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Covid Hospital Protocols and the Pregnant Patient by Dianne Heidingsfelder, MS, RD, CDCES, LDN

By Megan Watts posted 18 days ago

  

Covid Hospital Protocols and the Pregnant Patient by Dianne Heidingsfelder, MS, RD, CDCES, LDN

As a RD and CDCES in the Maternal Fetal Medicine Department at Magee Womens Hospital of Pittsburgh, my patient population is all pregnant woman with diabetes.  I wanted to take a closer look at our MFM department and our hospital’s COVID policies regarding our pregnant patients.  I posed some questions that were answered by Christina Megli, MD, one of our physicians.

Current MFM protocol for Covid at Magee:

  1. Testing for Covid during pregnancy-regular testing or only when mother reports symptoms or has been exposed to the virus? ​

~We are only doing known exposure or symptoms. We do not have a protocol for regular testing. We are not doing universal testing on presentation to labor and delivery.

  1. Video visits vs in-person. What times in pregnancy are in-person exams required? ~We have a protocol for video visits, this was taken from protocols written pre-Covid era. In general, the late 3rd trimester visits are recommended in person.
  2. What are the effects of the mother contracting Covid on herself and fetus?

~We have no protocols regarding this. There was a meeting on NICHD (National Institute of Child Health and Human Development) recently regarding this. Symptomatic pregnant people with COVID-19 have increased risk of morbidity. The risk of fetal infection is very, very low (< 3%). There is controversy regarding risk of effects on the fetus regarding prematurity, fetal growth, etc. 

  1. Are all patients recommended to get vaccinated?  What are the side effects of the vaccine to mother and fetus? ​

~We are consistent with the WHO/CDC/SMFM and ACOG language and have several who are writing the guidelines. It is a risk benefit discussion to have with providers regarding vaccination. 

  1. What are the delivery room protocol changes such as masks, testing for Covid, limit of number of family members, etc.? 

~We continue to have limited visitors. We do not perform universal testing and have N95s available for all providers for delivery.

  1. What are the special concerns/precautions for pregnant women with a T1DM, T2DM or GDM diagnosis and the COVID pandemic? ​

~Although medical complications may increase complication rates in pregnancy, we do not have additional precautions in place. We recommend all patients mask, social distance and remain vigilant.  

 

A special thanks to Dr. Megli for input!

 

To read more about COVID and pregnancy:

~ACOG (American College of Obstetricians and Gynecologists)

~NICHD (National Institute of Child Health and Human Development)

~SMFM (Society for Maternal Fetal Medicine)

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