Protective equipment to use in the vaginal delivery of the pregnant woman with suspected or diagnosed coronavirus disease 2019: delivery table shield.

Objective

Coronavirus disease 2019 (COVID-19) may be rapidly transmitted by respiratory droplets from patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Thus, healthcare professionals should be attentive in using personal protective equipment (PPE) during the management of suspected or diagnosed cases. In this study, we describe the use of a novel delivery table shield in the second stage of labor.

Study Design

We have designed the delivery table shield by ourselves. Subsequently, we had its plastic component produced by communicating with a manufacturer. Its upper nylon component is used only once for each patient. The mentioned shield poses no barrier for respiration of the mother and provides eye contact between the patient and the physician, thanks to its exclusive design. A 180-micron nylon clotting was used for covering, and polypropylene random copolymer pipes were used for the table legs.

Results

The photographs that were taken at our simulation center show the application of the delivery table shield (Figure ).

Figure

Photographs of the delivery table shield

The delivery table shield suits the delivery table. Its unique design protects the healthcare staff from respiratory droplets during the pushing and second stage of labor. The opening on the posterior side of the delivery table shield provides comfortable respiration for the mother during labor.

Sahin. Delivery table shield in the vaginal delivery of pregnant women with suspected or diagnosed COVID-19. Am J Obstet Gynecol 2020.

Conclusion

The Department of Gynecology and Obstetrics, Ankara City Hospital, has played an important role in the management of pregnant patients, right from the initial days of the COVID-19 pandemic. We prepared our algorithms and created flowcharts for cesarean and vaginal deliveries. Although literature data indicate that a significant number of the births in the COVID-19–positive cases were performed with cesarean delivery, vaginal delivery should be primarily considered in multiparous patients with available effacement and dilatation who present to the hospital at the advanced stages of pregnancy. PPE should be appropriately used during these procedures. Several cost-effective methods have been tested with regard to this issue by different disciplines. Lai et al have designed a carton-made protective shield to be used for intubation and extubation procedures during an operation. In addition, more developed designs such as intubation cabinets or biological safety cabinets have been introduced to clinical practice in various countries, and similar cabinets are currently used at our hospital. As one would expect, we all have an important question in our minds: Should we approach all deliveries as if they are COVID-19–positive cases? In a study by Sutton et al, 13.5% of asymptomatic pregnant women who presented to the hospital for delivery had positive test results for COVID-19. Similar to the study by Sutton et al, another recent study reported positive results for COVID-19 in 13.3% of asymptomatic pregnant patients. However, there are currently no available data on the number and rate of asymptomatic pregnant patients with COVID-19 in our country. Therefore, we conclude that the use of the delivery table shield and other PPE would be more reasonable only in the suspected or diagnosed cases. We also consider that this shield we have developed can be used against all infectious agents that carry the risk of transmission of respiratory-borne infections as well as the SARS-CoV-2 infection.