Justman Naftali, Shahak Gilad, Gutzeit Ola, Ben Zvi Dikla, Ginsberg Yuval, Solt Ido, Vitner Dana, Beloosesky Ron, Weiner Zeev, Zipori Yaniv
Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel.
Rappaport Faculty of Medicine, Technion-Institute of Technology, Haifa, Israel.
Isr Med Assoc J. 2020 Sep;22(9):533-537.
The World Health Organization classified coronavirus disease-19 (COVID-19) as a pandemic and recommends strict restrictions regarding most aspects of daily activities.
To evaluate whether the pandemic has changed the prenatal care and pregnancy outcome in pregnant women without COVID-19.
The authors conducted a cross-sectional study to describe changes in outpatient clinic visits and to compare the rates of cesarean and instrumental deliveries between two periods of time: March-April 2020 (during the COVID-19 outbreak) with March-April of the preceding year, 2019.
During the COVID-19 outbreak, visits to obstetric triage, gynecologic triage, high-risk clinic, and ultrasound units decreased by 36.4%, 34.7%, 32.8%, and 18.1%, respectively. The medical center experienced a 17.8% drop in the total number of births (610 births) compared with March and April 2019 (742 births). During the outbreak women were more likely to be nulliparous (33.3% vs. 27.6%, P = 0.02) and present with hypertensive disorders during pregnancy (7.5% vs. 4%, P = 0.005) or gestational diabetes (13% vs. 10%, P = 0.03). More epidural analgesia was used (83.1% vs. 77.1%, P = 0.006). There were more operative vaginal deliveries during the outbreak (16.7% vs. 6.8%, P = 0.01). All other maternal and neonatal outcomes were comparable between the two periods.
The medical facility experienced a major decline in all aspects of the routine obstetrics activities during the time of the pandemic. The higher rate of operative vaginal deliveries among nulliparous may be associated with the pandemic effect on the rate of high-risk patients.
世界卫生组织将冠状病毒病-19（COVID-19）列为大流行病，并建议对日常活动的大多数方面进行严格限制。
评估该大流行病是否改变了未感染COVID-19的孕妇的产前护理及妊娠结局。
作者进行了一项横断面研究，以描述门诊就诊情况的变化，并比较两个时间段（2020年3月至4月（COVID-19疫情期间）与上一年即2019年3月至4月）剖宫产和器械助产分娩的发生率。
在COVID-19疫情期间，产科分诊、妇科分诊、高危门诊及超声科室的就诊人次分别减少了36.4%、34.7%、32.8%和18.1%。与2019年3月和4月（742例分娩）相比，该医疗中心的总出生数下降了17.8%（610例分娩）。疫情期间，初产妇的比例更高（33.3%对27.6%，P = 0.02），孕期出现高血压疾病的比例更高（7.5%对4%，P = 0.005）或妊娠期糖尿病的比例更高（13%对10%，P = 0.03）。硬膜外镇痛的使用更多（83.1%对77.1%，P = 0.006）。疫情期间手术产钳助产的情况更多（16.7%对6.8%，P = 0.01）。两个时间段的所有其他母婴结局相当。
在大流行期间，该医疗机构的常规产科活动各方面均出现大幅下降。初产妇中手术产钳助产率较高可能与大流行对高危患者比例的影响有关。
