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英国 2019 冠状病毒病大流行期间的产科服务:对标准护理进行修改的全国调查。

Maternity services in the UK during the coronavirus disease 2019 pandemic: a national survey of modifications to standard care.

机构信息

Royal College of Obstetricians and Gynaecologists, London, UK.

Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.

出版信息

BJOG. 2021 Apr;128(5):880-889. doi: 10.1111/1471-0528.16547. Epub 2020 Nov 5.

Abstract

OBJECTIVE

To explore the modifications to maternity services across the UK, in response to the coronavirus disease 2019 (COVID-19) pandemic, in the context of the pandemic guidance issued by the Royal College of Obstetricians and Gynaecologists (RCOG), Royal College of Midwives (RCM) and NHS England.

DESIGN

National survey.

SETTING

UK maternity services during the COVID-19 pandemic.

POPULATION OR SAMPLE

Healthcare professionals working within maternity services.

METHODS

A national electronic survey was developed to investigate local modifications to general and specialist maternity care during the COVID-19 pandemic, in the context of the contemporaneous national pandemic guidance. After a pilot phase, the survey was distributed through professional networks by the RCOG and co-authors. The survey results were presented descriptively in tabular and graphic formats, with proportions compared using chi-square tests.

MAIN OUTCOME MEASURES

Service modifications made during the pandemic.

RESULTS

A total of 81 respondent sites, 42% of the 194 obstetric units in the UK, were included. They reported substantial and heterogeneous maternity service modifications. Seventy percent of units reported a reduction in antenatal appointments and 56% reported a reduction in postnatal appointments; 89% reported using remote consultation methods. A change to screening pathways for gestational diabetes mellitus was reported by 70%, and 59% had temporarily removed the offer of births at home or in a midwife-led unit. A reduction in emergency antenatal presentations was experienced by 86% of units.

CONCLUSIONS

This national survey documents the extensive impact of the COVID-19 pandemic on maternity services in the UK. More research is needed to understand the impact on maternity outcomes and experience.

TWEETABLE ABSTRACT

A national survey showed that UK maternity services were modified extensively and heterogeneously in response to COVID-19.

摘要

目的

探讨在英国,由于 2019 年冠状病毒病(COVID-19)大流行,在皇家妇产科医师学院(RCOG)、皇家助产士学院(RCM)和英格兰 NHS 发布的大流行指南的背景下,对产妇服务进行了哪些修改。

设计

全国性调查。

地点

COVID-19 大流行期间的英国产妇服务。

人群或样本

在产妇服务机构工作的医疗保健专业人员。

方法

开发了一项全国性的电子调查,以调查 COVID-19 大流行期间一般和专科产妇护理的局部修改情况,并根据同期的国家大流行指南进行了调查。在试点阶段之后,RCOG 和共同作者通过专业网络分发了该调查。调查结果以表格和图形格式呈现,使用卡方检验比较比例。

主要结果测量

大流行期间实施的服务修改。

结果

共纳入了 81 个应答站点,占英国 194 个产科单位的 42%。他们报告了大量且异构的产妇服务修改。70%的单位报告产前预约减少,56%报告产后预约减少;89%报告使用远程咨询方法。70%的单位报告了妊娠期糖尿病筛查途径的改变,59%的单位暂时取消了在家或在助产士主导的单位分娩的服务。86%的单位经历了急诊产前就诊的减少。

结论

这项全国性调查记录了 COVID-19 大流行对英国产妇服务的广泛影响。需要更多的研究来了解对产妇结局和体验的影响。

推文摘要

一项全国性调查显示,英国产妇服务因 COVID-19 而广泛且异构地进行了修改。

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