Gamze ACAVUT, Ramazan Erda PAY, Mustafa ULUBAY, Özlem EVLİYAOĞLU

6851

COVID-19 Pandemisinin Maternal-Neonatal Etkileri ve Yönetimi

Coronavirüs hastalığı, SARS-Cov-2 virüsünün neden olduğu solunum yolu hastalığıdır. İnsanlar arasında hızlı bir yayılım gösteren bu virüs pandemi olarak ilan edilmiştir ve tüm dünya sağlığını tehdit etmektedir. Damlacık yolu ve kontamine yüzeyler ile temas sonrası bulaşabilen virüs riskli gruplarda ölümcül olabilmektedir. Bu nedenle gebeler ve yenidoğanlar üzerinde hassasiyetle durulması gereken gruplardandır. Gebelikte ortaya çıkan anatomik ve fizyolojik değişiklikler, yenidoğanın immatür olması COVID-19 pandemisinin ele alınmasını önemli hale getirmiştir. COVID-19 pozitif olan gebelerin intrapartum ve postpartum dönemde yakın izlemi ve koruyucu ekipmanlar ile doğumun gerçekleştirilmesi gerekmektedir. İntrapartum dönemde mutlaka elektronik fetal monitörizasyon izlemi yapılmalıdır. Kullanılan tüm ekipmanların dezenfeksiyonu, en az sayıda sağlık ekibi ile doğumun gerçekleştirilmesi ve multidisipliner bir yaklaşım ile sürecin yönetilmesi gerekmektedir. Ayrıca yenidoğanın ilk bulguları ve APGAR skoru yakından izlenmeli, enfekte anne ile bebeği arasındaki mesafenin korunmasına özen gösterilmelidir. Yenidoğanın resüsitasyon ihtiyacı belirlenmeli, COVID-19 semptomları incelenmeli ve yoğun bakıma transferine karar verilmelidir. Transfer sırasında kullanılan ekipmanların dezenfeksiyonuna özen gösterilmelidir. Yoğun bakımda izlenen bebeklerin, anne ile birlikte negatif basınçlı odada izole edilmesi önerilmektedir. COVID-19’un emzirmeye engel olmadığı, koruyucu önlemler altında emzirmenin en erken sürede başlatılması gerektiği belirtilmektedir. Taburcu edilen olguların on dört gün izlenmesi önerilmektedir. Virüsün maternal ve neonatal etkileri göz önüne alınarak etkili biçimde yönetilmesi gerekmektedir.
Anahtar Kelimeler:

maternal yönetimi, neonatal etkileri, neonatal yönetimi, maternal etkileri, COVID-19, COVID-19, COVID-19, COVID-19, pandemi, emzirme, izolasyon

Maternal-Neonatal Effects and Management of COVID-19 Pandemic

Coronavirus disease is a respiratory disease caused by the SARS-Cov-2 virus. Rapidly spreading among people, this virus has been declared as a pandemic and threatens the health of the whole world. The virus that can be transmitted by droplets and after contact with contaminated surfaces can be fatal in risk groups. For this reason, pregnant women and newborns are among the groups that should be emphasized sensitively. The anatomical and physiological changes that occur during pregnancy and the immature of the newborn have made it essential to handle the COVID-19 pandemic. Pregnant women who are COVID-19 positive should be monitored closely during the intrapartum and postpartum period, and delivery should be performed with protective equipment. Electronic fetal monitoring must be performed during the intrapartum period. Disinfection of all the equipment used, delivery with the least number of healthcare teams and the process should be managed with a multidisciplinary approach. Besides, the first signs of the newborn and the APGAR score should be closely monitored, and care should be taken to maintain the distance between the infected mother and her baby. The need for resuscitation of the newborn should be determined, the symptoms of COVID-19 should be examined, and its transfer to intensive care should be decided. Care should be taken to disinfect the equipment used during the transfer. It is recommended that babies monitored in intensive care are isolated in a negative pressure room together with the mother. It is stated that COVID-19 does not prevent breastfeeding and breastfeeding should be started as soon as possible under protective measures. It is recommended to monitor the discharged cases for fourteen days. The virus needs to be managed effectively, taking into account maternal and neonatal effects.
Keywords:

COVID-19, COVID-19, pandemic, maternal effects, maternal management, neonatal effects, neonatal management, breastfeeding, isolation,

PDF

___

  • World Health Organization. Coronavirus disease (COVID-19) outbreak: rights, roles and responsibilities of health workers, including key consideratıons for occupational safety and health. March 18, 2020. Available from: https://www.who.int/publications-detail/coronavirus-disease-(covid-19)-outbreak-rights-roles-and-responsibilities-of-health-workers-including-key-considerations-for-occupational-safety-and-health. (Erişim tarihi: 10 Haziran 2020)
  • Centers for Disease Control and Prevention. What law enforcement personnel need to know about coronavirus disease 2019 (COVID-19). March 2020. Available from: https://www.cdc.gov/coronavirus/2019-ncov/community/guidance-law-enforcement.html. (Erişim tarihi: 10 Haziran 2020)
  • Özdemir Ö. Coronavirus Disease 2019 (COVID-19): Diagnosis and management. Erciyes Med J 2020; 42:242-247.
  • Aghdam MK, Jafari N, Eftekhari K. Novel coronavirus in a 15-day-old neonate with clinical signs of sepsis, a case report. Infect Dis (Lond) 2020; 52:427-429.
  • World Health Organization. Global Surveillance for COVID-19 caused by human Infection with COVID-19 Virus. Interim Guidance March 20, 2020. Available from: https://www.who.int/publications-detail/global-surveillance-for-covid-19-caused-by-human-infection-with-covid-19-virus-interim-guidance. (Erişim tarihi: 10 Haziran 2020)
  • United Nations Population Fund. COVID-19 Technical Brief for Maternity Services April 2020. Available from: https://www.unfpa.org/sites/default/files/resource-pdf/COVID-19_MNH_guidance_04.pdf . (Erişim tarihi: 10 Haziran 2020)
  • Zaigham M, Andersson O. Maternal and perinatal outcomes with COVID-19: A systematic review of 108 pregnancies. Acta Obstet Gynecol Scand 2020; 99:823-829.
  • United Nations Population Fund. Coronavirus Disease (COVID-19) Preparedness and Response-UNFPA Interim Technical Brief, Sexual and Reproductive Health and Rights, Maternal and Newborn Health & COVID-19. March 23, 2020. Available from: https://www.unfpa.org/sites/default/files/resource-pdf/COVID-19_Preparedness_and_Response-_UNFPA_Interim_Technical_Briefs_Maternal_and_Newborn_Health_-23_March_2020_.pdf . (Erişim tarihi: 10 Haziran 2020)
  • Maternal, Fetal Tıp ve Perinatoloji Derneği. Gebelikte Coronavirus Enfeksiyonu (COVID-19) Hakkında Görüş (3. Bilgilendirme, 03.04.2020). Available from: http://www.tmftp.org/files/Duyurular/3.bilgilendirme.pdf. (Erişim tarihi: 10 Haziran 2020)
  • Puopolo KM, Hudak ML, Kimberlin DW, Cummings J. Initial Guidance: Management of Infants Born to Mothers with COVID-19. American Academy of Pediatrics Committee on Fetus and Newborn, Section on Neonatal Perinatal Medicine, and Committee on Infectious Diseases. 2020. Available from: https://www.sigo.it/comunicati-covid-19/initial-guidance-management-of-infants-born-to-mothers-with-covid-19/. (Erişim tarihi: 10 Haziran 2020)
  • Luo Y, Yin K. Management of pregnant women infected with COVID-19. Lancet Infect Dis 2020; 20:513-514.
  • Ma X, Zhu J, Du L. Neonatal management during Coronavirus disease (COVID-19) outbreak: The Chinese experiences. Neoreviews 2020; 21:e293-e297.
  • Erdeve Ö, Çetinkaya M, Baş AY, et al. The Turkish Neonatal Society proposal for the management of COVID-19 in the neonatal intensive care unit. Turk Pediatri Ars 2020; 55:86-92.
  • Government of Western Australia Department of Health, COVID-19 Guidance for Neonatal Services. 2020. Available from: https://www.healthywa.wa.gov.au/-/media/Files/Corporate/general-documents/Infectious-diseases/PDF/Coronavirus/COVID-19-Guidlines-for-Neonatal-Services.ashx. (Erişim tarihi: 10 Haziran 2020)
  • John Hopkins. COVID-19, Maternal and Child Health, Nutrition-Literature Repository April, 2020. Available from: https://resourcecentre.savethechildren.net/node/17503/pdf/covid-19_maternal_and_child_health_nutrition_-_literature_repository_april_2020.pdf. (Erişim tarihi: 22 Mayıs 2020)
  • Karimi-Zarchi M, Neamatzadeh H, Dastgheib SA, et al. Vertical Transmission of Coronavirus Disease 19 (COVID-19) from Infected Pregnant Mothers to Neonates: A Review. Fetal Pediatr Pathol 2020; 39:246-250.
  • Chen H, Guo J, Wang C, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet 2020; 395(10226):809-815.
  • Yeşilçınar İ, Kıncı MF. COVID-19 Pandemisinde Doğumun İntrapartum ve Postpartum Yönetimi. Ege Klinikleri Tıp Dergisi 2020; 58:46-48.
  • National Health Commission of the People’s Republic of China. Diagnosis and treatment guideline for COVID-19 infection (trial version 6). 2020. Available from: http://www.kankyokansen.org/uploads/uploads/files/jsipc/protocol_V6.pdf. (Erişim tarihi: 22 Mayıs 2020)
  • Centers for Disease Control and Prevention. Healthcare Infection Prevention and Control FAQs for COVID-19. May 29, 2020. Available from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-faq.html. (Erişim tarihi: 22 Mayıs 2020)
  • Van Doremalen N, Bushmaker T, Morris DH, et al. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. N Engl J Med 2020; 382:1564-1567.
  • Donders F, Lonnée-Homann R, Tsiakalos A, et al. Guidlines ISIDOG Recommendations Concerning COVID-19 and Pregnancy. Diagnostics (Basel) 2020; 10:243.
  • Poon LC, Yang H, Kapur A, et al. Global interim guidance on coronavirus disease 2019 (COVID-19) during pregnancy and puerperium from FIGO and allied partners: Information for health care professionals. Int J Gynaecol Obstet 2020; 149:273-286.
  • Liang H, Acharya G. Novel coronavirus disease (COVID-19) in pregnancy: What clinical recommendations to follow? Acta Obstet Gynecol Scand 2020; 99:439-442.
  • Di Mascio D, Khalil A, Saccone G, et al. Outcome of coronavirus spectrum infections (SARS, MERS, COVID-19) during pregnancy: a systematic review and meta-analysis. Am J Obstet Gynecol MFM 2020; 2:100107.
  • The Australian and New Zealand Intensive Care Society (ANZICS): COVID-19 Guidlines Version 1. 2020. Available from: https://www.anzics.com.au/wp-content/uploads/2020/03/ANZICS-COVID-19-Guidelines-Version-1.pdf. (Erişim tarihi: 22 Mayıs 2020)
  • Brigham and Women’s Hospital. Brigham and Women’s Hospital Covid-19 Critical Care Clinical Guidelines. Available from: https://www.covidprotocols.org/. (Erişim tarihi: 24 Mayıs 2020)
  • Morau E, Bouvet L, Keita H, et al. Anaesthesia and intensive care in obstetrics during the COVID-19 pandemic. Anaesth Crit Care Pain Med 2020; 39:345-349.
  • Isobe K, Iwata M, Ishida F, et al. A case of pulmonary alveolar hemorrhage caused by methylergometrine. Nihon Kokyuki Gakkai Zasshi 2008; 46:1007-1012.
  • Stephens AJ, Barton JR, Bentum NA, Blackwell SC, Sibai BM. General Guidelines in the Management of an Obstetrical Patient on the Labor and Delivery Unit during the COVID-19 Pandemic. Am J Perinatol 2020; 37:829-836.
  • Chen R, Zhang Y, Huang L, Cheng B-H, Xia Z-Y, Meng Q-T. Safety and efficacy of different anesthetic regimens for parturients with COVID-19 undergoing Cesarean delivery: a case series of 17 patients. Can J Anaest 2020; 67:655-663.
  • Little P. Non-steroidal anti-inflammatory drugs and covid-19. BMJ 2020; 368:m1185.
  • Thachil J, Tang N, Gando S, et al. ISTH interim guidance on recognition and management of coagulopathy in COVID-19. J Thromb Haemost 2020; 18:1023-1026.
  • Dotters-Katz S, Hughes BL. Coronavirus (COVID-19) and Pregnancy: What Maternal-Fetal Medicine Subspecialists Need to Know. Society for Maternal-Fetal Medicine. Available from: https://s3.amazonaws.com/cdn.smfm.org/media/2262/COVID19_PDF.pdf. (Erişim tarihi: 28 Mayıs 2020)
  • Zhang L, Jiang Y, Wei M, et al. Analysis of the pregnancy outcomes in pregnant women with COVID-19 in Hubei Province. Zhonghua Fu Chan Ke Za Zhi 2020; 55:166-171.
  • Zeng H, Xu C, Fan J, et al. Antibodies in Infants Born to Mothers with COVID-19 Pneumonia. JAMA 2020; 323:1848-1849.
  • Chawla D, Chirla D, Dalwai S, et al. Perinatal-Neonatal Management of COVID-19 Infection - Guidelines of the Federation of Obstetric and Gynecological Societies of India (FOGSI), National Neonatology Forum of India (NNF), and Indian Academy of Pediatrics (IAP). Indian Pediatr 2020; 57:536-548. 
  • Aslan MM, Yuvacı HU, Köse O, Cevrioğlu AS, Özden S. COVID-19 ve Gebelik. J Biotechnol and Strategic Health Res 2020;1:10-13.
  • UNMC Nebraska Medicine, Maternal Child Health Guidelines May 4, 2020. Available from: https://www.nebraskamed.com/sites/default/files/documents/covid-19/maternal-child-health-guidelines-covid-19.pdf?date=05042020 . (Erişim tarihi: 2 Haziran 2020)
  • Davanzo R, Moro G, Sandri F, Agosti M, Moretti C, Mosca F. Breastfeeding and coronavirus disease-2019: Ad interim indications of the Italian Society of Neonatology endorsed by the Union of European Neonatal & Perinatal Societies. Matern Child Nutr 2020; 16:e13010.
Türk Kadın Sağlığı ve Neonatoloji Dergisi-Cover
  • Başlangıç: 2019
  • Yayıncı: Sağlık Bilimleri Üniversitesi Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim ve Araştırma Hastanesi
Arşiv
Sayıdaki Diğer Makaleler

Özellikli çalıştaylar ile jinekolojik onkoloji hemşirelerinin öğrenim düzeyinin arttırılması

İlker SELCUK, Ebru INAN KIRMIZIGÜL, Oğuzhan İNCELİ, Burak ERSAK, Şule ÖZEL, Yaprak USTUN

Gebelerde Hepatit B, Hepatit C ve HIV Seroprevalansı; Altı yıllık deneyim

İbrahim KALE, Rahime BAYIK, Semra KAVAS

COVID-19 Pandemisinin Maternal-Neonatal Etkileri ve Yönetimi

Gamze ACAVUT, Ramazan Erda PAY, Mustafa ULUBAY, Özlem EVLİYAOĞLU

Dev servikal myomu olan gebelikte başarılı servikal serklaj uygulanması

Yunus Emre TOPDAĞI, Emsal Pınar TOPDAĞI YILMAZ, Seray KAYA TOPDAĞI, Ali GUZEL

Tekrarlayan gebelik kaybı ve implantasyon başarısızlıklarında immünolojik faktörlerin yeri

Eser ÇOLAK, Hulusi ZEYNELOGLU