since pregnancy itself is a high risk condition
Fetal monitoring should be carried out regularly to ensure the wellbeing of the fetus. It’s suggested to regularly to check fetal heart rate and rate of contractions.
In case the mother is in respiratory distress, consider the use of early oxygen therapy with the goal of maintaining O2 saturation ≥95% and pO2 ≥ 70mmHg. In setting of advancing respiratory failure, consider mechanical ventilation
Use intravenous fluids conservatively unless cardiovascular instability is present
Screen for any other respiratory infection: viral and bacterial
Consider empiric antimicrobial therapy (because of risk for superimposed bacterial infections).
Judicious use of corticosteroids should be done to promote fetal maturity in the setting of an anticipated preterm delivery
If septic shock is suspected, institute prompt, targeted management.
Delivery and pregnancy termination decisions should be based on gestational age, maternal condition, and fetal stability, and maternal wishes. The clinical judgement should be done by multidisciplinary team of obstetrics, neonatologists, intensive care specialists, anesthetists and nursing staff.