General obstetric/MFM COVID-19 recommendations
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Prevention of spread should be the number 1 priority.
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Social distancing of at least 6 feet; if not feasible, extended dividers or other precautions.
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Any elective or non-urgent visits should be postponed.
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Each patient should be called to decide on need for next in-person visit and/or test.
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Any visit that can be done by telehealth should be done that way.
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No support person to accompany patient to outpatient visits unless they are an integral part of patient care.
Testing-specific recommendations:
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Pregnancy alone in the setting of new flu-like symptoms with negative influenza is sufficient to warrant COVID-19 testing; test especially if additional risk factors (eg, older, immunocompromised, advanced HIV, homeless, hemodialysis, etc).
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Symptomatic patients are best triaged via telehealth to assess their need for inpatient support or supplemental testing; in general, they should be presumed infected and self-isolate for 14 days. In-person evaluation is not indicated if symptoms are mild.
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Utilize drive-through testing or stand-alone testing rather than in-office testing where exposure can spread.
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Symptomatic patients who nonetheless arrive to hospital or office should be managed as if they are COVID-19 positive; so immediately properly isolated in designated areas, with appropriate (eg, N-95) mask on.
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Designated separate areas should be created in each unit for suspected COVID-19 patients: increase sanitization; hand sanitizer available at front desk, throughout waiting area; wipe down patient rooms after each patient; wipe down waiting area chairs frequently.
Practice-specific considerations and recommendations:
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Meetings should all be virtual/audio/video.
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Keep some providers at home, as feasible, with clinical duties, especially those at highest risk (eg, >60 years old and/or comorbidities).
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Practitioners should be leaders in their unit. COVID-19 leaders should be designated for each area (eg, L&D, outpatient; ultrasound). Use this and other guidance (SMFM; ISUOG; ACOG; WHO; CDC; etc) and adapt to your specific situation. No guideline can cover every scenario. Use this guidance and clinical judgment to avoid any contact as much as feasible.
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