Deepak Chawla1, Dinesh Chirla2, Samir Dalwai3, Ashok K Deorari4, Atul Ganatra5, Alpesh Gandhi6, Nandkishor S Kabra7, Praveen Kumar8, Pratima Mittal9, Bakul Jayant Parekh10, M Jeeva Sankar4, Tanu Singhal11, Sindhu Sivanandan12, Parikshit Tank13. 1. Department of Neonatology, GMCH, Chandigarh, India. 2. Intensive Care Services, Rainbow Children's hospital group, Mumbai, India. 3. Department of Pediatrics, Nanavati and Hinduja Hospitals, Mumbai, India. 4. Department of Pediatrics, AIIMS, New Delhi, India. 5. Dr RJ Ganatra's Nursing Home, Ahmedabad. India. 6. Department of Obstetrics and Gynecology, Arihant Women's hospital, Ahmedabad, India. 7. Neonatal Intensive Care Unit, Surya Hospital, Mumbai, India. 8. Department of Pediatrics, PGIMER, Chandigarh, India. Correspondence to: Dr Praveen Kumar, Professor, Department of Pediatrics, PGIMER, Chandigarh, India. drpkumarpgi@gmail.com. 9. Department of Obstetrics and Gynecology, VMMC and SJH, New Delhi, India. 10. BPCH and tertiary care Center, Mumbai, India. 11. Department of Pediatrics and Infectious Diseases, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute (KDAHMRI), Mumbai, India. 12. Department of Neonatology, JIPMER, Puducherry, India. 13. Department of Obstetrics and Gynecology, Ashwini Maternity and Surgical Centre, Mumbai; India.
Abstract
JUSTIFICATION: During the current rapidly evolving pandemic of COVID-19 infection, pregnant women with suspected or confirmed COVID-19 and their newborn infants form a special vulnerable group that needs immediate attention. Unlike other elective medical and surgical problems for which care can be deferred during the pandemic, pregnancies and childbirths continue. Perinatal period poses unique challenges and care of the mother-baby dyads requires special resources for prevention of transmission, diagnosis of infection and providing clinical care during labor, resuscitation and postnatal period. PROCESS: The GRADE approach recommended by the World Health Organization was used to develop the guideline. A Guideline Development Group (GDG) comprising of obstetricians, neonatologists and pediatricians was constituted. The GDG drafted a list of questions which are likely to be faced by clinicians involved in obstetric and neonatal care. An e-survey was carried out amongst a wider group of clinicians to invite more questions and prioritize. Literature search was carried out in PubMed and websites of relevant international and national professional organizations. Existing guidelines, systematic reviews, clinical trials, narrative reviews and other descriptive reports were reviewed. For the practice questions, the evidence was extracted into evidence profiles. The context, resources required, values and preferences were considered for developing the recommendations. OBJECTIVES: To provide recommendations for prevention of transmission, diagnosis of infection and providing clinical care during labor, resuscitation and postnatal period. RECOMMENDATIONS: A set of twenty recommendations are provided under the following broad headings: 1) pregnant women with travel history, clinical suspicion or confirmed COVID-19 infection; 2) neonatal care; 3) prevention and infection control; 4) diagnosis; 5) general questions.
JUSTIFICATION: During the current rapidly evolving pandemic of COVID-19infection, pregnant women with suspected or confirmed COVID-19 and their newborn infants form a special vulnerable group that needs immediate attention. Unlike other elective medical and surgical problems for which care can be deferred during the pandemic, pregnancies and childbirths continue. Perinatal period poses unique challenges and care of the mother-baby dyads requires special resources for prevention of transmission, diagnosis of infection and providing clinical care during labor, resuscitation and postnatal period. PROCESS: The GRADE approach recommended by the World Health Organization was used to develop the guideline. A Guideline Development Group (GDG) comprising of obstetricians, neonatologists and pediatricians was constituted. The GDG drafted a list of questions which are likely to be faced by clinicians involved in obstetric and neonatal care. An e-survey was carried out amongst a wider group of clinicians to invite more questions and prioritize. Literature search was carried out in PubMed and websites of relevant international and national professional organizations. Existing guidelines, systematic reviews, clinical trials, narrative reviews and other descriptive reports were reviewed. For the practice questions, the evidence was extracted into evidence profiles. The context, resources required, values and preferences were considered for developing the recommendations. OBJECTIVES: To provide recommendations for prevention of transmission, diagnosis of infection and providing clinical care during labor, resuscitation and postnatal period. RECOMMENDATIONS: A set of twenty recommendations are provided under the following broad headings: 1) pregnant women with travel history, clinical suspicion or confirmed COVID-19infection; 2) neonatal care; 3) prevention and infection control; 4) diagnosis; 5) general questions.
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