Infection prevention and control for labor and delivery, well baby nurseries, and neonatal intensive care units. Academic Article uri icon

Overview

abstract

  • During the early months of the COVID-19 pandemic, infection prevention and control (IP&C) for women in labor and mothers and newborns during delivery and receiving post-partum care was quite challenging for staff, patients, and support persons due to a relative lack of evidence-based practices, high rates of community transmission, and shortages of personal protective equipment (PPE). We present our IP&C policies and procedures for the obstetrical population developed from mid-March to mid-May 2020 when New York City served as the epicenter of the pandemic in the U.S. For patients, we describe screening for COVID-19, testing for SARS-CoV-2, and clearing patients from COVID-19 precautions. For staff, we address self-monitoring for symptoms, PPE in different clinical scenarios, and reducing staff exposures to SARS-CoV-2. For visitors/support persons, we address limiting them in labor and delivery, the postpartum units, and the NICU to promote staff and patient safety. We describe management of SARS-CoV-2-positive mothers and their newborns in both the well-baby nursery and in the neonatal ICU. Notably, in the well-baby nursery we do not separate SARS-CoV-2-positive mothers from their newborns, but emphasize maternal mask use and social distancing by placing newborns in isolates and asking mothers to remain 6 feet away unless feeding or changing their newborn. We also encourage direct breastfeeding and do not advocate early bathing. Newborns of SARS-CoV-2-positive mothers are considered persons under investigation (PUIs) until 14 days of life, the duration of the incubation period for SARS-CoV-2. We share two models of community-based care for PUI neonates. Finally, we provide our strategies for enhancing communication and education during the early months of the pandemic.

authors

  • Saiman, Lisa
  • Acker, Karen
  • Dumitru, Dani
  • Messina, Maria
  • Johnson, Candace
  • Zachariah, Philip
  • Abreu, Wanda
  • Saslaw, Minna
  • Keown, M Kathleen
  • Hanft, Erin
  • Liao, Grace
  • Johnson, Donna
  • Robinson, Kenya
  • Streltsova, Svetlana
  • Valderrama, Natali
  • Markan, Amrita
  • Rosado, Magda
  • Krishnamurthy, Ganga
  • Sahni, Rakesh
  • Penn, Anna A
  • Sheen, Jean Ju
  • Zork, Noelia
  • Aubey, Janice
  • Oxford-Horrey, Corrina
  • Goffman, Dena

publication date

  • October 12, 2020

Research

keywords

  • COVID-19
  • Delivery Rooms
  • Infection Control
  • Intensive Care Units, Neonatal
  • Nurseries, Hospital
  • Organizational Policy

Identity

PubMed Central ID

  • PMC7550181

Scopus Document Identifier

  • 85092676554

Digital Object Identifier (DOI)

  • 10.1097/AOG.0000000000003926

PubMed ID

  • 33071033

Additional Document Info

volume

  • 44

issue

  • 7