Authors (including presenting author) :
Chan LSL(1), Chung SFC(2), Lai FK(3), Lau LF(4), Lau SH(5), Leung WL(6), Tang KT(7), Lau WL(8)
Affiliation :
Department of Obstetrics & Gynaecology, Kwong Wah Hospital
Introduction :
Although pregnant women were initially considered as the high‐risk population for COVID‐19 infection, the prevalence since outbreak in December 2019 was limited in 2020 and 2021.
Until mid-February 2022, the number of pregnant women being affected tremendously increased and exerted great pressure on the health care workers serving the maternity and neonatal unit. As all the Airborne infection isolation rooms (AIIR) were fully occupied, enhancement of ward facilities and modification of service in the Department of Obstetrics and Gynaecology had been done to accommodate the overwhelm service needs.
Objectives :
To facilitate smooth operation in handling confirmed or suspected pregnant women at different gestation
To Identify and monitor symptoms and laboratory results closely
To prepare for imminent delivery whenever necessary
To provide the best possible care with suitable precautions while conducting or assisting the delivery.
Methodology :
A multidisciplinary team approach including obstetricians, midwives, nurses, dietitian, paediatricians, medical doctors, infection control team, facility and management team, and IT team were involved.
Development and update of COVID-19 related protocols: e.g., Management of Obstetric Woman (Booked and Non- Booked cases) under Quarantine Order for COVID-19 in KWH; Minimum Standards for Management of Babies Born of Mothers with History of, Suspected, or Active COVID-19; a Neonatal Consensus; Management of Obstetric Woman under Quarantine Order for COVID-19 in KWH; Operational Guideline for Infant Feeding Support for Confirmed / Suspected COVID-19 Mothers.
Enhancement work for ward ventilation and air change: e.g., Installation of exhausted fans in ward cubicles; use of air purifiers.
Modification of work flow: e.g., Relocation of day service (CTG, DM counselling, OGTT, etc.) and ward follow up (postnatal and gynaecology)
Disinfection of environment: e.g. Frequent (2-hourly) cleansing of environment; regular UV disinfection of cubicles
Collaboration and communication between disciplines: e.g. Use of specially designed Google Spreadsheets as common platforms (Interdepartmental Management Plan for COVID-19 In-Patient Women IN KWH; Outpatient COVID-19 Confirmed Pregnant Women) and "COVID Billboard".
Provision of infant feeding support: e.g., Consultation for counselling, education, and support from qualified Lactation Consultants during hospitalization and after discharge.
Result & Outcome :
There were totally 59 confirmed maternity cases discharged from obstetrics wards between 26 Feb and 27 Mar 2022. Between 28 March and 22 April 2022, there were total 122 (Booked 115; Non-booked 7) confirmed cases delivered in KWH. 1% were active infection, 3% Day 14 to 28, 96% recovered. About 1% required breastfeeding coaching in lactation clinic.
