National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia.
Emerging Threats and Disaster Management, Pediatric Population Health, Department of Healthy Resilient Children, Youth and Families, American Academy of Pediatrics, Itasca, Illinois.
Am J Perinatol. 2020 Aug;37(10):982-990. doi: 10.1055/s-0040-1712104. Epub 2020 May 21.
Emergency response to emerging threats with the potential for vertical transmission, such as the 2015 to 2017 response to Zika virus, presents unique clinical challenges that underscore the need for better communication and care coordination between obstetric and pediatric providers to promote optimal health for women and infants. Published guidelines for routine maternal-infant care during the perinatal period, and models for transitions of care in various health care settings are available, but no broad framework has addressed coordinated multidisciplinary care of the maternal-infant dyad during emergency response. We present a novel framework and strategies to improve care coordination and communication during an emergency response. The proposed framework includes (1) identification and collection of critical information to inform care, (2) key health care touchpoints for the maternal-infant dyad, and (3) primary pathways of communication and modes of transfer across touchpoints, as well as practical strategies. This framework and associated strategies can be modified to address the care coordination needs of pregnant women and their infants with possible exposure to other emerging infectious and noninfectious congenital threats that may require long-term, multidisciplinary management. KEY POINTS: · Emerging congential threats present unique coordination challenges for obstetric and pediatric clinicians during emergency response.. · We present a framework to help coodinate care of pregnant women/infants exposed to congenital threats.. · The framework identifies critical information to inform care, health care touchpoints, and communication/information transfer pathways..
应对具有垂直传播潜力的新兴威胁的应急响应,例如 2015 年至 2017 年对寨卡病毒的应对,带来了独特的临床挑战,这凸显了妇产科医生之间更好的沟通和护理协调的必要性,以促进妇女和婴儿的最佳健康。有针对围产期常规母婴护理的发布指南,以及在各种医疗保健环境中护理过渡的模式,但没有广泛的框架来解决应急响应期间母婴对子的协调多学科护理问题。我们提出了一个新的框架和策略,以改善应急响应期间的护理协调和沟通。拟议的框架包括:(1)确定和收集关键信息以提供护理,(2)母婴对子的关键医疗保健接触点,以及(3)主要的沟通途径和在接触点之间的转移模式,以及实用的策略。该框架和相关策略可以进行修改,以满足可能需要长期多学科管理的其他新发传染性和非传染性先天性威胁的孕妇及其婴儿的护理协调需求。要点:·新兴先天性威胁在应急响应期间对妇产科和儿科临床医生的协调提出了独特的挑战。·我们提出了一个框架来帮助协调接触先天性威胁的孕妇/婴儿的护理。·该框架确定了提供护理、医疗保健接触点以及沟通/信息传输途径所需的关键信息。