How to do obstetric examination under epidemic prevention and control? All you want to ask is here!

Recently, there have been many outbreaks of covid-19 across the country, and the situation of prevention and control is grim. In order to ensure the safety of maternal and infant mothers during the epidemic period, further publicize and popularize the knowledge and measures for the prevention and control of the new crown pneumonia epidemic, and enhance the awareness and ability of the public, especially pregnant women, to prevent and control the new crown pneumonia epidemic, the Health Education and Publicity Center of the Hunan Provincial Health Commission organized relevant experts from the Provincial Maternal and Child Health Hospital to provide authoritative answers to the hot spots, difficulties and doubts of pregnant women and their relatives under the epidemic prevention and control, and provide health tips and medical advice for pregnant women.

01

Do I need a maternity check-up during the pandemic?

Generally speaking, there are 7-11 routine obstetric examinations during pregnancy, and pregnant women who are in the outbreak period or have not ended the isolation period can appropriately postpone the time of obstetric examination, but at several key checkpoints, pregnant women must still try to check. Like what:

First trimester (11 to 13+6 weeks): NT testing is required, which is a screening indicator for fetal malformations in the first trimester of pregnancy and is also used for risk assessment of early fetal Down syndrome.

Second trimester (20-24 weeks): a four-dimensional ultrasound is required to rule out structural malformations of the fetus.

Second trimester (24-28 weeks): Pregnancy screening for gestational diabetes mellitus (OGTT experiment) is required to prevent maternal risk due to failure to control blood sugar.

Third trimester (28-40 weeks): need to know how the fetus is in the womb and evaluate the mode of delivery. The most important monitoring indicator when staying at home is fetal motility, pregnant women can count fetal movements, strengthen self-monitoring of fetal movements and record.

02

Is it possible to postpone the obstetric examination during the epidemic?

Affected by the epidemic, some communities are sealed or controlled, coupled with the temporary suspension of outpatient clinics and emergency departments in some hospitals, going out during the epidemic may increase the risk of infection, so if it is not an emergency department, it is not close to the due date, and there are no special high-risk factors for pregnant women, you can choose to postpone the obstetric examination.

How is a high-risk pregnancy judged? If the √ is green in the health register, it is low risk, in this case it can be self-monitored at home;

If it is yellow, there is a certain risk, while self-monitoring, regular online consultation;

If it is an orange or red risk, a purple risk, be sure to perform a formal obstetric examination as required.

03

What preparations do I need to make for a maternity check-up during the pandemic?

1. It is recommended that pregnant mothers must make an online appointment before coming to the hospital for obstetric examination, and come to the hospital for obstetric examination according to the time period;

2. During the epidemic period, the pre-examination triage at the entrance of the hospital should be tested with double codes, etc.;

3. Pregnant mothers with medium and high risk of yellow and red codes should report to the community in advance and prepare a 24-hour negative nucleic acid test report.

04

During the epidemic prevention and control period, what situations do pregnant mothers need to seek medical treatment as soon as possible?

If a pregnant mother has suspicious symptoms such as fever, fatigue, dry cough, nasal congestion, runny nose, sore throat, diarrhea, etc., and she has a history of travel to areas with high incidence of the epidemic, a history of residence or a history of close contact with a confirmed patient, she should go to the designated medical institution to seek medical treatment as soon as possible.

In addition, abnormal conditions during pregnancy, such as headache, dizziness, unclear vision, shortness of breath, increased blood pressure, vaginal bleeding or abnormal fluid, abdominal pain, abnormal fetal movement, etc., or when there are signs of childbirth, you should seek medical attention in time.

Pregnant mothers should not delay medical treatment due to fear and worry, and should be protected when seeking medical treatment.

05

Once a pregnant mother has an abnormal situation, how should she choose to seek medical treatment?

1. Pregnant mothers should first go to the hospital's fever clinic for investigation due to fever; 2. If the pregnant mother has no fever and seeks medical treatment due to non-obstetric conditions, she should choose a medical institution that can meet the needs and has a small outpatient volume. 3. If you seek medical treatment due to obstetric conditions, except for emergencies, try to choose a file hospital, make an appointment and preparation before treatment, shorten the time for medical treatment as much as possible, pay attention to prevention, and reduce the number of accompanying personnel.

06

What are the precautions for visiting the hospital during the epidemic?

1. When you need to seek medical treatment, try to make an appointment in advance, visit the doctor at different times, avoid centralized treatment, and shorten the time for medical treatment as much as possible. Please follow the rules of one doctor, one patient and one consultation room when visiting the doctor. When arriving at the hospital, you should show the health code, itinerary code, etc. in accordance with the requirements of epidemic prevention and control, and if necessary, you must cooperate with filling in the flow adjustment form.

2. On the way to the hospital and in the hospital, pregnant women and accompanying family members should wear medical surgical masks throughout the journey; it is recommended to carry hand sanitizer or disinfectant wipes with them to maintain hand hygiene; and when waiting in the hospital, they should maintain safe social distancing (at least 1 meter).

3. After going out to go home, you should properly dispose of the mask, change clothes, wash your hands, and wash your face, facial features and other exposed parts. Clothes should be washed and disinfected as soon as possible, and coats should be placed in the air circulation.

07

What should pregnant women pay attention to in home isolation?

Pregnant women should do a good job of self-health monitoring when living at home. Pay attention to daily body temperature measurement, do a good job of reasonable diet, regularly monitor fetal movements, appropriate indoor activities, in principle, non-essential do not go out; if you really need to go out, you need to wear a mask; do not gather, do not visit each other, wear a mask and maintain a distance of more than 1m when communicating with people, wash your hands frequently, use bath towels, tableware, bedding and other daily necessities alone to avoid cross-infection; when turning on air conditioning, it is recommended to keep the room temperature at about 25 degrees, open the window ventilation 2-3 times a day, each time not less than 30 minutes. According to the requirements of epidemic prevention and control, do a good job of nucleic acid testing.

08

What are the nucleic acid testing requirements for outpatient and inpatient wards?

Newly hospitalized patients and companions must be admitted to the hospital with 48-hour negative results of nucleic acid, and patients and companions in the hospital must review the nucleic acid once a week, update the double code daily and carry out health monitoring.

Non-essential non-visitation, no escort, strict implementation of one person and one accompaniment, the accompanying person must apply for an electronic escort certificate on the day of hospitalization, and must not leave the ward at will.

If a yellow code appears in an inpatient or accompanying patient, on the basis of protection, the nucleic acid is collected in time and personnel control is done.

09

If I am diagnosed with novel coronavirus infection, can I continue my pregnancy? Will it be transmitted to the fetus?

There is currently insufficient evidence to show that there is a risk of mother-to-child transmission due to the novel coronavirus infection, and there is no evidence to show whether the virus itself is harmful to the embryo and fetus.

If the infection in the first trimester has a persistent high fever of more than 38.5 °C, it has certain harm to the embryonic tissue and requires special attention.

If a pregnant mother is diagnosed with a novel coronavirus infection, a multidisciplinary consultation should be made to decide whether to continue the pregnancy according to the gestational age, severity of the condition, etc.

Suspected or confirmed novel coronavirus infection, what should the baby do after the pregnancy gives birth?

It is recommended that the baby be isolated for at least 14 days after birth, during which direct breastfeeding is not recommended, and it is recommended that the mother express milk regularly and ensure lactation until the viral infection is ruled out or cured before breastfeeding.

Source: Health Education and Publicity Center of Hunan Provincial Health Commission